CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 167 Codes

HCC 267: Deep Vein Thrombosis and Pulmonary Embolism ICD-10-CM

CMS-HCC Category 267 (Deep Vein Thrombosis and Pulmonary Embolism) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.245 and 0.568 to a beneficiary's RAF score depending on the payment segment (0.294 for a community, non-dual, aged enrollee). 167 ICD-10-CM diagnosis codes map to HCC 267. 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
+0.294
RAF, Community Non-Dual Aged
167
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, aged0.294
Community, partial-benefit dual, aged0.338
Community, full-benefit dual, aged0.445
Community, non-dual, disabled0.431
Community, partial-benefit dual, disabled0.498
Community, full-benefit dual, disabled0.568
Institutional0.245

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 HCC 267 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.

ICD-10-CM

ICD-10-CM Codes That Map to HCC 267 167 codes

167 of 167 shown
  • I26.01 Septic pulmonary embolism with acute cor pulmonale from V24 HCC 85, HCC 107
  • I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale from V24 HCC 85, HCC 107
  • I26.03 Cement embolism of pulmonary artery with acute cor pulmonale from V24 HCC 85, HCC 107
  • I26.04 Fat embolism of pulmonary artery with acute cor pulmonale from V24 HCC 85, HCC 107
  • I26.09 Other pulmonary embolism with acute cor pulmonale from V24 HCC 85, HCC 107
  • I26.90 Septic pulmonary embolism without acute cor pulmonale from V24 HCC 107
  • I26.92 Saddle embolus of pulmonary artery without acute cor pulmonale from V24 HCC 107
  • I26.93 Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale from V24 HCC 107
  • I26.94 Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale from V24 HCC 107
  • I26.95 Cement embolism of pulmonary artery without acute cor pulmonale from V24 HCC 107
  • I26.96 Fat embolism of pulmonary artery without acute cor pulmonale from V24 HCC 107
  • I26.99 Other pulmonary embolism without acute cor pulmonale from V24 HCC 107
  • I27.82 Chronic pulmonary embolism from V24 HCC 107
  • I80.10 Phlebitis and thrombophlebitis of unspecified femoral vein from V24 HCC 108
  • I80.11 Phlebitis and thrombophlebitis of right femoral vein from V24 HCC 108
  • I80.12 Phlebitis and thrombophlebitis of left femoral vein from V24 HCC 108
  • I80.13 Phlebitis and thrombophlebitis of femoral vein, bilateral from V24 HCC 108
  • I80.201 Phlebitis and thrombophlebitis of unspecified deep vessels of right lower extremity from V24 HCC 108
  • I80.202 Phlebitis and thrombophlebitis of unspecified deep vessels of left lower extremity from V24 HCC 108
  • I80.203 Phlebitis and thrombophlebitis of unspecified deep vessels of lower extremities, bilateral from V24 HCC 108
  • I80.209 Phlebitis and thrombophlebitis of unspecified deep vessels of unspecified lower extremity from V24 HCC 108
  • I80.211 Phlebitis and thrombophlebitis of right iliac vein from V24 HCC 108
  • I80.212 Phlebitis and thrombophlebitis of left iliac vein from V24 HCC 108
  • I80.213 Phlebitis and thrombophlebitis of iliac vein, bilateral from V24 HCC 108
  • I80.219 Phlebitis and thrombophlebitis of unspecified iliac vein from V24 HCC 108
  • I80.221 Phlebitis and thrombophlebitis of right popliteal vein from V24 HCC 108
  • I80.222 Phlebitis and thrombophlebitis of left popliteal vein from V24 HCC 108
  • I80.223 Phlebitis and thrombophlebitis of popliteal vein, bilateral from V24 HCC 108
  • I80.229 Phlebitis and thrombophlebitis of unspecified popliteal vein from V24 HCC 108
  • I80.231 Phlebitis and thrombophlebitis of right tibial vein from V24 HCC 108
  • I80.232 Phlebitis and thrombophlebitis of left tibial vein from V24 HCC 108
  • I80.233 Phlebitis and thrombophlebitis of tibial vein, bilateral from V24 HCC 108
  • I80.239 Phlebitis and thrombophlebitis of unspecified tibial vein from V24 HCC 108
  • I80.241 Phlebitis and thrombophlebitis of right peroneal vein from V24 HCC 108
  • I80.242 Phlebitis and thrombophlebitis of left peroneal vein from V24 HCC 108
  • I80.243 Phlebitis and thrombophlebitis of peroneal vein, bilateral from V24 HCC 108
  • I80.249 Phlebitis and thrombophlebitis of unspecified peroneal vein from V24 HCC 108
