HCC 379: Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone ICD-10-CM
CMS-HCC Category 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 1.420 and 2.580 to a beneficiary's RAF score depending on the payment segment (1.965 for a community, non-dual, aged enrollee). 25 ICD-10-CM diagnosis codes map to HCC 379. 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 | 1.965 |
| Community, partial-benefit dual, aged | 2.349 |
| Community, full-benefit dual, aged | 2.580 |
| Community, non-dual, disabled | 2.140 |
| Community, partial-benefit dual, disabled | 2.349 |
| Community, full-benefit dual, disabled | 2.570 |
| Institutional | 1.420 |
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 379 in turn supersedes HCC 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle), HCC 381 (Pressure Ulcer of Skin with Full Thickness Skin Loss), HCC 382 (Pressure Ulcer of Skin with Partial Thickness Skin Loss), and HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle).
ICD-10-CM Codes That Map to HCC 379 25 codes
- L89.004 Pressure ulcer of unspecified elbow, stage 4 from V24 HCC 157
- L89.014 Pressure ulcer of right elbow, stage 4 from V24 HCC 157
- L89.024 Pressure ulcer of left elbow, stage 4 from V24 HCC 157
- L89.104 Pressure ulcer of unspecified part of back, stage 4 from V24 HCC 157
- L89.114 Pressure ulcer of right upper back, stage 4 from V24 HCC 157
- L89.124 Pressure ulcer of left upper back, stage 4 from V24 HCC 157
- L89.134 Pressure ulcer of right lower back, stage 4 from V24 HCC 157
- L89.144 Pressure ulcer of left lower back, stage 4 from V24 HCC 157
- L89.154 Pressure ulcer of sacral region, stage 4 from V24 HCC 157
- L89.204 Pressure ulcer of unspecified hip, stage 4 from V24 HCC 157
- L89.214 Pressure ulcer of right hip, stage 4 from V24 HCC 157
- L89.224 Pressure ulcer of left hip, stage 4 from V24 HCC 157
- L89.304 Pressure ulcer of unspecified buttock, stage 4 from V24 HCC 157
- L89.314 Pressure ulcer of right buttock, stage 4 from V24 HCC 157
- L89.324 Pressure ulcer of left buttock, stage 4 from V24 HCC 157
- L89.44 Pressure ulcer of contiguous site of back, buttock and hip, stage 4 from V24 HCC 157
- L89.504 Pressure ulcer of unspecified ankle, stage 4 from V24 HCC 157
- L89.514 Pressure ulcer of right ankle, stage 4 from V24 HCC 157
- L89.524 Pressure ulcer of left ankle, stage 4 from V24 HCC 157
- L89.604 Pressure ulcer of unspecified heel, stage 4 from V24 HCC 157
- L89.614 Pressure ulcer of right heel, stage 4 from V24 HCC 157
- L89.624 Pressure ulcer of left heel, stage 4 from V24 HCC 157
- L89.814 Pressure ulcer of head, stage 4 from V24 HCC 157
- L89.894 Pressure ulcer of other site, stage 4 from V24 HCC 157
- L89.94 Pressure ulcer of unspecified site, stage 4 from V24 HCC 157
Every code above carries the full HCC 379 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 379
What is HCC 379 in the CMS-HCC model?
HCC 379 is CMS-HCC Category 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) in the V28 risk adjustment model. It covers 25 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 379?
For payment year 2026, HCC 379 adds 1.965 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 1.420 to 2.580 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.
