CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 180 Codes

HCC 298: Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage ICD-10-CM

CMS-HCC Category 298 (Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.301 and 0.545 to a beneficiary's RAF score depending on the payment segment (0.336 for a community, non-dual, aged enrollee). 180 ICD-10-CM diagnosis codes map to HCC 298. 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
+0.336
RAF, Community Non-Dual Aged
180
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, aged0.336
Community, partial-benefit dual, aged0.327
Community, full-benefit dual, aged0.323
Community, non-dual, disabled0.364
Community, partial-benefit dual, disabled0.301
Community, full-benefit dual, disabled0.319
Institutional0.545

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 HCC 298 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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 298 180 codes

180 of 180 shown
  • E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema from V24 HCC 18
  • E08.3211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E08.3212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E08.3219 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E08.3311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E08.3312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E08.3319 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E08.3411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E08.3412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E08.3419 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E08.3511 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18, HCC 122
  • E08.3512 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18, HCC 122
  • E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18, HCC 122
  • E08.3519 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18, HCC 122
  • E08.3521 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye from V24 HCC 18, HCC 122
  • E08.3522 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye from V24 HCC 18, HCC 122
  • E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral from V24 HCC 18, HCC 122
  • E08.3529 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye from V24 HCC 18, HCC 122
  • E08.3531 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye from V24 HCC 18, HCC 122
  • E08.3532 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye from V24 HCC 18, HCC 122
  • E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral from V24 HCC 18, HCC 122
  • E08.3539 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye from V24 HCC 18, HCC 122
  • E08.3541 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye from V24 HCC 18, HCC 122
  • E08.3542 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye from V24 HCC 18, HCC 122
  • E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral from V24 HCC 18, HCC 122
  • E08.3549 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye from V24 HCC 18, HCC 122
  • E08.3551 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye from V24 HCC 18, HCC 122
  • E08.3552 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye from V24 HCC 18, HCC 122
  • E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral from V24 HCC 18, HCC 122
  • E08.3559 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye from V24 HCC 18, HCC 122
  • E08.3591 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18, HCC 122
  • E08.3592 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18, HCC 122
  • E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18, HCC 122
  • E08.3599 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye from V24 HCC 18, HCC 122
  • E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema from V24 HCC 18
  • E10.3211 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E10.3212 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E10.3311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E10.3312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E10.3313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E10.3411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E10.3412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E10.3413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E10.3511 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18, HCC 122
  • E10.3512 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18, HCC 122
  • E10.3513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18, HCC 122
  • E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18, HCC 122
  • E10.3521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye from V24 HCC 18, HCC 122
  • E10.3522 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye from V24 HCC 18, HCC 122
  • E10.3523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral from V24 HCC 18, HCC 122
  • E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye from V24 HCC 18, HCC 122
  • E10.3531 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye from V24 HCC 18, HCC 122
  • E10.3532 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye from V24 HCC 18, HCC 122
  • E10.3533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral from V24 HCC 18, HCC 122
  • E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye from V24 HCC 18, HCC 122
  • E10.3541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye from V24 HCC 18, HCC 122
  • E10.3542 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye from V24 HCC 18, HCC 122
  • E10.3543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral from V24 HCC 18, HCC 122
  • E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye from V24 HCC 18, HCC 122
  • E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye from V24 HCC 18, HCC 122
  • E10.3552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye from V24 HCC 18, HCC 122
  • E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral from V24 HCC 18, HCC 122
  • E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye from V24 HCC 18, HCC 122
  • E10.3591 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18, HCC 122
  • E10.3592 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18, HCC 122
  • E10.3593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18, HCC 122
  • E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye from V24 HCC 18, HCC 122
  • E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema from V24 HCC 18
  • E11.3211 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E11.3212 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E11.3213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E11.3311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E11.3312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E11.3313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E11.3411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E11.3412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E11.3413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E11.3511 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18, HCC 122
  • E11.3512 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18, HCC 122
  • E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18, HCC 122
  • E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18, HCC 122
  • E11.3521 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye from V24 HCC 18, HCC 122
  • E11.3522 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye from V24 HCC 18, HCC 122
  • E11.3523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral from V24 HCC 18, HCC 122
  • E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye from V24 HCC 18, HCC 122
  • E11.3531 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye from V24 HCC 18, HCC 122
