V28 HCC 409Community non-dual aged RAF 0.598

Amputation Status, Lower Limb/Amputation Complications

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 409 carries a community non-dual aged RAF of 0.598, and 44 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 263, HCC 405 when a more severe category in the same disease group is also present.

RAF factors

The community factor varies by Medicaid and originally-disabled status; the institutional factor applies to long-term-institutional members. These are the CMS-HCC V28 PY2026 relative factors.

Community NA: 0.598Community PBA: 0.604Community FBA: 0.799Community ND: 0.562Community PBD: 0.623Community FBD: 0.844Institutional: 0.284

V28 hierarchy

Trumped by: HCC 263, HCC 405 (a more severe category in the same disease group supersedes this one).

ICD-10-CM codes that map to HCC 409 (44)

Payable diagnosis codes that map to this category under CMS-HCC V28 PY2026. Open any code for its full description, HCC mapping, and coding guidance.

Frequently asked questions

What is CMS-HCC V28 category 409?

HCC 409 is "Amputation Status, Lower Limb/Amputation Complications", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 44 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 409?

The community non-dual aged relative factor for CMS-HCC V28 category 409 is 0.598. The exact factor varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 Rate Announcement.

How many ICD-10-CM codes map to HCC 409?

44 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 409 (Amputation Status, Lower Limb/Amputation Complications) for payment year 2026.

Which categories trump HCC 409 in the V28 hierarchy?

HCC 409 is superseded by HCC 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene), HCC 405 (Traumatic Amputations and Complications). When a more severe category in the same disease group is documented, it is counted instead of HCC 409.

Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.