V28 HCC 64
Cirrhosis of Liver
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 64 has a source-labeled community non-dual aged reference coefficient of 0.447, and 6 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 62, HCC 63 when a more severe category in the same disease group is also present.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.
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.
V28 hierarchy
Trumped by: HCC 62, HCC 63 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 65, HCC 68 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 64 (6)
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.
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 64?
HCC 64 is "Cirrhosis of Liver", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 6 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 64?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 64 is 0.447. 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 64?
6 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 64 (Cirrhosis of Liver) for payment year 2026.
Which categories trump HCC 64 in the V28 hierarchy?
HCC 64 is superseded by HCC 62 (Liver Transplant Status/Complications), HCC 63 (Chronic Liver Failure/End-Stage Liver Disorders). When a more severe category in the same disease group is documented, it is counted instead of HCC 64.
Related condition guides
In-depth HCC coding guides for conditions that map to category 64, 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.