CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 233 Codes

HCC 20: Lung and Other Severe Cancers ICD-10-CM

CMS-HCC Category 20 (Lung and Other Severe Cancers) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.672 and 1.214 to a beneficiary's RAF score depending on the payment segment (1.136 for a community, non-dual, aged enrollee). 233 ICD-10-CM diagnosis codes map to HCC 20. A more severe related category (HCC 17, HCC 18, and HCC 19) 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
+1.136
RAF, Community Non-Dual Aged
233
ICD-10-CM Codes
HCC 17
Superseded By
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged1.136
Community, partial-benefit dual, aged1.214
Community, full-benefit dual, aged1.166
Community, non-dual, disabled0.978
Community, partial-benefit dual, disabled1.067
Community, full-benefit dual, disabled1.173
Institutional0.672

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 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic), HCC 18 (Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid), and HCC 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers) supersede HCC 20 when reported together. HCC 20 in turn supersedes HCC 21 (Lymphoma and Other Cancers), HCC 22 (Bladder, Colorectal, and Other Cancers), and HCC 23 (Prostate, Breast, and Other Cancers and Tumors).

ICD-10-CM

ICD-10-CM Codes That Map to HCC 20 233 codes

233 of 233 shown
  • C15.3 Malignant neoplasm of upper third of esophagus from V24 HCC 9
  • C15.4 Malignant neoplasm of middle third of esophagus from V24 HCC 9
  • C15.5 Malignant neoplasm of lower third of esophagus from V24 HCC 9
  • C15.8 Malignant neoplasm of overlapping sites of esophagus from V24 HCC 9
  • C15.9 Malignant neoplasm of esophagus, unspecified from V24 HCC 9
  • C16.0 Malignant neoplasm of cardia from V24 HCC 9
  • C16.1 Malignant neoplasm of fundus of stomach from V24 HCC 9
  • C16.2 Malignant neoplasm of body of stomach from V24 HCC 9
  • C16.3 Malignant neoplasm of pyloric antrum from V24 HCC 9
  • C16.4 Malignant neoplasm of pylorus from V24 HCC 9
  • C16.5 Malignant neoplasm of lesser curvature of stomach, unspecified from V24 HCC 9
  • C16.6 Malignant neoplasm of greater curvature of stomach, unspecified from V24 HCC 9
  • C16.8 Malignant neoplasm of overlapping sites of stomach from V24 HCC 9
  • C16.9 Malignant neoplasm of stomach, unspecified from V24 HCC 9
  • C17.0 Malignant neoplasm of duodenum from V24 HCC 9
  • C17.1 Malignant neoplasm of jejunum from V24 HCC 9
  • C17.2 Malignant neoplasm of ileum from V24 HCC 9
  • C17.3 Meckel's diverticulum, malignant from V24 HCC 9
  • C17.8 Malignant neoplasm of overlapping sites of small intestine from V24 HCC 9
  • C17.9 Malignant neoplasm of small intestine, unspecified from V24 HCC 9
  • C22.0 Liver cell carcinoma from V24 HCC 9
  • C22.1 Intrahepatic bile duct carcinoma from V24 HCC 9
  • C22.2 Hepatoblastoma from V24 HCC 9
  • C22.3 Angiosarcoma of liver from V24 HCC 9
  • C22.4 Other sarcomas of liver from V24 HCC 9
  • C22.7 Other specified carcinomas of liver from V24 HCC 9
  • C22.8 Malignant neoplasm of liver, primary, unspecified as to type from V24 HCC 9
  • C22.9 Malignant neoplasm of liver, not specified as primary or secondary from V24 HCC 9
  • C23 Malignant neoplasm of gallbladder from V24 HCC 9
  • C24.0 Malignant neoplasm of extrahepatic bile duct from V24 HCC 9
