Calculate Risk Adjustment Factor scores from demographics and HCC codes using CMS-HCC V24 and V28 models
Source: 2026 CMS Rate Announcement · Official CMS-HCC coefficients
Select demographics, add HCC codes, and click Calculate to see the RAF score breakdown.
The Risk Adjustment Factor (RAF) score is a numeric value used by the Centers for Medicare & Medicaid Services (CMS) to predict the expected healthcare costs for a Medicare Advantage beneficiary. RAF scores drive capitated payment amounts to health plans: a higher score means higher expected costs and larger reimbursement. The CMS-HCC (Hierarchical Condition Category) model calculates RAF scores from three components — a demographic base factor, condition category coefficients, and disease interaction terms. HCC Buddy's RAF Score Calculator uses the official 2026 CMS-HCC coefficients for both V24 and V28 models.
Select age, sex, and enrollment type to set the base factor
Enter HCC numbers directly or search by ICD-10 code to auto-map
See total score with full breakdown: base, conditions, and interactions
Based on official CMS-HCC model coefficients from the 2026 Rate Announcement
