CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 90 Codes

HCC 385: Severe Skin Burn or Condition ICD-10-CM

CMS-HCC Category 385 (Severe Skin Burn or Condition) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.000 and 2.362 to a beneficiary's RAF score depending on the payment segment (1.291 for a community, non-dual, aged enrollee). 90 ICD-10-CM diagnosis codes map to HCC 385. It sits at the top of its hierarchy: no other condition category supersedes it.

✓ Built from the official CMS PY 2026 risk adjustment filesV28 pays 100% of MA risk scores from PY 2026
+1.291
RAF, Community Non-Dual Aged
90
ICD-10-CM Codes
Top
Of Its Hierarchy
PY 2026
Dataset
CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment SegmentRelative Factor
Community, non-dual, aged1.291
Community, partial-benefit dual, aged0.000
Community, full-benefit dual, aged2.362
Community, non-dual, disabled0.234
Community, partial-benefit dual, disabled0.204
Community, full-benefit dual, disabled0.857
Institutional0.000

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 HCC 385 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.

ICD-10-CM

ICD-10-CM Codes That Map to HCC 385 90 codes

90 of 90 shown
  • T31.11 Burns involving 10-19% of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.21 Burns involving 20-29% of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.22 Burns involving 20-29% of body surface with 20-29% third degree burns from V24 HCC 162
  • T31.31 Burns involving 30-39% of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.32 Burns involving 30-39% of body surface with 20-29% third degree burns from V24 HCC 162
  • T31.33 Burns involving 30-39% of body surface with 30-39% third degree burns from V24 HCC 162
  • T31.41 Burns involving 40-49% of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.42 Burns involving 40-49% of body surface with 20-29% third degree burns from V24 HCC 162
  • T31.43 Burns involving 40-49% of body surface with 30-39% third degree burns from V24 HCC 162
  • T31.44 Burns involving 40-49% of body surface with 40-49% third degree burns from V24 HCC 162
  • T31.51 Burns involving 50-59% of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.52 Burns involving 50-59% of body surface with 20-29% third degree burns from V24 HCC 162
  • T31.53 Burns involving 50-59% of body surface with 30-39% third degree burns from V24 HCC 162
  • T31.54 Burns involving 50-59% of body surface with 40-49% third degree burns from V24 HCC 162
  • T31.55 Burns involving 50-59% of body surface with 50-59% third degree burns from V24 HCC 162
  • T31.61 Burns involving 60-69% of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.62 Burns involving 60-69% of body surface with 20-29% third degree burns from V24 HCC 162
  • T31.63 Burns involving 60-69% of body surface with 30-39% third degree burns from V24 HCC 162
  • T31.64 Burns involving 60-69% of body surface with 40-49% third degree burns from V24 HCC 162
  • T31.65 Burns involving 60-69% of body surface with 50-59% third degree burns from V24 HCC 162
  • T31.66 Burns involving 60-69% of body surface with 60-69% third degree burns from V24 HCC 162
  • T31.71 Burns involving 70-79% of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.72 Burns involving 70-79% of body surface with 20-29% third degree burns from V24 HCC 162
  • T31.73 Burns involving 70-79% of body surface with 30-39% third degree burns from V24 HCC 162
  • T31.74 Burns involving 70-79% of body surface with 40-49% third degree burns from V24 HCC 162
  • T31.75 Burns involving 70-79% of body surface with 50-59% third degree burns from V24 HCC 162
  • T31.76 Burns involving 70-79% of body surface with 60-69% third degree burns from V24 HCC 162
  • T31.77 Burns involving 70-79% of body surface with 70-79% third degree burns from V24 HCC 162
  • T31.81 Burns involving 80-89% of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.82 Burns involving 80-89% of body surface with 20-29% third degree burns from V24 HCC 162
  • T31.83 Burns involving 80-89% of body surface with 30-39% third degree burns from V24 HCC 162
  • T31.84 Burns involving 80-89% of body surface with 40-49% third degree burns from V24 HCC 162
  • T31.85 Burns involving 80-89% of body surface with 50-59% third degree burns from V24 HCC 162
  • T31.86 Burns involving 80-89% of body surface with 60-69% third degree burns from V24 HCC 162
  • T31.87 Burns involving 80-89% of body surface with 70-79% third degree burns from V24 HCC 162
  • T31.88 Burns involving 80-89% of body surface with 80-89% third degree burns from V24 HCC 162
  • T31.91 Burns involving 90% or more of body surface with 10-19% third degree burns from V24 HCC 162
  • T31.92 Burns involving 90% or more of body surface with 20-29% third degree burns from V24 HCC 162
  • T31.93 Burns involving 90% or more of body surface with 30-39% third degree burns from V24 HCC 162
  • T31.94 Burns involving 90% or more of body surface with 40-49% third degree burns from V24 HCC 162
  • T31.95 Burns involving 90% or more of body surface with 50-59% third degree burns from V24 HCC 162
  • T31.96 Burns involving 90% or more of body surface with 60-69% third degree burns from V24 HCC 162
  • T31.97 Burns involving 90% or more of body surface with 70-79% third degree burns from V24 HCC 162
  • T31.98 Burns involving 90% or more of body surface with 80-89% third degree burns from V24 HCC 162
