CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 127 Codes

HCC 263: Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene ICD-10-CM

CMS-HCC Category 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.696 and 1.432 to a beneficiary's RAF score depending on the payment segment (1.118 for a community, non-dual, aged enrollee). 127 ICD-10-CM diagnosis codes map to HCC 263. It sits at the top of its hierarchy: no other condition category supersedes it.

✓ Built from the official CMS PY 2026 risk adjustment filesV28 pays 100% of MA risk scores from PY 2026
+1.118
RAF, Community Non-Dual Aged
127
ICD-10-CM Codes
Top
Of Its Hierarchy
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged1.118
Community, partial-benefit dual, aged1.007
Community, full-benefit dual, aged1.432
Community, non-dual, disabled1.066
Community, partial-benefit dual, disabled1.056
Community, full-benefit dual, disabled1.276
Institutional0.696

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. HCC 263 in turn supersedes HCC 264 (Vascular Disease with Complications), HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle), and HCC 409 (Amputation Status, Lower Limb/Amputation Complications).

ICD-10-CM

ICD-10-CM Codes That Map to HCC 263 127 codes

127 of 127 shown
  • A48.0 Gas gangrene from V24 HCC 106
  • E08.52 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene from V24 HCC 18, HCC 106
  • E10.52 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene from V24 HCC 18, HCC 106
  • E11.52 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene from V24 HCC 18, HCC 106
  • E13.52 Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene from V24 HCC 18, HCC 106
  • I70.231 Atherosclerosis of native arteries of right leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.232 Atherosclerosis of native arteries of right leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.233 Atherosclerosis of native arteries of right leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.234 Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.235 Atherosclerosis of native arteries of right leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.238 Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.239 Atherosclerosis of native arteries of right leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.241 Atherosclerosis of native arteries of left leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.242 Atherosclerosis of native arteries of left leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.243 Atherosclerosis of native arteries of left leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.244 Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.245 Atherosclerosis of native arteries of left leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.248 Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.249 Atherosclerosis of native arteries of left leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.25 Atherosclerosis of native arteries of other extremities with ulceration from V24 HCC 106, HCC 161
  • I70.261 Atherosclerosis of native arteries of extremities with gangrene, right leg from V24 HCC 106
  • I70.262 Atherosclerosis of native arteries of extremities with gangrene, left leg from V24 HCC 106
  • I70.263 Atherosclerosis of native arteries of extremities with gangrene, bilateral legs from V24 HCC 106
  • I70.268 Atherosclerosis of native arteries of extremities with gangrene, other extremity from V24 HCC 106
  • I70.269 Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity from V24 HCC 106
  • I70.331 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.332 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.333 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.334 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.335 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.338 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.339 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.341 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.342 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.343 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.344 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.345 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.348 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.349 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.35 Atherosclerosis of unspecified type of bypass graft(s) of other extremity with ulceration from V24 HCC 106, HCC 161
  • I70.361 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, right leg from V24 HCC 106
  • I70.362 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, left leg from V24 HCC 106
  • I70.363 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, bilateral legs from V24 HCC 106
  • I70.368 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other extremity from V24 HCC 106
  • I70.369 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, unspecified extremity from V24 HCC 106
  • I70.431 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.432 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.433 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.434 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.435 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.438 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.439 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.441 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.442 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.443 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.444 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.445 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.448 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.449 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.45 Atherosclerosis of autologous vein bypass graft(s) of other extremity with ulceration from V24 HCC 106, HCC 161
  • I70.461 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg from V24 HCC 106
  • I70.462 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, left leg from V24 HCC 106
  • I70.463 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, bilateral legs from V24 HCC 106
  • I70.468 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, other extremity from V24 HCC 106
  • I70.469 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, unspecified extremity from V24 HCC 106
  • I70.531 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.532 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.533 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.534 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.535 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.538 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.539 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.541 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.542 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.543 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.544 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.545 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.548 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.549 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.55 Atherosclerosis of nonautologous biological bypass graft(s) of other extremity with ulceration from V24 HCC 106, HCC 161
  • I70.561 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, right leg from V24 HCC 106
  • I70.562 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, left leg from V24 HCC 106
  • I70.563 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, bilateral legs from V24 HCC 106
  • I70.568 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, other extremity from V24 HCC 106
  • I70.569 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, unspecified extremity from V24 HCC 106
  • I70.631 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.632 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.633 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.634 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.635 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.638 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.639 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.641 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.642 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.643 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.644 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.645 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.648 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.649 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.65 Atherosclerosis of nonbiological bypass graft(s) of other extremity with ulceration from V24 HCC 106, HCC 161
  • I70.661 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, right leg from V24 HCC 106
  • I70.662 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, left leg from V24 HCC 106
  • I70.663 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, bilateral legs from V24 HCC 106
  • I70.668 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, other extremity from V24 HCC 106
  • I70.669 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, unspecified extremity from V24 HCC 106
  • I70.731 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.732 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.733 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.734 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.735 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.738 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.739 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.741 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of thigh from V24 HCC 106, HCC 161
  • I70.742 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of calf from V24 HCC 106, HCC 161
  • I70.743 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of ankle from V24 HCC 106, HCC 161
  • I70.744 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of heel and midfoot from V24 HCC 106, HCC 161
  • I70.745 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other part of foot from V24 HCC 106, HCC 161
  • I70.748 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of other part of lower leg from V24 HCC 106, HCC 161
  • I70.749 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration of unspecified site from V24 HCC 106, HCC 161
  • I70.75 Atherosclerosis of other type of bypass graft(s) of other extremity with ulceration from V24 HCC 106, HCC 161
  • I70.761 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, right leg from V24 HCC 106
  • I70.762 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, left leg from V24 HCC 106
  • I70.763 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, bilateral legs from V24 HCC 106
  • I70.768 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, other extremity from V24 HCC 106
  • I70.769 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene, unspecified extremity from V24 HCC 106
  • I73.01 Raynaud's syndrome with gangrene from V24 HCC 106
  • I96 Gangrene, not elsewhere classified from V24 HCC 106

Every code above carries the full HCC 263 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 263

What is HCC 263 in the CMS-HCC model?

HCC 263 is CMS-HCC Category 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) in the V28 risk adjustment model. It covers 127 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 263?

For payment year 2026, HCC 263 adds 1.118 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.696 to 1.432 across the seven payment segments shown above.

Related References

All HCC CategoriesHCC 264 CodesHCC 383 CodesHCC 409 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.