Crohn's Disease (Regional Enteritis)
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 80 carries a community non-dual aged RAF of 0.55, and 28 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 77 when a more severe category in the same disease group is also present.
Medically reviewed by Jess P., CPC · Reviewed: May 30, 2026
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.
Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.
V28 hierarchy
Trumped by: HCC 77 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 81 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 80 (28)
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.
- K50.00Crohn's disease of small intestine without complications
- K50.011Crohn's disease of small intestine with rectal bleeding
- K50.012Crohn's disease of small intestine with intestinal obstruction
- K50.013Crohn's disease of small intestine with fistula
- K50.014Crohn's disease of small intestine with abscess
- K50.018Crohn's disease of small intestine with other complication
- K50.019Crohn's disease of small intestine with unspecified complications
- K50.10Crohn's disease of large intestine without complications
- K50.111Crohn's disease of large intestine with rectal bleeding
- K50.112Crohn's disease of large intestine with intestinal obstruction
- K50.113Crohn's disease of large intestine with fistula
- K50.114Crohn's disease of large intestine with abscess
- K50.118Crohn's disease of large intestine with other complication
- K50.119Crohn's disease of large intestine with unspecified complications
- K50.80Crohn's disease of both small and large intestine without complications
- K50.811Crohn's disease of both small and large intestine with rectal bleeding
- K50.812Crohn's disease of both small and large intestine with intestinal obstruction
- K50.813Crohn's disease of both small and large intestine with fistula
- K50.814Crohn's disease of both small and large intestine with abscess
- K50.818Crohn's disease of both small and large intestine with other complication
- K50.819Crohn's disease of both small and large intestine with unspecified complications
- K50.90Crohn's disease, unspecified, without complications
- K50.911Crohn's disease, unspecified, with rectal bleeding
- K50.912Crohn's disease, unspecified, with intestinal obstruction
- K50.913Crohn's disease, unspecified, with fistula
- K50.914Crohn's disease, unspecified, with abscess
- K50.918Crohn's disease, unspecified, with other complication
- K50.919Crohn's disease, unspecified, with unspecified complications
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 80?
HCC 80 is "Crohn's Disease (Regional Enteritis)", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 28 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 80?
The community non-dual aged relative factor for CMS-HCC V28 category 80 is 0.55. 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 80?
28 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 80 (Crohn's Disease (Regional Enteritis)) for payment year 2026.
Which categories trump HCC 80 in the V28 hierarchy?
HCC 80 is superseded by HCC 77 (Intestine Transplant Status/Complications). When a more severe category in the same disease group is documented, it is counted instead of HCC 80.
Related references
Sources
CMS published ICD-10-CM mapping file plus 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.