CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 308 Codes

HCC 37: Diabetes with Chronic Complications ICD-10-CM

CMS-HCC Category 37 (Diabetes with Chronic Complications) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.166 and 0.280 to a beneficiary's RAF score depending on the payment segment (0.166 for a community, non-dual, aged enrollee). 308 ICD-10-CM diagnosis codes map to HCC 37. A more severe related category (HCC 35 and HCC 36) supersedes it when both are reported.

✓ Built from the official CMS PY 2026 risk adjustment filesV28 pays 100% of MA risk scores from PY 2026
+0.166
RAF, Community Non-Dual Aged
308
ICD-10-CM Codes
HCC 35
Superseded By
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged0.166
Community, partial-benefit dual, aged0.166
Community, full-benefit dual, aged0.186
Community, non-dual, disabled0.191
Community, partial-benefit dual, disabled0.210
Community, full-benefit dual, disabled0.235
Institutional0.280

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 35 (Pancreas Transplant Status) and HCC 36 (Diabetes with Severe Acute Complications) supersede HCC 37 when reported together. HCC 37 in turn supersedes HCC 38 (Diabetes with No, Glycemic, or Unspecified Complications).

ICD-10-CM

ICD-10-CM Codes That Map to HCC 37 308 codes

308 of 308 shown
  • E08.21 Diabetes mellitus due to underlying condition with diabetic nephropathy from V24 HCC 18
  • E08.22 Diabetes mellitus due to underlying condition with diabetic chronic kidney disease from V24 HCC 18
  • E08.29 Diabetes mellitus due to underlying condition with other diabetic kidney complication from V24 HCC 18
  • E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema from V24 HCC 18
  • E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without 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
  • E08.3291 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E08.3292 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E08.3293 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E08.3299 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without 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
  • E08.3391 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E08.3392 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E08.3393 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E08.3399 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without 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
  • E08.3491 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E08.3492 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E08.3493 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E08.3499 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without 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
  • E08.36 Diabetes mellitus due to underlying condition with diabetic cataract from V24 HCC 18
  • E08.37X1 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye from V24 HCC 18
  • E08.37X2 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye from V24 HCC 18
  • E08.37X3 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral from V24 HCC 18
  • E08.37X9 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, unspecified eye from V24 HCC 18
  • E08.39 Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication from V24 HCC 18
  • E08.40 Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified from V24 HCC 18
  • E08.41 Diabetes mellitus due to underlying condition with diabetic mononeuropathy from V24 HCC 18
  • E08.42 Diabetes mellitus due to underlying condition with diabetic polyneuropathy from V24 HCC 18
  • E08.43 Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy from V24 HCC 18
  • E08.44 Diabetes mellitus due to underlying condition with diabetic amyotrophy from V24 HCC 18
  • E08.49 Diabetes mellitus due to underlying condition with other diabetic neurological complication from V24 HCC 18
  • E08.51 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene from V24 HCC 18, HCC 108
  • E08.52 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene from V24 HCC 18, HCC 106
  • E08.59 Diabetes mellitus due to underlying condition with other circulatory complications from V24 HCC 18
  • E08.610 Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy from V24 HCC 18
  • E08.618 Diabetes mellitus due to underlying condition with other diabetic arthropathy from V24 HCC 18
  • E08.620 Diabetes mellitus due to underlying condition with diabetic dermatitis from V24 HCC 18
  • E08.621 Diabetes mellitus due to underlying condition with foot ulcer from V24 HCC 18, HCC 161
  • E08.622 Diabetes mellitus due to underlying condition with other skin ulcer from V24 HCC 18, HCC 161
  • E08.628 Diabetes mellitus due to underlying condition with other skin complications from V24 HCC 18
  • E08.630 Diabetes mellitus due to underlying condition with periodontal disease from V24 HCC 18
  • E08.638 Diabetes mellitus due to underlying condition with other oral complications from V24 HCC 18
  • E08.69 Diabetes mellitus due to underlying condition with other specified complication from V24 HCC 18
  • E10.21 Type 1 diabetes mellitus with diabetic nephropathy from V24 HCC 18
  • E10.22 Type 1 diabetes mellitus with diabetic chronic kidney disease from V24 HCC 18
  • E10.29 Type 1 diabetes mellitus with other diabetic kidney complication from V24 HCC 18
