HCC 283: Empyema, Lung Abscess ICD-10-CM
CMS-HCC Category 283 (Empyema, Lung Abscess) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.000 and 0.204 to a beneficiary's RAF score depending on the payment segment (0.204 for a community, non-dual, aged enrollee). 7 ICD-10-CM diagnosis codes map to HCC 283. A more severe related category (HCC 282) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.204 |
| Community, partial-benefit dual, aged | 0.000 |
| Community, full-benefit dual, aged | 0.131 |
| Community, non-dual, disabled | 0.000 |
| Community, partial-benefit dual, disabled | 0.000 |
| Community, full-benefit dual, disabled | 0.074 |
| Institutional | 0.000 |
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 282 (Aspiration and Specified Bacterial Pneumonias) supersedes HCC 283 when reported together.
ICD-10-CM Codes That Map to HCC 283 7 codes
- A06.5 Amebic lung abscess from V24 HCC 115
- J85.0 Gangrene and necrosis of lung from V24 HCC 115
- J85.1 Abscess of lung with pneumonia from V24 HCC 115
- J85.2 Abscess of lung without pneumonia from V24 HCC 115
- J85.3 Abscess of mediastinum from V24 HCC 115
- J86.0 Pyothorax with fistula from V24 HCC 115
- J86.9 Pyothorax without fistula from V24 HCC 115
Every code above carries the full HCC 283 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 283
What is HCC 283 in the CMS-HCC model?
HCC 283 is CMS-HCC Category 283 (Empyema, Lung Abscess) in the V28 risk adjustment model. It covers 7 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 283?
For payment year 2026, HCC 283 adds 0.204 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.000 to 0.204 across the seven payment segments shown above.
Which categories supersede HCC 283?
HCC 282 (Aspiration and Specified Bacterial Pneumonias) sits above HCC 283 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.
