CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 152 Codes

HCC 380: Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle ICD-10-CM

CMS-HCC Category 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.839 and 1.422 to a beneficiary's RAF score depending on the payment segment (1.078 for a community, non-dual, aged enrollee). 152 ICD-10-CM diagnosis codes map to HCC 380. A more severe related category (HCC 379) 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
+1.078
RAF, Community Non-Dual Aged
152
ICD-10-CM Codes
HCC 379
Superseded By
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged1.078
Community, partial-benefit dual, aged1.268
Community, full-benefit dual, aged1.422
Community, non-dual, disabled1.091
Community, partial-benefit dual, disabled1.378
Community, full-benefit dual, disabled1.285
Institutional0.839

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 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) supersedes HCC 380 when reported together. HCC 380 in turn supersedes 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

ICD-10-CM Codes That Map to HCC 380 152 codes

152 of 152 shown
  • L97.103 Non-pressure chronic ulcer of unspecified thigh with necrosis of muscle from V24 HCC 161
  • L97.104 Non-pressure chronic ulcer of unspecified thigh with necrosis of bone from V24 HCC 161
  • L97.105 Non-pressure chronic ulcer of unspecified thigh with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.106 Non-pressure chronic ulcer of unspecified thigh with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.113 Non-pressure chronic ulcer of right thigh with necrosis of muscle from V24 HCC 161
  • L97.114 Non-pressure chronic ulcer of right thigh with necrosis of bone from V24 HCC 161
  • L97.115 Non-pressure chronic ulcer of right thigh with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.116 Non-pressure chronic ulcer of right thigh with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.123 Non-pressure chronic ulcer of left thigh with necrosis of muscle from V24 HCC 161
  • L97.124 Non-pressure chronic ulcer of left thigh with necrosis of bone from V24 HCC 161
  • L97.125 Non-pressure chronic ulcer of left thigh with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.126 Non-pressure chronic ulcer of left thigh with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.203 Non-pressure chronic ulcer of unspecified calf with necrosis of muscle from V24 HCC 161
  • L97.204 Non-pressure chronic ulcer of unspecified calf with necrosis of bone from V24 HCC 161
  • L97.205 Non-pressure chronic ulcer of unspecified calf with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.206 Non-pressure chronic ulcer of unspecified calf with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.213 Non-pressure chronic ulcer of right calf with necrosis of muscle from V24 HCC 161
  • L97.214 Non-pressure chronic ulcer of right calf with necrosis of bone from V24 HCC 161
  • L97.215 Non-pressure chronic ulcer of right calf with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.216 Non-pressure chronic ulcer of right calf with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.223 Non-pressure chronic ulcer of left calf with necrosis of muscle from V24 HCC 161
  • L97.224 Non-pressure chronic ulcer of left calf with necrosis of bone from V24 HCC 161
  • L97.225 Non-pressure chronic ulcer of left calf with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.226 Non-pressure chronic ulcer of left calf with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.303 Non-pressure chronic ulcer of unspecified ankle with necrosis of muscle from V24 HCC 161
  • L97.304 Non-pressure chronic ulcer of unspecified ankle with necrosis of bone from V24 HCC 161
  • L97.305 Non-pressure chronic ulcer of unspecified ankle with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.306 Non-pressure chronic ulcer of unspecified ankle with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.313 Non-pressure chronic ulcer of right ankle with necrosis of muscle from V24 HCC 161
  • L97.314 Non-pressure chronic ulcer of right ankle with necrosis of bone from V24 HCC 161
  • L97.315 Non-pressure chronic ulcer of right ankle with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.316 Non-pressure chronic ulcer of right ankle with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.323 Non-pressure chronic ulcer of left ankle with necrosis of muscle from V24 HCC 161
  • L97.324 Non-pressure chronic ulcer of left ankle with necrosis of bone from V24 HCC 161