  • E11.3532 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye from V24 HCC 18, HCC 122
  • E11.3533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral from V24 HCC 18, HCC 122
  • E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye from V24 HCC 18, HCC 122
  • E11.3541 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye from V24 HCC 18, HCC 122
  • E11.3542 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye from V24 HCC 18, HCC 122
  • E11.3543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral from V24 HCC 18, HCC 122
  • E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye from V24 HCC 18, HCC 122
  • E11.3551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye from V24 HCC 18, HCC 122
  • E11.3552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye from V24 HCC 18, HCC 122
  • E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral from V24 HCC 18, HCC 122
  • E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye from V24 HCC 18, HCC 122
  • E11.3591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18, HCC 122
  • E11.3592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18, HCC 122
  • E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18, HCC 122
  • E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye from V24 HCC 18, HCC 122
  • E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema from V24 HCC 18
  • E13.3211 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E13.3212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E13.3213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E13.3219 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E13.3311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E13.3312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E13.3313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E13.3319 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E13.3411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18
  • E13.3412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18
  • E13.3413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18
  • E13.3419 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18
  • E13.3511 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye from V24 HCC 18, HCC 122
  • E13.3512 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye from V24 HCC 18, HCC 122
  • E13.3513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral from V24 HCC 18, HCC 122
  • E13.3519 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye from V24 HCC 18, HCC 122
  • E13.3521 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye from V24 HCC 18, HCC 122
  • E13.3522 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye from V24 HCC 18, HCC 122
  • E13.3523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral from V24 HCC 18, HCC 122
  • E13.3529 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye from V24 HCC 18, HCC 122
  • E13.3531 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye from V24 HCC 18, HCC 122
  • E13.3532 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye from V24 HCC 18, HCC 122
  • E13.3533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral from V24 HCC 18, HCC 122
  • E13.3539 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye from V24 HCC 18, HCC 122
  • E13.3541 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye from V24 HCC 18, HCC 122
  • E13.3542 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye from V24 HCC 18, HCC 122
  • E13.3543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral from V24 HCC 18, HCC 122
  • E13.3549 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye from V24 HCC 18, HCC 122
  • E13.3551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye from V24 HCC 18, HCC 122
  • E13.3552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye from V24 HCC 18, HCC 122
  • E13.3553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral from V24 HCC 18, HCC 122
  • E13.3559 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye from V24 HCC 18, HCC 122
  • E13.3591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18, HCC 122
  • E13.3592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18, HCC 122
  • E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18, HCC 122
  • E13.3599 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye from V24 HCC 18, HCC 122
  • H34.8110 Central retinal vein occlusion, right eye, with macular edema new to V28
  • H34.8111 Central retinal vein occlusion, right eye, with retinal neovascularization new to V28
  • H34.8112 Central retinal vein occlusion, right eye, stable new to V28
  • H34.8120 Central retinal vein occlusion, left eye, with macular edema new to V28
  • H34.8121 Central retinal vein occlusion, left eye, with retinal neovascularization new to V28
  • H34.8122 Central retinal vein occlusion, left eye, stable new to V28
  • H34.8130 Central retinal vein occlusion, bilateral, with macular edema new to V28
  • H34.8131 Central retinal vein occlusion, bilateral, with retinal neovascularization new to V28
  • H34.8132 Central retinal vein occlusion, bilateral, stable new to V28
  • H34.8190 Central retinal vein occlusion, unspecified eye, with macular edema new to V28
  • H34.8191 Central retinal vein occlusion, unspecified eye, with retinal neovascularization new to V28
  • H34.8192 Central retinal vein occlusion, unspecified eye, stable new to V28
  • H34.8310 Tributary (branch) retinal vein occlusion, right eye, with macular edema new to V28
  • H34.8311 Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization new to V28
  • H34.8312 Tributary (branch) retinal vein occlusion, right eye, stable new to V28
  • H34.8320 Tributary (branch) retinal vein occlusion, left eye, with macular edema new to V28
  • H34.8321 Tributary (branch) retinal vein occlusion, left eye, with retinal neovascularization new to V28
  • H34.8322 Tributary (branch) retinal vein occlusion, left eye, stable new to V28
  • H34.8330 Tributary (branch) retinal vein occlusion, bilateral, with macular edema new to V28
  • H34.8331 Tributary (branch) retinal vein occlusion, bilateral, with retinal neovascularization new to V28
  • H34.8332 Tributary (branch) retinal vein occlusion, bilateral, stable new to V28
  • H34.8390 Tributary (branch) retinal vein occlusion, unspecified eye, with macular edema new to V28
  • H34.8391 Tributary (branch) retinal vein occlusion, unspecified eye, with retinal neovascularization new to V28
  • H34.8392 Tributary (branch) retinal vein occlusion, unspecified eye, stable new to V28
  • H36.821 Proliferative sickle-cell retinopathy, right eye from V24 HCC 46, HCC 122
  • H36.822 Proliferative sickle-cell retinopathy, left eye from V24 HCC 46, HCC 122
  • H36.823 Proliferative sickle-cell retinopathy, bilateral from V24 HCC 46, HCC 122
  • H36.829 Proliferative sickle-cell retinopathy, unspecified eye from V24 HCC 46, HCC 122
  • H43.10 Vitreous hemorrhage, unspecified eye from V24 HCC 122
  • H43.11 Vitreous hemorrhage, right eye from V24 HCC 122
  • H43.12 Vitreous hemorrhage, left eye from V24 HCC 122
  • H43.13 Vitreous hemorrhage, bilateral from V24 HCC 122

Every code above carries the full HCC 298 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 298

What is HCC 298 in the CMS-HCC model?

HCC 298 is CMS-HCC Category 298 (Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage) in the V28 risk adjustment model. It covers 180 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 298?

For payment year 2026, HCC 298 adds 0.336 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 0.301 to 0.545 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.