  • I80.251 Phlebitis and thrombophlebitis of right calf muscular vein from V24 HCC 108
  • I80.252 Phlebitis and thrombophlebitis of left calf muscular vein from V24 HCC 108
  • I80.253 Phlebitis and thrombophlebitis of calf muscular vein, bilateral from V24 HCC 108
  • I80.259 Phlebitis and thrombophlebitis of unspecified calf muscular vein from V24 HCC 108
  • I80.291 Phlebitis and thrombophlebitis of other deep vessels of right lower extremity from V24 HCC 108
  • I80.292 Phlebitis and thrombophlebitis of other deep vessels of left lower extremity from V24 HCC 108
  • I80.293 Phlebitis and thrombophlebitis of other deep vessels of lower extremity, bilateral from V24 HCC 108
  • I80.299 Phlebitis and thrombophlebitis of other deep vessels of unspecified lower extremity from V24 HCC 108
  • I82.0 Budd-Chiari syndrome from V24 HCC 108
  • I82.210 Acute embolism and thrombosis of superior vena cava from V24 HCC 108
  • I82.211 Chronic embolism and thrombosis of superior vena cava from V24 HCC 108
  • I82.220 Acute embolism and thrombosis of inferior vena cava from V24 HCC 108
  • I82.221 Chronic embolism and thrombosis of inferior vena cava from V24 HCC 108
  • I82.290 Acute embolism and thrombosis of other thoracic veins from V24 HCC 108
  • I82.291 Chronic embolism and thrombosis of other thoracic veins from V24 HCC 108
  • I82.3 Embolism and thrombosis of renal vein from V24 HCC 108
  • I82.401 Acute embolism and thrombosis of unspecified deep veins of right lower extremity from V24 HCC 108
  • I82.402 Acute embolism and thrombosis of unspecified deep veins of left lower extremity from V24 HCC 108
  • I82.403 Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral from V24 HCC 108
  • I82.409 Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity from V24 HCC 108
  • I82.411 Acute embolism and thrombosis of right femoral vein from V24 HCC 108
  • I82.412 Acute embolism and thrombosis of left femoral vein from V24 HCC 108
  • I82.413 Acute embolism and thrombosis of femoral vein, bilateral from V24 HCC 108
  • I82.419 Acute embolism and thrombosis of unspecified femoral vein from V24 HCC 108
  • I82.421 Acute embolism and thrombosis of right iliac vein from V24 HCC 108
  • I82.422 Acute embolism and thrombosis of left iliac vein from V24 HCC 108
  • I82.423 Acute embolism and thrombosis of iliac vein, bilateral from V24 HCC 108
  • I82.429 Acute embolism and thrombosis of unspecified iliac vein from V24 HCC 108
  • I82.431 Acute embolism and thrombosis of right popliteal vein from V24 HCC 108
  • I82.432 Acute embolism and thrombosis of left popliteal vein from V24 HCC 108
  • I82.433 Acute embolism and thrombosis of popliteal vein, bilateral from V24 HCC 108
  • I82.439 Acute embolism and thrombosis of unspecified popliteal vein from V24 HCC 108
  • I82.441 Acute embolism and thrombosis of right tibial vein from V24 HCC 108
  • I82.442 Acute embolism and thrombosis of left tibial vein from V24 HCC 108
  • I82.443 Acute embolism and thrombosis of tibial vein, bilateral from V24 HCC 108
  • I82.449 Acute embolism and thrombosis of unspecified tibial vein from V24 HCC 108
  • I82.451 Acute embolism and thrombosis of right peroneal vein from V24 HCC 108
  • I82.452 Acute embolism and thrombosis of left peroneal vein from V24 HCC 108
  • I82.453 Acute embolism and thrombosis of peroneal vein, bilateral from V24 HCC 108
  • I82.459 Acute embolism and thrombosis of unspecified peroneal vein from V24 HCC 108
  • I82.461 Acute embolism and thrombosis of right calf muscular vein from V24 HCC 108
  • I82.462 Acute embolism and thrombosis of left calf muscular vein from V24 HCC 108
  • I82.463 Acute embolism and thrombosis of calf muscular vein, bilateral from V24 HCC 108
  • I82.469 Acute embolism and thrombosis of unspecified calf muscular vein from V24 HCC 108
  • I82.491 Acute embolism and thrombosis of other specified deep vein of right lower extremity from V24 HCC 108
  • I82.492 Acute embolism and thrombosis of other specified deep vein of left lower extremity from V24 HCC 108
  • I82.493 Acute embolism and thrombosis of other specified deep vein of lower extremity, bilateral from V24 HCC 108
  • I82.499 Acute embolism and thrombosis of other specified deep vein of unspecified lower extremity from V24 HCC 108