  • L97.325 Non-pressure chronic ulcer of left ankle with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.326 Non-pressure chronic ulcer of left ankle with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.403 Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of muscle from V24 HCC 161
  • L97.404 Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of bone from V24 HCC 161
  • L97.405 Non-pressure chronic ulcer of unspecified heel and midfoot with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.406 Non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.413 Non-pressure chronic ulcer of right heel and midfoot with necrosis of muscle from V24 HCC 161
  • L97.414 Non-pressure chronic ulcer of right heel and midfoot with necrosis of bone from V24 HCC 161
  • L97.415 Non-pressure chronic ulcer of right heel and midfoot with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.416 Non-pressure chronic ulcer of right heel and midfoot with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.423 Non-pressure chronic ulcer of left heel and midfoot with necrosis of muscle from V24 HCC 161
  • L97.424 Non-pressure chronic ulcer of left heel and midfoot with necrosis of bone from V24 HCC 161
  • L97.425 Non-pressure chronic ulcer of left heel and midfoot with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.426 Non-pressure chronic ulcer of left heel and midfoot with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.503 Non-pressure chronic ulcer of other part of unspecified foot with necrosis of muscle from V24 HCC 161
  • L97.504 Non-pressure chronic ulcer of other part of unspecified foot with necrosis of bone from V24 HCC 161
  • L97.505 Non-pressure chronic ulcer of other part of unspecified foot with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.506 Non-pressure chronic ulcer of other part of unspecified foot with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.513 Non-pressure chronic ulcer of other part of right foot with necrosis of muscle from V24 HCC 161
  • L97.514 Non-pressure chronic ulcer of other part of right foot with necrosis of bone from V24 HCC 161
  • L97.515 Non-pressure chronic ulcer of other part of right foot with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.516 Non-pressure chronic ulcer of other part of right foot with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.523 Non-pressure chronic ulcer of other part of left foot with necrosis of muscle from V24 HCC 161
  • L97.524 Non-pressure chronic ulcer of other part of left foot with necrosis of bone from V24 HCC 161
  • L97.525 Non-pressure chronic ulcer of other part of left foot with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.526 Non-pressure chronic ulcer of other part of left foot with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.803 Non-pressure chronic ulcer of other part of unspecified lower leg with necrosis of muscle from V24 HCC 161
  • L97.804 Non-pressure chronic ulcer of other part of unspecified lower leg with necrosis of bone from V24 HCC 161
  • L97.805 Non-pressure chronic ulcer of other part of unspecified lower leg with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.806 Non-pressure chronic ulcer of other part of unspecified lower leg with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.813 Non-pressure chronic ulcer of other part of right lower leg with necrosis of muscle from V24 HCC 161
  • L97.814 Non-pressure chronic ulcer of other part of right lower leg with necrosis of bone from V24 HCC 161
  • L97.815 Non-pressure chronic ulcer of other part of right lower leg with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.816 Non-pressure chronic ulcer of other part of right lower leg with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.823 Non-pressure chronic ulcer of other part of left lower leg with necrosis of muscle from V24 HCC 161
  • L97.824 Non-pressure chronic ulcer of other part of left lower leg with necrosis of bone from V24 HCC 161
  • L97.825 Non-pressure chronic ulcer of other part of left lower leg with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.826 Non-pressure chronic ulcer of other part of left lower leg with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.903 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of muscle from V24 HCC 161
  • L97.904 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of bone from V24 HCC 161
