V28 HCC 81Community non-dual aged RAF 0.244

Ulcerative Colitis

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 81 carries a community non-dual aged RAF of 0.244, and 49 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 77, HCC 80 when a more severe category in the same disease group is also present.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.

Community NA: 0.244Community PBA: 0.205Community FBA: 0.201Community ND: 0.285Community PBD: 0.237Community FBD: 0.286Institutional: 0.258

V28 hierarchy

Trumped by: HCC 77, HCC 80 (a more severe category in the same disease group supersedes this one).

ICD-10-CM codes that map to HCC 81 (49)

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 81?

HCC 81 is "Ulcerative Colitis", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 49 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 81?

The community non-dual aged relative factor for CMS-HCC V28 category 81 is 0.244. 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 81?

49 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 81 (Ulcerative Colitis) for payment year 2026.

Which categories trump HCC 81 in the V28 hierarchy?

HCC 81 is superseded by HCC 77 (Intestine Transplant Status/Complications), HCC 80 (Crohn's Disease (Regional Enteritis)). When a more severe category in the same disease group is documented, it is counted instead of HCC 81.

Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.