  • E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema from V24 HCC 18
  • E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without 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
  • E10.3291 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E10.3292 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E10.3293 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without 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
  • E10.3391 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E10.3392 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E10.3393 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without 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
  • E10.3491 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E10.3492 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E10.3493 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without 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
  • E10.36 Type 1 diabetes mellitus with diabetic cataract from V24 HCC 18
  • E10.37X1 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye from V24 HCC 18
  • E10.37X2 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye from V24 HCC 18
  • E10.37X3 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral from V24 HCC 18
  • E10.37X9 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye from V24 HCC 18
  • E10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complication from V24 HCC 18
  • E10.40 Type 1 diabetes mellitus with diabetic neuropathy, unspecified from V24 HCC 18
  • E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy from V24 HCC 18
  • E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy from V24 HCC 18
  • E10.43 Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy from V24 HCC 18
  • E10.44 Type 1 diabetes mellitus with diabetic amyotrophy from V24 HCC 18
  • E10.49 Type 1 diabetes mellitus with other diabetic neurological complication from V24 HCC 18
  • E10.51 Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene from V24 HCC 18, HCC 108
  • E10.52 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene from V24 HCC 18, HCC 106
  • E10.59 Type 1 diabetes mellitus with other circulatory complications from V24 HCC 18
  • E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy from V24 HCC 18
  • E10.618 Type 1 diabetes mellitus with other diabetic arthropathy from V24 HCC 18
  • E10.620 Type 1 diabetes mellitus with diabetic dermatitis from V24 HCC 18
  • E10.621 Type 1 diabetes mellitus with foot ulcer from V24 HCC 18, HCC 161
  • E10.622 Type 1 diabetes mellitus with other skin ulcer from V24 HCC 18, HCC 161
  • E10.628 Type 1 diabetes mellitus with other skin complications from V24 HCC 18
  • E10.630 Type 1 diabetes mellitus with periodontal disease from V24 HCC 18
  • E10.638 Type 1 diabetes mellitus with other oral complications from V24 HCC 18
  • E10.69 Type 1 diabetes mellitus with other specified complication from V24 HCC 18
  • E11.21 Type 2 diabetes mellitus with diabetic nephropathy from V24 HCC 18
  • E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease from V24 HCC 18
  • E11.29 Type 2 diabetes mellitus with other diabetic kidney complication from V24 HCC 18
  • E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema from V24 HCC 18
  • E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without 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
  • E11.3291 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E11.3292 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E11.3293 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without 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
  • E11.3391 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E11.3392 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E11.3393 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without 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
  • E11.3491 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E11.3492 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E11.3493 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without 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
  • E11.36 Type 2 diabetes mellitus with diabetic cataract from V24 HCC 18
  • E11.37X1 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye from V24 HCC 18
  • E11.37X2 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye from V24 HCC 18
  • E11.37X3 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral from V24 HCC 18
  • E11.37X9 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye from V24 HCC 18
  • E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication from V24 HCC 18
  • E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified from V24 HCC 18
  • E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy from V24 HCC 18
  • E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy from V24 HCC 18
  • E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy from V24 HCC 18
  • E11.44 Type 2 diabetes mellitus with diabetic amyotrophy from V24 HCC 18
  • E11.49 Type 2 diabetes mellitus with other diabetic neurological complication from V24 HCC 18
  • E11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene from V24 HCC 18, HCC 108
  • E11.52 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene from V24 HCC 18, HCC 106
