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 HCC 300 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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 (living at home, age 65 or over, not also enrolled in Medicaid). 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.
