V28 HCC 68
Cholangitis and Obstruction of Bile Duct Without Gallstones
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 68 has a source-labeled community non-dual aged reference coefficient of 0.388, and 8 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 62, HCC 63, HCC 64 when a more severe category in the same disease group is also present.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, HCC 64 (a more severe category in the same disease group supersedes this one).
ICD-10-CM codes that map to HCC 68 (8)
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 68?
HCC 68 is "Cholangitis and Obstruction of Bile Duct Without Gallstones", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 8 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 68?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 68 is 0.388. 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 68?
8 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 68 (Cholangitis and Obstruction of Bile Duct Without Gallstones) for payment year 2026.
Which categories trump HCC 68 in the V28 hierarchy?
HCC 68 is superseded by HCC 62 (Liver Transplant Status/Complications), HCC 63 (Chronic Liver Failure/End-Stage Liver Disorders), HCC 64 (Cirrhosis of Liver). When a more severe category in the same disease group is documented, it is counted instead of HCC 68.
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.