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 HCC 267 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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 (living at home, age 65 or over, not also enrolled in Medicaid). 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.