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 HCC 385 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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 (living at home, age 65 or over, not also enrolled in Medicaid). 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.