HCC 300: Exudative Macular Degeneration ICD-10-CM
CMS-HCC Category 300 (Exudative Macular Degeneration) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.196 and 0.596 to a beneficiary's RAF score depending on the payment segment (0.596 for a community, non-dual, aged enrollee). 16 ICD-10-CM diagnosis codes map to HCC 300. It sits at the top of its hierarchy: no other condition category supersedes it.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.596 |
| Community, partial-benefit dual, aged | 0.459 |
| Community, full-benefit dual, aged | 0.370 |
| Community, non-dual, disabled | 0.366 |
| Community, partial-benefit dual, disabled | 0.380 |
| Community, full-benefit dual, disabled | 0.255 |
| Institutional | 0.196 |
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 HCC 300 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.
ICD-10-CM Codes That Map to HCC 300 16 codes
- H35.3210 Exudative age-related macular degeneration, right eye, stage unspecified from V24 HCC 124
- H35.3211 Exudative age-related macular degeneration, right eye, with active choroidal neovascularization from V24 HCC 124
- H35.3212 Exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization from V24 HCC 124
- H35.3213 Exudative age-related macular degeneration, right eye, with inactive scar from V24 HCC 124
- H35.3220 Exudative age-related macular degeneration, left eye, stage unspecified from V24 HCC 124
- H35.3221 Exudative age-related macular degeneration, left eye, with active choroidal neovascularization from V24 HCC 124
- H35.3222 Exudative age-related macular degeneration, left eye, with inactive choroidal neovascularization from V24 HCC 124
- H35.3223 Exudative age-related macular degeneration, left eye, with inactive scar from V24 HCC 124
- H35.3230 Exudative age-related macular degeneration, bilateral, stage unspecified from V24 HCC 124
- H35.3231 Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization from V24 HCC 124
- H35.3232 Exudative age-related macular degeneration, bilateral, with inactive choroidal neovascularization from V24 HCC 124
- H35.3233 Exudative age-related macular degeneration, bilateral, with inactive scar from V24 HCC 124
- H35.3290 Exudative age-related macular degeneration, unspecified eye, stage unspecified from V24 HCC 124
- H35.3291 Exudative age-related macular degeneration, unspecified eye, with active choroidal neovascularization from V24 HCC 124
- H35.3292 Exudative age-related macular degeneration, unspecified eye, with inactive choroidal neovascularization from V24 HCC 124
- H35.3293 Exudative age-related macular degeneration, unspecified eye, with inactive scar from V24 HCC 124
Every code above carries the full HCC 300 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 300
What is HCC 300 in the CMS-HCC model?
HCC 300 is CMS-HCC Category 300 (Exudative Macular Degeneration) in the V28 risk adjustment model. It covers 16 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 300?
For payment year 2026, HCC 300 adds 0.596 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.196 to 0.596 across the seven payment segments shown above.
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.
