Cholangitis and Obstruction of Bile Duct Without Gallstones
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 68 carries a community non-dual aged RAF of 0.388, and 8 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 62, HCC 63, HCC 64 when a more severe category in the same disease group is also present.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.
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)
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 68?
HCC 68 is "Cholangitis and Obstruction of Bile Duct Without Gallstones", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 8 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 68?
The community non-dual aged relative factor for CMS-HCC V28 category 68 is 0.388. 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 68?
8 payable ICD-10-CM diagnosis codes map to 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HCC 68 is superseded by HCC 62 (Liver Transplant Status/Complications), HCC 63 (Chronic Liver Failure/End-Stage Liver Disorders), HCC 64 (Cirrhosis of Liver).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.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.