V28 HCC 48
Morbid Obesity
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 48 has a source-labeled community non-dual aged reference coefficient of 0.186, and 9 ICD-10-CM diagnosis codes appear in its official mapping.
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.
These are source-labeled code-level HCC coefficient references, not a full member score. Use the RAF Calculator with complete member context for CMS-HCC V28 PY2026. No score is shown unless every required source and calculation check passes.
ICD-10-CM codes that map to HCC 48 (9)
ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. Open any code for its full description 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
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 48?
HCC 48 is "Morbid Obesity", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 9 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 48?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 48 is 0.186. The exact coefficient varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 model files.
How many ICD-10-CM codes map to HCC 48?
9 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 48 (Morbid Obesity) for payment year 2026.
Related condition guides
In-depth HCC coding guides for conditions that map to category 48, with documentation tips, common mistakes, and the V24-to-V28 changes.
Related references
Sources
CMS ICD-10-CM order-file billability plus the published mapping and CMS-HCC V28 PY2026 model software. CMS-HCC V28 model published at CMS.gov Risk Adjustors; ICD-10-CM member codes from the CMS ICD-10-CM code set.
Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 30, 2026.