  • I82.4Y1 Acute embolism and thrombosis of unspecified deep veins of right proximal lower extremity from V24 HCC 108
  • I82.4Y2 Acute embolism and thrombosis of unspecified deep veins of left proximal lower extremity from V24 HCC 108
  • I82.4Y3 Acute embolism and thrombosis of unspecified deep veins of proximal lower extremity, bilateral from V24 HCC 108
  • I82.4Y9 Acute embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity from V24 HCC 108
  • I82.4Z1 Acute embolism and thrombosis of unspecified deep veins of right distal lower extremity from V24 HCC 108
  • I82.4Z2 Acute embolism and thrombosis of unspecified deep veins of left distal lower extremity from V24 HCC 108
  • I82.4Z3 Acute embolism and thrombosis of unspecified deep veins of distal lower extremity, bilateral from V24 HCC 108
  • I82.4Z9 Acute embolism and thrombosis of unspecified deep veins of unspecified distal lower extremity from V24 HCC 108
  • I82.501 Chronic embolism and thrombosis of unspecified deep veins of right lower extremity from V24 HCC 108
  • I82.502 Chronic embolism and thrombosis of unspecified deep veins of left lower extremity from V24 HCC 108
  • I82.503 Chronic embolism and thrombosis of unspecified deep veins of lower extremity, bilateral from V24 HCC 108
  • I82.509 Chronic embolism and thrombosis of unspecified deep veins of unspecified lower extremity from V24 HCC 108
  • I82.511 Chronic embolism and thrombosis of right femoral vein from V24 HCC 108
  • I82.512 Chronic embolism and thrombosis of left femoral vein from V24 HCC 108
  • I82.513 Chronic embolism and thrombosis of femoral vein, bilateral from V24 HCC 108
  • I82.519 Chronic embolism and thrombosis of unspecified femoral vein from V24 HCC 108
  • I82.521 Chronic embolism and thrombosis of right iliac vein from V24 HCC 108
  • I82.522 Chronic embolism and thrombosis of left iliac vein from V24 HCC 108
  • I82.523 Chronic embolism and thrombosis of iliac vein, bilateral from V24 HCC 108
  • I82.529 Chronic embolism and thrombosis of unspecified iliac vein from V24 HCC 108
  • I82.531 Chronic embolism and thrombosis of right popliteal vein from V24 HCC 108
  • I82.532 Chronic embolism and thrombosis of left popliteal vein from V24 HCC 108
  • I82.533 Chronic embolism and thrombosis of popliteal vein, bilateral from V24 HCC 108
  • I82.539 Chronic embolism and thrombosis of unspecified popliteal vein from V24 HCC 108
  • I82.541 Chronic embolism and thrombosis of right tibial vein from V24 HCC 108
  • I82.542 Chronic embolism and thrombosis of left tibial vein from V24 HCC 108
  • I82.543 Chronic embolism and thrombosis of tibial vein, bilateral from V24 HCC 108
  • I82.549 Chronic embolism and thrombosis of unspecified tibial vein from V24 HCC 108
  • I82.551 Chronic embolism and thrombosis of right peroneal vein from V24 HCC 108
  • I82.552 Chronic embolism and thrombosis of left peroneal vein from V24 HCC 108
  • I82.553 Chronic embolism and thrombosis of peroneal vein, bilateral from V24 HCC 108
  • I82.559 Chronic embolism and thrombosis of unspecified peroneal vein from V24 HCC 108
  • I82.561 Chronic embolism and thrombosis of right calf muscular vein from V24 HCC 108
  • I82.562 Chronic embolism and thrombosis of left calf muscular vein from V24 HCC 108
  • I82.563 Chronic embolism and thrombosis of calf muscular vein, bilateral from V24 HCC 108
  • I82.569 Chronic embolism and thrombosis of unspecified calf muscular vein from V24 HCC 108
  • I82.591 Chronic embolism and thrombosis of other specified deep vein of right lower extremity from V24 HCC 108
  • I82.592 Chronic embolism and thrombosis of other specified deep vein of left lower extremity from V24 HCC 108
  • I82.593 Chronic embolism and thrombosis of other specified deep vein of lower extremity, bilateral from V24 HCC 108
  • I82.599 Chronic embolism and thrombosis of other specified deep vein of unspecified lower extremity from V24 HCC 108
  • I82.5Y1 Chronic embolism and thrombosis of unspecified deep veins of right proximal lower extremity from V24 HCC 108
  • I82.5Y2 Chronic embolism and thrombosis of unspecified deep veins of left proximal lower extremity from V24 HCC 108
  • I82.5Y3 Chronic embolism and thrombosis of unspecified deep veins of proximal lower extremity, bilateral from V24 HCC 108