  • C24.1 Malignant neoplasm of ampulla of Vater from V24 HCC 9
  • C24.8 Malignant neoplasm of overlapping sites of biliary tract from V24 HCC 9
  • C24.9 Malignant neoplasm of biliary tract, unspecified from V24 HCC 9
  • C25.0 Malignant neoplasm of head of pancreas from V24 HCC 9
  • C25.1 Malignant neoplasm of body of pancreas from V24 HCC 9
  • C25.2 Malignant neoplasm of tail of pancreas from V24 HCC 9
  • C25.3 Malignant neoplasm of pancreatic duct from V24 HCC 9
  • C25.4 Malignant neoplasm of endocrine pancreas from V24 HCC 9
  • C25.7 Malignant neoplasm of other parts of pancreas from V24 HCC 9
  • C25.8 Malignant neoplasm of overlapping sites of pancreas from V24 HCC 9
  • C25.9 Malignant neoplasm of pancreas, unspecified from V24 HCC 9
  • C33 Malignant neoplasm of trachea from V24 HCC 9
  • C34.00 Malignant neoplasm of unspecified main bronchus from V24 HCC 9
  • C34.01 Malignant neoplasm of right main bronchus from V24 HCC 9
  • C34.02 Malignant neoplasm of left main bronchus from V24 HCC 9
  • C34.10 Malignant neoplasm of upper lobe, unspecified bronchus or lung from V24 HCC 9
  • C34.11 Malignant neoplasm of upper lobe, right bronchus or lung from V24 HCC 9
  • C34.12 Malignant neoplasm of upper lobe, left bronchus or lung from V24 HCC 9
  • C34.2 Malignant neoplasm of middle lobe, bronchus or lung from V24 HCC 9
  • C34.30 Malignant neoplasm of lower lobe, unspecified bronchus or lung from V24 HCC 9
  • C34.31 Malignant neoplasm of lower lobe, right bronchus or lung from V24 HCC 9
  • C34.32 Malignant neoplasm of lower lobe, left bronchus or lung from V24 HCC 9
  • C34.80 Malignant neoplasm of overlapping sites of unspecified bronchus and lung from V24 HCC 9
  • C34.81 Malignant neoplasm of overlapping sites of right bronchus and lung from V24 HCC 9
  • C34.82 Malignant neoplasm of overlapping sites of left bronchus and lung from V24 HCC 9
  • C34.90 Malignant neoplasm of unspecified part of unspecified bronchus or lung from V24 HCC 9
  • C34.91 Malignant neoplasm of unspecified part of right bronchus or lung from V24 HCC 9
  • C34.92 Malignant neoplasm of unspecified part of left bronchus or lung from V24 HCC 9
  • C38.0 Malignant neoplasm of heart from V24 HCC 11
  • C38.4 Malignant neoplasm of pleura from V24 HCC 9
  • C48.0 Malignant neoplasm of retroperitoneum from V24 HCC 9
  • C48.1 Malignant neoplasm of specified parts of peritoneum from V24 HCC 9
  • C48.2 Malignant neoplasm of peritoneum, unspecified from V24 HCC 9
  • C48.8 Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum from V24 HCC 9
  • C70.0 Malignant neoplasm of cerebral meninges from V24 HCC 10
  • C70.1 Malignant neoplasm of spinal meninges from V24 HCC 10
  • C70.9 Malignant neoplasm of meninges, unspecified from V24 HCC 10
  • C71.0 Malignant neoplasm of cerebrum, except lobes and ventricles from V24 HCC 10
  • C71.1 Malignant neoplasm of frontal lobe from V24 HCC 10
  • C71.2 Malignant neoplasm of temporal lobe from V24 HCC 10
  • C71.3 Malignant neoplasm of parietal lobe from V24 HCC 10
  • C71.4 Malignant neoplasm of occipital lobe from V24 HCC 10
  • C71.5 Malignant neoplasm of cerebral ventricle from V24 HCC 10
  • C71.6 Malignant neoplasm of cerebellum from V24 HCC 10
  • C71.7 Malignant neoplasm of brain stem from V24 HCC 10
  • C71.8 Malignant neoplasm of overlapping sites of brain from V24 HCC 10
  • C71.9 Malignant neoplasm of brain, unspecified from V24 HCC 10