  • L97.905 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.906 Non-pressure chronic ulcer of unspecified part of unspecified lower leg with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.913 Non-pressure chronic ulcer of unspecified part of right lower leg with necrosis of muscle from V24 HCC 161
  • L97.914 Non-pressure chronic ulcer of unspecified part of right lower leg with necrosis of bone from V24 HCC 161
  • L97.915 Non-pressure chronic ulcer of unspecified part of right lower leg with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.916 Non-pressure chronic ulcer of unspecified part of right lower leg with bone involvement without evidence of necrosis from V24 HCC 161
  • L97.923 Non-pressure chronic ulcer of unspecified part of left lower leg with necrosis of muscle from V24 HCC 161
  • L97.924 Non-pressure chronic ulcer of unspecified part of left lower leg with necrosis of bone from V24 HCC 161
  • L97.925 Non-pressure chronic ulcer of unspecified part of left lower leg with muscle involvement without evidence of necrosis from V24 HCC 161
  • L97.926 Non-pressure chronic ulcer of unspecified part of left lower leg with bone involvement without evidence of necrosis from V24 HCC 161
  • L98.413 Non-pressure chronic ulcer of buttock with necrosis of muscle from V24 HCC 161
  • L98.414 Non-pressure chronic ulcer of buttock with necrosis of bone from V24 HCC 161
  • L98.415 Non-pressure chronic ulcer of buttock with muscle involvement without evidence of necrosis from V24 HCC 161
  • L98.416 Non-pressure chronic ulcer of buttock with bone involvement without evidence of necrosis from V24 HCC 161
  • L98.423 Non-pressure chronic ulcer of back with necrosis of muscle from V24 HCC 161
  • L98.424 Non-pressure chronic ulcer of back with necrosis of bone from V24 HCC 161
  • L98.425 Non-pressure chronic ulcer of back with muscle involvement without evidence of necrosis from V24 HCC 161
  • L98.426 Non-pressure chronic ulcer of back with bone involvement without evidence of necrosis from V24 HCC 161
  • L98.433 Non-pressure chronic ulcer of abdomen with necrosis of muscle new to V28
  • L98.434 Non-pressure chronic ulcer of abdomen with necrosis of bone new to V28
  • L98.435 Non-pressure chronic ulcer of abdomen with muscle involvement without evidence of necrosis new to V28
  • L98.436 Non-pressure chronic ulcer of abdomen with bone involvement without evidence of necrosis new to V28
  • L98.443 Non-pressure chronic ulcer of chest with necrosis of muscle new to V28
  • L98.444 Non-pressure chronic ulcer of chest with necrosis of bone new to V28
  • L98.445 Non-pressure chronic ulcer of chest with muscle involvement without evidence of necrosis new to V28
  • L98.446 Non-pressure chronic ulcer of chest with bone involvement without evidence of necrosis new to V28
  • L98.453 Non-pressure chronic ulcer of neck with necrosis of muscle new to V28
  • L98.454 Non-pressure chronic ulcer of neck with necrosis of bone new to V28
  • L98.455 Non-pressure chronic ulcer of neck with muscle involvement without evidence of necrosis new to V28
  • L98.456 Non-pressure chronic ulcer of neck with bone involvement without evidence of necrosis new to V28
  • L98.463 Non-pressure chronic ulcer of face with necrosis of muscle new to V28
  • L98.464 Non-pressure chronic ulcer of face with necrosis of bone new to V28
  • L98.465 Non-pressure chronic ulcer of face with muscle involvement without evidence of necrosis new to V28
  • L98.466 Non-pressure chronic ulcer of face with bone involvement without evidence of necrosis new to V28
  • L98.473 Non-pressure chronic ulcer of groin with necrosis of muscle new to V28
  • L98.474 Non-pressure chronic ulcer of groin with necrosis of bone new to V28
  • L98.475 Non-pressure chronic ulcer of groin with muscle involvement without evidence of necrosis new to V28
  • L98.476 Non-pressure chronic ulcer of groin with bone involvement without evidence of necrosis new to V28
  • L98.493 Non-pressure chronic ulcer of skin of other sites with necrosis of muscle from V24 HCC 161
  • L98.494 Non-pressure chronic ulcer of skin of other sites with necrosis of bone from V24 HCC 161
  • L98.495 Non-pressure chronic ulcer of skin of other sites with muscle involvement without evidence of necrosis from V24 HCC 161
  • L98.496 Non-pressure chronic ulcer of skin of other sites with bone involvement without evidence of necrosis from V24 HCC 161
  • L98.A113 Non-pressure chronic ulcer of right upper arm with necrosis of muscle new to V28
