Morbid Obesity
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 48 carries a community non-dual aged RAF of 0.186, and 9 payable ICD-10-CM diagnosis codes map to it.
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.
ICD-10-CM codes that map to HCC 48 (9)
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.
- E66.01Morbid (severe) obesity due to excess calories
- E66.2Morbid (severe) obesity with alveolar hypoventilation
- E66.813Obesity, class 3
- Z68.41Body mass index [BMI] 40.0-44.9, adult
- Z68.42Body mass index [BMI] 45.0-49.9, adult
- Z68.43Body mass index [BMI] 50.0-59.9, adult
- Z68.44Body mass index [BMI] 60.0-69.9, adult
- Z68.45Body mass index [BMI] 70 or greater, adult
- Z68.56Body mass index [BMI] pediatric, greater than or equal to 140% of the 95th percentile for age
Frequently asked questions
What is CMS-HCC V28 category 48?
HCC 48 is "Morbid Obesity", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 9 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 48?
The community non-dual aged relative factor for CMS-HCC V28 category 48 is 0.186. 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 48?
9 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 48 (Morbid Obesity) for payment year 2026.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.