CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 33 Codes

HCC 180: Quadriplegia ICD-10-CM

CMS-HCC Category 180 (Quadriplegia) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.735 and 1.399 to a beneficiary's RAF score depending on the payment segment (1.125 for a community, non-dual, aged enrollee). 33 ICD-10-CM diagnosis codes map to HCC 180. A more severe related category (HCC 191 and HCC 192) supersedes it when both are reported.

✓ Built from the official CMS PY 2026 risk adjustment filesV28 pays 100% of MA risk scores from PY 2026
+1.125
RAF, Community Non-Dual Aged
33
ICD-10-CM Codes
HCC 191
Superseded By
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged1.125
Community, partial-benefit dual, aged1.311
Community, full-benefit dual, aged1.068
Community, non-dual, disabled0.986
Community, partial-benefit dual, disabled1.399
Community, full-benefit dual, disabled1.095
Institutional0.735

A beneficiary is scored in exactly one segment, set by Medicaid (dual) status, aged or disabled entitlement, and residence. Factors are relative weights, not dollar amounts; new-enrollee segments score on demographics only. In the hierarchy, HCC 191 (Quadriplegic Cerebral Palsy) and HCC 192 (Cerebral Palsy, Except Quadriplegic) supersede HCC 180 when reported together. HCC 180 in turn supersedes HCC 181 (Paraplegia), HCC 182 (Spinal Cord Disorders/Injuries), HCC 253 (Hemiplegia/Hemiparesis), and HCC 254 (Monoplegia, Other Paralytic Syndromes).

ICD-10-CM

ICD-10-CM Codes That Map to HCC 180 33 codes

33 of 33 shown
  • G82.50 Quadriplegia, unspecified from V24 HCC 70
  • G82.51 Quadriplegia, C1-C4 complete from V24 HCC 70
  • G82.52 Quadriplegia, C1-C4 incomplete from V24 HCC 70
  • G82.53 Quadriplegia, C5-C7 complete from V24 HCC 70
  • G82.54 Quadriplegia, C5-C7 incomplete from V24 HCC 70
  • R53.2 Functional quadriplegia from V24 HCC 70
  • S14.111A Complete lesion at C1 level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.111D Complete lesion at C1 level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.111S Complete lesion at C1 level of cervical spinal cord, sequela from V24 HCC 70
  • S14.112A Complete lesion at C2 level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.112D Complete lesion at C2 level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.112S Complete lesion at C2 level of cervical spinal cord, sequela from V24 HCC 70
  • S14.113A Complete lesion at C3 level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.113D Complete lesion at C3 level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.113S Complete lesion at C3 level of cervical spinal cord, sequela from V24 HCC 70
  • S14.114A Complete lesion at C4 level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.114D Complete lesion at C4 level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.114S Complete lesion at C4 level of cervical spinal cord, sequela from V24 HCC 70
  • S14.115A Complete lesion at C5 level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.115D Complete lesion at C5 level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.115S Complete lesion at C5 level of cervical spinal cord, sequela from V24 HCC 70
  • S14.116A Complete lesion at C6 level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.116D Complete lesion at C6 level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.116S Complete lesion at C6 level of cervical spinal cord, sequela from V24 HCC 70
  • S14.117A Complete lesion at C7 level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.117D Complete lesion at C7 level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.117S Complete lesion at C7 level of cervical spinal cord, sequela from V24 HCC 70
  • S14.118A Complete lesion at C8 level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.118D Complete lesion at C8 level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.118S Complete lesion at C8 level of cervical spinal cord, sequela from V24 HCC 70
  • S14.119A Complete lesion at unspecified level of cervical spinal cord, initial encounter from V24 HCC 70
  • S14.119D Complete lesion at unspecified level of cervical spinal cord, subsequent encounter from V24 HCC 70
  • S14.119S Complete lesion at unspecified level of cervical spinal cord, sequela from V24 HCC 70

Every code above carries the full HCC 180 weight when documented and reported on a Medicare Advantage encounter. The code link opens its full page with the complete risk adjustment card.

Questions About HCC 180

What is HCC 180 in the CMS-HCC model?

HCC 180 is CMS-HCC Category 180 (Quadriplegia) in the V28 risk adjustment model. It covers 33 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 180?

For payment year 2026, HCC 180 adds 1.125 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.735 to 1.399 across the seven payment segments shown above.

Which categories supersede HCC 180?

HCC 191 (Quadriplegic Cerebral Palsy) and HCC 192 (Cerebral Palsy, Except Quadriplegic) sit above HCC 180 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.

Related References

All HCC CategoriesHCC 191 CodesHCC 192 CodesHCC 181 CodesHCC 182 CodesHCC 253 CodesHCC 254 CodesV24 to V28: What ChangedICD-10-CM Code Lookup

Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.