CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 71 Codes

HCC 264: Vascular Disease with Complications ICD-10-CM

CMS-HCC Category 264 (Vascular Disease with Complications) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.338 and 0.622 to a beneficiary's RAF score depending on the payment segment (0.455 for a community, non-dual, aged enrollee). 71 ICD-10-CM diagnosis codes map to HCC 264. A more severe related category (HCC 263) 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
+0.455
RAF, Community Non-Dual Aged
71
ICD-10-CM Codes
HCC 263
Superseded By
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged0.455
Community, partial-benefit dual, aged0.513
Community, full-benefit dual, aged0.498
Community, non-dual, disabled0.520
Community, partial-benefit dual, disabled0.622
Community, full-benefit dual, disabled0.461
Institutional0.338

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 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) supersedes HCC 264 when reported together.

ICD-10-CM

ICD-10-CM Codes That Map to HCC 264 71 codes

71 of 71 shown
  • I70.221 Atherosclerosis of native arteries of extremities with rest pain, right leg from V24 HCC 108
  • I70.222 Atherosclerosis of native arteries of extremities with rest pain, left leg from V24 HCC 108
  • I70.223 Atherosclerosis of native arteries of extremities with rest pain, bilateral legs from V24 HCC 108
  • I70.228 Atherosclerosis of native arteries of extremities with rest pain, other extremity from V24 HCC 108
  • I70.229 Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity from V24 HCC 108
  • I70.321 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, right leg from V24 HCC 108
  • I70.322 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, left leg from V24 HCC 108
  • I70.323 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, bilateral legs from V24 HCC 108
  • I70.328 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, other extremity from V24 HCC 108
  • I70.329 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, unspecified extremity from V24 HCC 108
  • I70.421 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, right leg from V24 HCC 108
  • I70.422 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, left leg from V24 HCC 108
  • I70.423 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, bilateral legs from V24 HCC 108
  • I70.428 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, other extremity from V24 HCC 108
  • I70.429 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, unspecified extremity from V24 HCC 108
  • I70.521 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, right leg from V24 HCC 108
  • I70.522 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, left leg from V24 HCC 108
  • I70.523 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, bilateral legs from V24 HCC 108
  • I70.528 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, other extremity from V24 HCC 108
  • I70.529 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, unspecified extremity from V24 HCC 108
  • I70.621 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, right leg from V24 HCC 108
  • I70.622 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, left leg from V24 HCC 108
  • I70.623 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, bilateral legs from V24 HCC 108
  • I70.628 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, other extremity from V24 HCC 108
  • I70.629 Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, unspecified extremity from V24 HCC 108
  • I70.721 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, right leg from V24 HCC 108
  • I70.722 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg from V24 HCC 108
  • I70.723 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, bilateral legs from V24 HCC 108
  • I70.728 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, other extremity from V24 HCC 108
  • I70.729 Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, unspecified extremity from V24 HCC 108
  • I71.00 Dissection of unspecified site of aorta from V24 HCC 107
  • I71.010 Dissection of ascending aorta from V24 HCC 107
  • I71.011 Dissection of aortic arch from V24 HCC 107
  • I71.012 Dissection of descending thoracic aorta from V24 HCC 107
  • I71.019 Dissection of thoracic aorta, unspecified from V24 HCC 107
  • I71.02 Dissection of abdominal aorta from V24 HCC 107
  • I71.03 Dissection of thoracoabdominal aorta from V24 HCC 107
  • I71.10 Thoracic aortic aneurysm, ruptured, unspecified from V24 HCC 107
  • I71.11 Aneurysm of the ascending aorta, ruptured from V24 HCC 107
  • I71.12 Aneurysm of the aortic arch, ruptured from V24 HCC 107
  • I71.13 Aneurysm of the descending thoracic aorta, ruptured from V24 HCC 107
  • I71.30 Abdominal aortic aneurysm, ruptured, unspecified from V24 HCC 107
  • I71.31 Pararenal abdominal aortic aneurysm, ruptured from V24 HCC 107
  • I71.32 Juxtarenal abdominal aortic aneurysm, ruptured from V24 HCC 107
  • I71.33 Infrarenal abdominal aortic aneurysm, ruptured from V24 HCC 107
  • I71.50 Thoracoabdominal aortic aneurysm, ruptured, unspecified from V24 HCC 107
  • I71.51 Supraceliac aneurysm of the thoracoabdominal aorta, ruptured from V24 HCC 107
  • I71.52 Paravisceral aneurysm of the thoracoabdominal aorta, ruptured from V24 HCC 107
  • I71.8 Aortic aneurysm of unspecified site, ruptured from V24 HCC 107
  • I74.01 Saddle embolus of abdominal aorta from V24 HCC 107
  • I74.09 Other arterial embolism and thrombosis of abdominal aorta from V24 HCC 107
  • I74.10 Embolism and thrombosis of unspecified parts of aorta from V24 HCC 107
  • I74.11 Embolism and thrombosis of thoracic aorta from V24 HCC 107
  • I74.19 Embolism and thrombosis of other parts of aorta from V24 HCC 107
  • I74.2 Embolism and thrombosis of arteries of the upper extremities from V24 HCC 107
  • I74.3 Embolism and thrombosis of arteries of the lower extremities from V24 HCC 107
  • I74.4 Embolism and thrombosis of arteries of extremities, unspecified from V24 HCC 107
  • I74.5 Embolism and thrombosis of iliac artery from V24 HCC 107
  • I74.8 Embolism and thrombosis of other arteries from V24 HCC 107
  • I74.9 Embolism and thrombosis of unspecified artery from V24 HCC 107
  • I75.011 Atheroembolism of right upper extremity from V24 HCC 107
  • I75.012 Atheroembolism of left upper extremity from V24 HCC 107
  • I75.013 Atheroembolism of bilateral upper extremities from V24 HCC 107
  • I75.019 Atheroembolism of unspecified upper extremity from V24 HCC 107
  • I75.021 Atheroembolism of right lower extremity from V24 HCC 107
  • I75.022 Atheroembolism of left lower extremity from V24 HCC 107
  • I75.023 Atheroembolism of bilateral lower extremities from V24 HCC 107
  • I75.029 Atheroembolism of unspecified lower extremity from V24 HCC 107
  • I75.81 Atheroembolism of kidney from V24 HCC 107
  • I75.89 Atheroembolism of other site from V24 HCC 107
  • I76 Septic arterial embolism from V24 HCC 107

Every code above carries the full HCC 264 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 264

What is HCC 264 in the CMS-HCC model?

HCC 264 is CMS-HCC Category 264 (Vascular Disease with Complications) in the V28 risk adjustment model. It covers 71 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 264?

For payment year 2026, HCC 264 adds 0.455 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.338 to 0.622 across the seven payment segments shown above.

Which categories supersede HCC 264?

HCC 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) sits above HCC 264 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.

Related References

All HCC CategoriesHCC 263 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.