  • C72.0 Malignant neoplasm of spinal cord from V24 HCC 10
  • C72.1 Malignant neoplasm of cauda equina from V24 HCC 10
  • C72.20 Malignant neoplasm of unspecified olfactory nerve from V24 HCC 10
  • C72.21 Malignant neoplasm of right olfactory nerve from V24 HCC 10
  • C72.22 Malignant neoplasm of left olfactory nerve from V24 HCC 10
  • C72.30 Malignant neoplasm of unspecified optic nerve from V24 HCC 10
  • C72.31 Malignant neoplasm of right optic nerve from V24 HCC 10
  • C72.32 Malignant neoplasm of left optic nerve from V24 HCC 10
  • C72.40 Malignant neoplasm of unspecified acoustic nerve from V24 HCC 10
  • C72.41 Malignant neoplasm of right acoustic nerve from V24 HCC 10
  • C72.42 Malignant neoplasm of left acoustic nerve from V24 HCC 10
  • C72.50 Malignant neoplasm of unspecified cranial nerve from V24 HCC 10
  • C72.59 Malignant neoplasm of other cranial nerves from V24 HCC 10
  • C72.9 Malignant neoplasm of central nervous system, unspecified from V24 HCC 10
  • C75.1 Malignant neoplasm of pituitary gland from V24 HCC 10
  • C75.2 Malignant neoplasm of craniopharyngeal duct from V24 HCC 10
  • C75.3 Malignant neoplasm of pineal gland from V24 HCC 10
  • C77.3 Secondary and unspecified malignant neoplasm of axilla and upper limb lymph nodes from V24 HCC 10
  • C83.10 Mantle cell lymphoma, unspecified site from V24 HCC 10
  • C83.11 Mantle cell lymphoma, lymph nodes of head, face, and neck from V24 HCC 10
  • C83.12 Mantle cell lymphoma, intrathoracic lymph nodes from V24 HCC 10
  • C83.13 Mantle cell lymphoma, intra-abdominal lymph nodes from V24 HCC 10
  • C83.14 Mantle cell lymphoma, lymph nodes of axilla and upper limb from V24 HCC 10
  • C83.15 Mantle cell lymphoma, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C83.16 Mantle cell lymphoma, intrapelvic lymph nodes from V24 HCC 10
  • C83.17 Mantle cell lymphoma, spleen from V24 HCC 10
  • C83.18 Mantle cell lymphoma, lymph nodes of multiple sites from V24 HCC 10
  • C83.19 Mantle cell lymphoma, extranodal and solid organ sites from V24 HCC 10
  • C83.1A Mantle cell lymphoma, in remission from V24 HCC 10
  • C83.30 Diffuse large B-cell lymphoma, unspecified site from V24 HCC 10
  • C83.31 Diffuse large B-cell lymphoma, lymph nodes of head, face, and neck from V24 HCC 10
  • C83.32 Diffuse large B-cell lymphoma, intrathoracic lymph nodes from V24 HCC 10
  • C83.33 Diffuse large B-cell lymphoma, intra-abdominal lymph nodes from V24 HCC 10
  • C83.34 Diffuse large B-cell lymphoma, lymph nodes of axilla and upper limb from V24 HCC 10
  • C83.35 Diffuse large B-cell lymphoma, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C83.36 Diffuse large B-cell lymphoma, intrapelvic lymph nodes from V24 HCC 10
  • C83.37 Diffuse large B-cell lymphoma, spleen from V24 HCC 10
  • C83.38 Diffuse large B-cell lymphoma, lymph nodes of multiple sites from V24 HCC 10
  • C83.390 Primary central nervous system lymphoma from V24 HCC 10
  • C83.398 Diffuse large B-cell lymphoma of other extranodal and solid organ sites from V24 HCC 10
  • C83.3A Diffuse large B-cell lymphoma, in remission from V24 HCC 10
  • C83.50 Lymphoblastic (diffuse) lymphoma, unspecified site from V24 HCC 10
  • C83.51 Lymphoblastic (diffuse) lymphoma, lymph nodes of head, face, and neck from V24 HCC 10
  • C83.52 Lymphoblastic (diffuse) lymphoma, intrathoracic lymph nodes from V24 HCC 10
