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 CMS Medicare Advantage risk adjustment program 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 coefficients from the official 2026 CMS-HCC model software and ICD-10 mappings for both V24 and V28 models. For a plain-language overview of how HCC categories work in primary care reimbursement, the AAFP Hierarchical Condition Category guide is a widely cited physician-facing reference.
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
RAF Score Calculation Guide: How Risk Adjustment Factors Work
A complete guide to RAF score components, demographic factors, and HCC weights.
Free RAF Score Calculator: How Risk Adjustment Works in 2026
How to use the RAF calculator for Medicare Advantage patient modeling.
HCC V28 Changes 2026: Complete Guide to the New Model
What changed in V28, how the 2026 blend works, and how to adapt your workflow.
