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 HCC 298 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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