  • L98.A114 Non-pressure chronic ulcer of right upper arm with necrosis of bone new to V28
  • L98.A115 Non-pressure chronic ulcer of right upper arm with muscle involvement without evidence of necrosis new to V28
  • L98.A116 Non-pressure chronic ulcer of right upper arm with bone involvement without evidence of necrosis new to V28
  • L98.A123 Non-pressure chronic ulcer of left upper arm with necrosis of muscle new to V28
  • L98.A124 Non-pressure chronic ulcer of left upper arm with necrosis of bone new to V28
  • L98.A125 Non-pressure chronic ulcer of left upper arm with muscle involvement without evidence of necrosis new to V28
  • L98.A126 Non-pressure chronic ulcer of left upper arm with bone involvement without evidence of necrosis new to V28
  • L98.A193 Non-pressure chronic ulcer of unspecified upper arm with necrosis of muscle new to V28
  • L98.A194 Non-pressure chronic ulcer of unspecified upper arm with necrosis of bone new to V28
  • L98.A195 Non-pressure chronic ulcer of unspecified upper arm with muscle involvement without evidence of necrosis new to V28
  • L98.A196 Non-pressure chronic ulcer of unspecified upper arm with bone involvement without evidence of necrosis new to V28
  • L98.A213 Non-pressure chronic ulcer of right forearm with necrosis of muscle new to V28
  • L98.A214 Non-pressure chronic ulcer of right forearm with necrosis of bone new to V28
  • L98.A215 Non-pressure chronic ulcer of right forearm with muscle involvement without evidence of necrosis new to V28
  • L98.A216 Non-pressure chronic ulcer of right forearm with bone involvement without evidence of necrosis new to V28
  • L98.A223 Non-pressure chronic ulcer of left forearm with necrosis of muscle new to V28
  • L98.A224 Non-pressure chronic ulcer of left forearm with necrosis of bone new to V28
  • L98.A225 Non-pressure chronic ulcer of left forearm with muscle involvement without evidence of necrosis new to V28
  • L98.A226 Non-pressure chronic ulcer of left forearm with bone involvement without evidence of necrosis new to V28
  • L98.A293 Non-pressure chronic ulcer of unspecified forearm with necrosis of muscle new to V28
  • L98.A294 Non-pressure chronic ulcer of unspecified forearm with necrosis of bone new to V28
  • L98.A295 Non-pressure chronic ulcer of unspecified forearm with muscle involvement without evidence of necrosis new to V28
  • L98.A296 Non-pressure chronic ulcer of unspecified forearm with bone involvement without evidence of necrosis new to V28
  • L98.A313 Non-pressure chronic ulcer of right hand with necrosis of muscle new to V28
  • L98.A314 Non-pressure chronic ulcer of right hand with necrosis of bone new to V28
  • L98.A315 Non-pressure chronic ulcer of right hand with muscle involvement without evidence of necrosis new to V28
  • L98.A316 Non-pressure chronic ulcer of right hand with bone involvement without evidence of necrosis new to V28
  • L98.A323 Non-pressure chronic ulcer of left hand with necrosis of muscle new to V28
  • L98.A324 Non-pressure chronic ulcer of left hand with necrosis of bone new to V28
  • L98.A325 Non-pressure chronic ulcer of left hand with muscle involvement without evidence of necrosis new to V28
  • L98.A326 Non-pressure chronic ulcer of left hand with bone involvement without evidence of necrosis new to V28
  • L98.A393 Non-pressure chronic ulcer of unspecified hand with necrosis of muscle new to V28
  • L98.A394 Non-pressure chronic ulcer of unspecified hand with necrosis of bone new to V28
  • L98.A395 Non-pressure chronic ulcer of unspecified hand with muscle involvement without evidence of necrosis new to V28
  • L98.A396 Non-pressure chronic ulcer of unspecified hand with bone involvement without evidence of necrosis new to V28

Every code above carries the full HCC 380 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 380

What is HCC 380 in the CMS-HCC model?

HCC 380 is CMS-HCC Category 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle) in the V28 risk adjustment model. It covers 152 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 380?

For payment year 2026, HCC 380 adds 1.078 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.839 to 1.422 across the seven payment segments shown above.

Which categories supersede HCC 380?

HCC 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) sits above HCC 380 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.

Related References

All HCC CategoriesHCC 379 CodesHCC 381 CodesHCC 382 CodesHCC 383 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.