  • C83.53 Lymphoblastic (diffuse) lymphoma, intra-abdominal lymph nodes from V24 HCC 10
  • C83.54 Lymphoblastic (diffuse) lymphoma, lymph nodes of axilla and upper limb from V24 HCC 10
  • C83.55 Lymphoblastic (diffuse) lymphoma, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C83.56 Lymphoblastic (diffuse) lymphoma, intrapelvic lymph nodes from V24 HCC 10
  • C83.57 Lymphoblastic (diffuse) lymphoma, spleen from V24 HCC 10
  • C83.58 Lymphoblastic (diffuse) lymphoma, lymph nodes of multiple sites from V24 HCC 10
  • C83.59 Lymphoblastic (diffuse) lymphoma, extranodal and solid organ sites from V24 HCC 10
  • C83.5A Lymphoblastic (diffuse) lymphoma, in remission from V24 HCC 10
  • C83.70 Burkitt lymphoma, unspecified site from V24 HCC 10
  • C83.71 Burkitt lymphoma, lymph nodes of head, face, and neck from V24 HCC 10
  • C83.72 Burkitt lymphoma, intrathoracic lymph nodes from V24 HCC 10
  • C83.73 Burkitt lymphoma, intra-abdominal lymph nodes from V24 HCC 10
  • C83.74 Burkitt lymphoma, lymph nodes of axilla and upper limb from V24 HCC 10
  • C83.75 Burkitt lymphoma, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C83.76 Burkitt lymphoma, intrapelvic lymph nodes from V24 HCC 10
  • C83.77 Burkitt lymphoma, spleen from V24 HCC 10
  • C83.78 Burkitt lymphoma, lymph nodes of multiple sites from V24 HCC 10
  • C83.79 Burkitt lymphoma, extranodal and solid organ sites from V24 HCC 10
  • C83.7A Burkitt lymphoma, in remission from V24 HCC 10
  • C84.00 Mycosis fungoides, unspecified site from V24 HCC 10
  • C84.01 Mycosis fungoides, lymph nodes of head, face, and neck from V24 HCC 10
  • C84.02 Mycosis fungoides, intrathoracic lymph nodes from V24 HCC 10
  • C84.03 Mycosis fungoides, intra-abdominal lymph nodes from V24 HCC 10
  • C84.04 Mycosis fungoides, lymph nodes of axilla and upper limb from V24 HCC 10
  • C84.05 Mycosis fungoides, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C84.06 Mycosis fungoides, intrapelvic lymph nodes from V24 HCC 10
  • C84.07 Mycosis fungoides, spleen from V24 HCC 10
  • C84.08 Mycosis fungoides, lymph nodes of multiple sites from V24 HCC 10
  • C84.09 Mycosis fungoides, extranodal and solid organ sites from V24 HCC 10
  • C84.0A Mycosis fungoides, in remission from V24 HCC 10
  • C84.60 Anaplastic large cell lymphoma, ALK-positive, unspecified site from V24 HCC 10
  • C84.61 Anaplastic large cell lymphoma, ALK-positive, lymph nodes of head, face, and neck from V24 HCC 10
  • C84.62 Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes from V24 HCC 10
  • C84.63 Anaplastic large cell lymphoma, ALK-positive, intra-abdominal lymph nodes from V24 HCC 10
  • C84.64 Anaplastic large cell lymphoma, ALK-positive, lymph nodes of axilla and upper limb from V24 HCC 10
  • C84.65 Anaplastic large cell lymphoma, ALK-positive, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C84.66 Anaplastic large cell lymphoma, ALK-positive, intrapelvic lymph nodes from V24 HCC 10
  • C84.67 Anaplastic large cell lymphoma, ALK-positive, spleen from V24 HCC 10
  • C84.68 Anaplastic large cell lymphoma, ALK-positive, lymph nodes of multiple sites from V24 HCC 10
  • C84.69 Anaplastic large cell lymphoma, ALK-positive, extranodal and solid organ sites from V24 HCC 10
  • C84.6A Anaplastic large cell lymphoma, ALK-positive, in remission from V24 HCC 10
  • C84.90 Mature T/NK-cell lymphomas, unspecified, unspecified site from V24 HCC 10