  • I82.5Y9 Chronic embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity from V24 HCC 108
  • I82.5Z1 Chronic embolism and thrombosis of unspecified deep veins of right distal lower extremity from V24 HCC 108
  • I82.5Z2 Chronic embolism and thrombosis of unspecified deep veins of left distal lower extremity from V24 HCC 108
  • I82.5Z3 Chronic embolism and thrombosis of unspecified deep veins of distal lower extremity, bilateral from V24 HCC 108
  • I82.5Z9 Chronic embolism and thrombosis of unspecified deep veins of unspecified distal lower extremity from V24 HCC 108
  • I82.621 Acute embolism and thrombosis of deep veins of right upper extremity from V24 HCC 108
  • I82.622 Acute embolism and thrombosis of deep veins of left upper extremity from V24 HCC 108
  • I82.623 Acute embolism and thrombosis of deep veins of upper extremity, bilateral from V24 HCC 108
  • I82.629 Acute embolism and thrombosis of deep veins of unspecified upper extremity from V24 HCC 108
  • I82.721 Chronic embolism and thrombosis of deep veins of right upper extremity from V24 HCC 108
  • I82.722 Chronic embolism and thrombosis of deep veins of left upper extremity from V24 HCC 108
  • I82.723 Chronic embolism and thrombosis of deep veins of upper extremity, bilateral from V24 HCC 108
  • I82.729 Chronic embolism and thrombosis of deep veins of unspecified upper extremity from V24 HCC 108
  • I82.A11 Acute embolism and thrombosis of right axillary vein from V24 HCC 108
  • I82.A12 Acute embolism and thrombosis of left axillary vein from V24 HCC 108
  • I82.A13 Acute embolism and thrombosis of axillary vein, bilateral from V24 HCC 108
  • I82.A19 Acute embolism and thrombosis of unspecified axillary vein from V24 HCC 108
  • I82.A21 Chronic embolism and thrombosis of right axillary vein from V24 HCC 108
  • I82.A22 Chronic embolism and thrombosis of left axillary vein from V24 HCC 108
  • I82.A23 Chronic embolism and thrombosis of axillary vein, bilateral from V24 HCC 108
  • I82.A29 Chronic embolism and thrombosis of unspecified axillary vein from V24 HCC 108
  • I82.B11 Acute embolism and thrombosis of right subclavian vein from V24 HCC 108
  • I82.B12 Acute embolism and thrombosis of left subclavian vein from V24 HCC 108
  • I82.B13 Acute embolism and thrombosis of subclavian vein, bilateral from V24 HCC 108
  • I82.B19 Acute embolism and thrombosis of unspecified subclavian vein from V24 HCC 108
  • I82.B21 Chronic embolism and thrombosis of right subclavian vein from V24 HCC 108
  • I82.B22 Chronic embolism and thrombosis of left subclavian vein from V24 HCC 108
  • I82.B23 Chronic embolism and thrombosis of subclavian vein, bilateral from V24 HCC 108
  • I82.B29 Chronic embolism and thrombosis of unspecified subclavian vein from V24 HCC 108
  • I82.C11 Acute embolism and thrombosis of right internal jugular vein from V24 HCC 108
  • I82.C12 Acute embolism and thrombosis of left internal jugular vein from V24 HCC 108
  • I82.C13 Acute embolism and thrombosis of internal jugular vein, bilateral from V24 HCC 108
  • I82.C19 Acute embolism and thrombosis of unspecified internal jugular vein from V24 HCC 108
  • I82.C21 Chronic embolism and thrombosis of right internal jugular vein from V24 HCC 108
  • I82.C22 Chronic embolism and thrombosis of left internal jugular vein from V24 HCC 108
  • I82.C23 Chronic embolism and thrombosis of internal jugular vein, bilateral from V24 HCC 108
  • I82.C29 Chronic embolism and thrombosis of unspecified internal jugular vein from V24 HCC 108
  • T79.0XXA Air embolism (traumatic), initial encounter from V24 HCC 173
  • T79.1XXA Fat embolism (traumatic), initial encounter from V24 HCC 173

Every code above carries the full HCC 267 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 267

What is HCC 267 in the CMS-HCC model?

HCC 267 is CMS-HCC Category 267 (Deep Vein Thrombosis and Pulmonary Embolism) in the V28 risk adjustment model. It covers 167 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 267?

For payment year 2026, HCC 267 adds 0.294 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.245 to 0.568 across the seven payment segments shown above.

Related References

All HCC CategoriesV24 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.