  • E11.59 Type 2 diabetes mellitus with other circulatory complications from V24 HCC 18
  • E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy from V24 HCC 18
  • E11.618 Type 2 diabetes mellitus with other diabetic arthropathy from V24 HCC 18
  • E11.620 Type 2 diabetes mellitus with diabetic dermatitis from V24 HCC 18
  • E11.621 Type 2 diabetes mellitus with foot ulcer from V24 HCC 18, HCC 161
  • E11.622 Type 2 diabetes mellitus with other skin ulcer from V24 HCC 18, HCC 161
  • E11.628 Type 2 diabetes mellitus with other skin complications from V24 HCC 18
  • E11.630 Type 2 diabetes mellitus with periodontal disease from V24 HCC 18
  • E11.638 Type 2 diabetes mellitus with other oral complications from V24 HCC 18
  • E11.69 Type 2 diabetes mellitus with other specified complication from V24 HCC 18
  • E13.21 Other specified diabetes mellitus with diabetic nephropathy from V24 HCC 18
  • E13.22 Other specified diabetes mellitus with diabetic chronic kidney disease from V24 HCC 18
  • E13.29 Other specified diabetes mellitus with other diabetic kidney complication from V24 HCC 18
  • E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema from V24 HCC 18
  • E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without 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
  • E13.3291 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E13.3292 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E13.3293 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E13.3299 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without 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
  • E13.3391 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E13.3392 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E13.3393 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E13.3399 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without 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
  • E13.3491 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye from V24 HCC 18
  • E13.3492 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye from V24 HCC 18
  • E13.3493 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral from V24 HCC 18
  • E13.3499 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without 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
  • E13.36 Other specified diabetes mellitus with diabetic cataract from V24 HCC 18
  • E13.37X1 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye from V24 HCC 18
  • E13.37X2 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye from V24 HCC 18
  • E13.37X3 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral from V24 HCC 18
  • E13.37X9 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye from V24 HCC 18
  • E13.39 Other specified diabetes mellitus with other diabetic ophthalmic complication from V24 HCC 18
  • E13.40 Other specified diabetes mellitus with diabetic neuropathy, unspecified from V24 HCC 18
  • E13.41 Other specified diabetes mellitus with diabetic mononeuropathy from V24 HCC 18
  • E13.42 Other specified diabetes mellitus with diabetic polyneuropathy from V24 HCC 18
  • E13.43 Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy from V24 HCC 18
  • E13.44 Other specified diabetes mellitus with diabetic amyotrophy from V24 HCC 18
  • E13.49 Other specified diabetes mellitus with other diabetic neurological complication from V24 HCC 18
  • E13.51 Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene from V24 HCC 18, HCC 108
  • E13.52 Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene from V24 HCC 18, HCC 106
  • E13.59 Other specified diabetes mellitus with other circulatory complications from V24 HCC 18
  • E13.610 Other specified diabetes mellitus with diabetic neuropathic arthropathy from V24 HCC 18
  • E13.618 Other specified diabetes mellitus with other diabetic arthropathy from V24 HCC 18
  • E13.620 Other specified diabetes mellitus with diabetic dermatitis from V24 HCC 18
  • E13.621 Other specified diabetes mellitus with foot ulcer from V24 HCC 18, HCC 161
  • E13.622 Other specified diabetes mellitus with other skin ulcer from V24 HCC 18, HCC 161
  • E13.628 Other specified diabetes mellitus with other skin complications from V24 HCC 18
  • E13.630 Other specified diabetes mellitus with periodontal disease from V24 HCC 18
  • E13.638 Other specified diabetes mellitus with other oral complications from V24 HCC 18
  • E13.69 Other specified diabetes mellitus with other specified complication from V24 HCC 18

Every code above carries the full HCC 37 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 37

What is HCC 37 in the CMS-HCC model?

HCC 37 is CMS-HCC Category 37 (Diabetes with Chronic Complications) in the V28 risk adjustment model. It covers 308 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 37?

For payment year 2026, HCC 37 adds 0.166 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.166 to 0.280 across the seven payment segments shown above.

Which categories supersede HCC 37?

HCC 35 (Pancreas Transplant Status) and HCC 36 (Diabetes with Severe Acute Complications) sit above HCC 37 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.

Related References

All HCC CategoriesHCC 35 CodesHCC 36 CodesHCC 38 CodesV24 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.