  • C84.91 Mature T/NK-cell lymphomas, unspecified, lymph nodes of head, face, and neck from V24 HCC 10
  • C84.92 Mature T/NK-cell lymphomas, unspecified, intrathoracic lymph nodes from V24 HCC 10
  • C84.93 Mature T/NK-cell lymphomas, unspecified, intra-abdominal lymph nodes from V24 HCC 10
  • C84.94 Mature T/NK-cell lymphomas, unspecified, lymph nodes of axilla and upper limb from V24 HCC 10
  • C84.95 Mature T/NK-cell lymphomas, unspecified, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C84.96 Mature T/NK-cell lymphomas, unspecified, intrapelvic lymph nodes from V24 HCC 10
  • C84.97 Mature T/NK-cell lymphomas, unspecified, spleen from V24 HCC 10
  • C84.98 Mature T/NK-cell lymphomas, unspecified, lymph nodes of multiple sites from V24 HCC 10
  • C84.99 Mature T/NK-cell lymphomas, unspecified, extranodal and solid organ sites from V24 HCC 10
  • C84.9A Mature T/NK-cell lymphomas, unspecified, in remission from V24 HCC 10
  • C84.A0 Cutaneous T-cell lymphoma, unspecified, unspecified site from V24 HCC 10
  • C84.A1 Cutaneous T-cell lymphoma, unspecified lymph nodes of head, face, and neck from V24 HCC 10
  • C84.A2 Cutaneous T-cell lymphoma, unspecified, intrathoracic lymph nodes from V24 HCC 10
  • C84.A3 Cutaneous T-cell lymphoma, unspecified, intra-abdominal lymph nodes from V24 HCC 10
  • C84.A4 Cutaneous T-cell lymphoma, unspecified, lymph nodes of axilla and upper limb from V24 HCC 10
  • C84.A5 Cutaneous T-cell lymphoma, unspecified, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C84.A6 Cutaneous T-cell lymphoma, unspecified, intrapelvic lymph nodes from V24 HCC 10
  • C84.A7 Cutaneous T-cell lymphoma, unspecified, spleen from V24 HCC 10
  • C84.A8 Cutaneous T-cell lymphoma, unspecified, lymph nodes of multiple sites from V24 HCC 10
  • C84.A9 Cutaneous T-cell lymphoma, unspecified, extranodal and solid organ sites from V24 HCC 10
  • C84.AA Cutaneous T-cell lymphoma, unspecified, in remission from V24 HCC 10
  • C84.Z0 Other mature T/NK-cell lymphomas, unspecified site from V24 HCC 10
  • C84.Z1 Other mature T/NK-cell lymphomas, lymph nodes of head, face, and neck from V24 HCC 10
  • C84.Z2 Other mature T/NK-cell lymphomas, intrathoracic lymph nodes from V24 HCC 10
  • C84.Z3 Other mature T/NK-cell lymphomas, intra-abdominal lymph nodes from V24 HCC 10
  • C84.Z4 Other mature T/NK-cell lymphomas, lymph nodes of axilla and upper limb from V24 HCC 10
  • C84.Z5 Other mature T/NK-cell lymphomas, lymph nodes of inguinal region and lower limb from V24 HCC 10
  • C84.Z6 Other mature T/NK-cell lymphomas, intrapelvic lymph nodes from V24 HCC 10
  • C84.Z7 Other mature T/NK-cell lymphomas, spleen from V24 HCC 10
  • C84.Z8 Other mature T/NK-cell lymphomas, lymph nodes of multiple sites from V24 HCC 10
  • C84.Z9 Other mature T/NK-cell lymphomas, extranodal and solid organ sites from V24 HCC 10
  • C84.ZA Other mature T/NK-cell lymphomas, in remission from V24 HCC 10
  • C86.00 Extranodal NK/T-cell lymphoma, nasal type not having achieved remission from V24 HCC 10
  • C86.01 Extranodal NK/T-cell lymphoma, nasal type, in remission from V24 HCC 10
  • C86.10 Hepatosplenic T-cell lymphoma not having achieved remission from V24 HCC 10
  • C86.11 Hepatosplenic T-cell lymphoma, in remission from V24 HCC 10
  • C86.20 Enteropathy-type (intestinal) T-cell lymphoma not having achieved remission from V24 HCC 10