  • T31.99 Burns involving 90% or more of body surface with 90% or more third degree burns from V24 HCC 162
  • T32.11 Corrosions involving 10-19% of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.21 Corrosions involving 20-29% of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.22 Corrosions involving 20-29% of body surface with 20-29% third degree corrosion from V24 HCC 162
  • T32.31 Corrosions involving 30-39% of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.32 Corrosions involving 30-39% of body surface with 20-29% third degree corrosion from V24 HCC 162
  • T32.33 Corrosions involving 30-39% of body surface with 30-39% third degree corrosion from V24 HCC 162
  • T32.41 Corrosions involving 40-49% of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.42 Corrosions involving 40-49% of body surface with 20-29% third degree corrosion from V24 HCC 162
  • T32.43 Corrosions involving 40-49% of body surface with 30-39% third degree corrosion from V24 HCC 162
  • T32.44 Corrosions involving 40-49% of body surface with 40-49% third degree corrosion from V24 HCC 162
  • T32.51 Corrosions involving 50-59% of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.52 Corrosions involving 50-59% of body surface with 20-29% third degree corrosion from V24 HCC 162
  • T32.53 Corrosions involving 50-59% of body surface with 30-39% third degree corrosion from V24 HCC 162
  • T32.54 Corrosions involving 50-59% of body surface with 40-49% third degree corrosion from V24 HCC 162
  • T32.55 Corrosions involving 50-59% of body surface with 50-59% third degree corrosion from V24 HCC 162
  • T32.61 Corrosions involving 60-69% of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.62 Corrosions involving 60-69% of body surface with 20-29% third degree corrosion from V24 HCC 162
  • T32.63 Corrosions involving 60-69% of body surface with 30-39% third degree corrosion from V24 HCC 162
  • T32.64 Corrosions involving 60-69% of body surface with 40-49% third degree corrosion from V24 HCC 162
  • T32.65 Corrosions involving 60-69% of body surface with 50-59% third degree corrosion from V24 HCC 162
  • T32.66 Corrosions involving 60-69% of body surface with 60-69% third degree corrosion from V24 HCC 162
  • T32.71 Corrosions involving 70-79% of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.72 Corrosions involving 70-79% of body surface with 20-29% third degree corrosion from V24 HCC 162
  • T32.73 Corrosions involving 70-79% of body surface with 30-39% third degree corrosion from V24 HCC 162
  • T32.74 Corrosions involving 70-79% of body surface with 40-49% third degree corrosion from V24 HCC 162
  • T32.75 Corrosions involving 70-79% of body surface with 50-59% third degree corrosion from V24 HCC 162
  • T32.76 Corrosions involving 70-79% of body surface with 60-69% third degree corrosion from V24 HCC 162
  • T32.77 Corrosions involving 70-79% of body surface with 70-79% third degree corrosion from V24 HCC 162
  • T32.81 Corrosions involving 80-89% of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.82 Corrosions involving 80-89% of body surface with 20-29% third degree corrosion from V24 HCC 162
  • T32.83 Corrosions involving 80-89% of body surface with 30-39% third degree corrosion from V24 HCC 162
  • T32.84 Corrosions involving 80-89% of body surface with 40-49% third degree corrosion from V24 HCC 162
  • T32.85 Corrosions involving 80-89% of body surface with 50-59% third degree corrosion from V24 HCC 162
  • T32.86 Corrosions involving 80-89% of body surface with 60-69% third degree corrosion from V24 HCC 162
  • T32.87 Corrosions involving 80-89% of body surface with 70-79% third degree corrosion from V24 HCC 162
  • T32.88 Corrosions involving 80-89% of body surface with 80-89% third degree corrosion from V24 HCC 162
  • T32.91 Corrosions involving 90% or more of body surface with 10-19% third degree corrosion from V24 HCC 162
  • T32.92 Corrosions involving 90% or more of body surface with 20-29% third degree corrosion from V24 HCC 162
  • T32.93 Corrosions involving 90% or more of body surface with 30-39% third degree corrosion from V24 HCC 162
  • T32.94 Corrosions involving 90% or more of body surface with 40-49% third degree corrosion from V24 HCC 162
  • T32.95 Corrosions involving 90% or more of body surface with 50-59% third degree corrosion from V24 HCC 162
  • T32.96 Corrosions involving 90% or more of body surface with 60-69% third degree corrosion from V24 HCC 162
  • T32.97 Corrosions involving 90% or more of body surface with 70-79% third degree corrosion from V24 HCC 162
  • T32.98 Corrosions involving 90% or more of body surface with 80-89% third degree corrosion from V24 HCC 162
  • T32.99 Corrosions involving 90% or more of body surface with 90% or more third degree corrosion from V24 HCC 162

Every code above carries the full HCC 385 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 385

What is HCC 385 in the CMS-HCC model?

HCC 385 is CMS-HCC Category 385 (Severe Skin Burn or Condition) in the V28 risk adjustment model. It covers 90 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 385?

For payment year 2026, HCC 385 adds 1.291 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.000 to 2.362 across the seven payment segments shown above.

Related References

All HCC CategoriesV24 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.