  • C86.21 Enteropathy-type (intestinal) T-cell lymphoma, in remission from V24 HCC 10
  • C86.60 Primary cutaneous CD30-positive T-cell proliferations not having achieved remission from V24 HCC 10
  • C86.61 Primary cutaneous CD30-positive T-cell proliferations, in remission from V24 HCC 10
  • C91.A0 Mature B-cell leukemia Burkitt-type not having achieved remission from V24 HCC 10
  • C91.A1 Mature B-cell leukemia Burkitt-type, in remission from V24 HCC 10
  • C91.A2 Mature B-cell leukemia Burkitt-type, in relapse from V24 HCC 10
  • C92.20 Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission from V24 HCC 9
  • C92.21 Atypical chronic myeloid leukemia, BCR/ABL-negative, in remission from V24 HCC 9
  • C92.22 Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse from V24 HCC 9
  • C92.90 Myeloid leukemia, unspecified, not having achieved remission from V24 HCC 9
  • C92.91 Myeloid leukemia, unspecified in remission from V24 HCC 9
  • C92.92 Myeloid leukemia, unspecified in relapse from V24 HCC 9
  • C92.Z0 Other myeloid leukemia not having achieved remission from V24 HCC 9
  • C92.Z1 Other myeloid leukemia, in remission from V24 HCC 9
  • C92.Z2 Other myeloid leukemia, in relapse from V24 HCC 9
  • C93.10 Chronic myelomonocytic leukemia not having achieved remission from V24 HCC 9
  • C93.11 Chronic myelomonocytic leukemia, in remission from V24 HCC 9
  • C93.12 Chronic myelomonocytic leukemia, in relapse from V24 HCC 9
  • C93.30 Juvenile myelomonocytic leukemia, not having achieved remission from V24 HCC 9
  • C93.31 Juvenile myelomonocytic leukemia, in remission from V24 HCC 9
  • C93.32 Juvenile myelomonocytic leukemia, in relapse from V24 HCC 9
  • C93.90 Monocytic leukemia, unspecified, not having achieved remission from V24 HCC 9
  • C93.91 Monocytic leukemia, unspecified in remission from V24 HCC 9
  • C93.92 Monocytic leukemia, unspecified in relapse from V24 HCC 9
  • C93.Z0 Other monocytic leukemia, not having achieved remission from V24 HCC 9
  • C93.Z1 Other monocytic leukemia, in remission from V24 HCC 9
  • C93.Z2 Other monocytic leukemia, in relapse from V24 HCC 9
  • C94.30 Mast cell leukemia not having achieved remission from V24 HCC 9
  • C94.31 Mast cell leukemia, in remission from V24 HCC 9
  • C94.32 Mast cell leukemia, in relapse from V24 HCC 9
  • C94.80 Other specified leukemias not having achieved remission from V24 HCC 9
  • C94.81 Other specified leukemias, in remission from V24 HCC 9
  • C94.82 Other specified leukemias, in relapse from V24 HCC 9

Every code above carries the full HCC 20 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 20

What is HCC 20 in the CMS-HCC model?

HCC 20 is CMS-HCC Category 20 (Lung and Other Severe Cancers) in the V28 risk adjustment model. It covers 233 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 20?

For payment year 2026, HCC 20 adds 1.136 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.672 to 1.214 across the seven payment segments shown above.

Which categories supersede HCC 20?

HCC 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic), HCC 18 (Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid), and HCC 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers) sit above HCC 20 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.

Related References

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.