CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 339 Codes

HCC 401: Vertebral Fractures without Spinal Cord Injury ICD-10-CM

CMS-HCC Category 401 (Vertebral Fractures without Spinal Cord Injury) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.231 and 0.622 to a beneficiary's RAF score depending on the payment segment (0.522 for a community, non-dual, aged enrollee). 339 ICD-10-CM diagnosis codes map to HCC 401. 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
+0.522
RAF, Community Non-Dual Aged
339
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, aged0.522
Community, partial-benefit dual, aged0.538
Community, full-benefit dual, aged0.622
Community, non-dual, disabled0.605
Community, partial-benefit dual, disabled0.412
Community, full-benefit dual, disabled0.559
Institutional0.231

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 HCC 401 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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 401 339 codes

339 of 339 shown
  • M48.50XA Collapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture from V24 HCC 169
  • M48.51XA Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, initial encounter for fracture from V24 HCC 169
  • M48.52XA Collapsed vertebra, not elsewhere classified, cervical region, initial encounter for fracture from V24 HCC 169
  • M48.53XA Collapsed vertebra, not elsewhere classified, cervicothoracic region, initial encounter for fracture from V24 HCC 169
  • M48.54XA Collapsed vertebra, not elsewhere classified, thoracic region, initial encounter for fracture from V24 HCC 169
  • M48.55XA Collapsed vertebra, not elsewhere classified, thoracolumbar region, initial encounter for fracture from V24 HCC 169
  • M48.56XA Collapsed vertebra, not elsewhere classified, lumbar region, initial encounter for fracture from V24 HCC 169
  • M48.57XA Collapsed vertebra, not elsewhere classified, lumbosacral region, initial encounter for fracture from V24 HCC 169
  • M48.58XA Collapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture from V24 HCC 169
  • M80.08XA Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture from V24 HCC 169
  • M80.88XA Other osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture from V24 HCC 169
  • S12.000A Unspecified displaced fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.000B Unspecified displaced fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.001A Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.001B Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.01XA Stable burst fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.01XB Stable burst fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.02XA Unstable burst fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.02XB Unstable burst fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.030A Displaced posterior arch fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.030B Displaced posterior arch fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.031A Nondisplaced posterior arch fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.031B Nondisplaced posterior arch fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.040A Displaced lateral mass fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.040B Displaced lateral mass fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.041A Nondisplaced lateral mass fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.041B Nondisplaced lateral mass fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.090A Other displaced fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.090B Other displaced fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.091A Other nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.091B Other nondisplaced fracture of first cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.100A Unspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.100B Unspecified displaced fracture of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.101A Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.101B Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.110A Anterior displaced Type II dens fracture, initial encounter for closed fracture from V24 HCC 169
  • S12.110B Anterior displaced Type II dens fracture, initial encounter for open fracture from V24 HCC 169
  • S12.111A Posterior displaced Type II dens fracture, initial encounter for closed fracture from V24 HCC 169
  • S12.111B Posterior displaced Type II dens fracture, initial encounter for open fracture from V24 HCC 169
  • S12.112A Nondisplaced Type II dens fracture, initial encounter for closed fracture from V24 HCC 169
  • S12.112B Nondisplaced Type II dens fracture, initial encounter for open fracture from V24 HCC 169
  • S12.120A Other displaced dens fracture, initial encounter for closed fracture from V24 HCC 169
  • S12.120B Other displaced dens fracture, initial encounter for open fracture from V24 HCC 169
  • S12.121A Other nondisplaced dens fracture, initial encounter for closed fracture from V24 HCC 169
  • S12.121B Other nondisplaced dens fracture, initial encounter for open fracture from V24 HCC 169
  • S12.130A Unspecified traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.130B Unspecified traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.131A Unspecified traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.131B Unspecified traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.14XA Type III traumatic spondylolisthesis of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.14XB Type III traumatic spondylolisthesis of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.150A Other traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.150B Other traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.151A Other traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.151B Other traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.190A Other displaced fracture of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.190B Other displaced fracture of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.191A Other nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.191B Other nondisplaced fracture of second cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.200A Unspecified displaced fracture of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.200B Unspecified displaced fracture of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.201A Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.201B Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.230A Unspecified traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.230B Unspecified traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.231A Unspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.231B Unspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.24XA Type III traumatic spondylolisthesis of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.24XB Type III traumatic spondylolisthesis of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.250A Other traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.250B Other traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.251A Other traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.251B Other traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.290A Other displaced fracture of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.290B Other displaced fracture of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.291A Other nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.291B Other nondisplaced fracture of third cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.300A Unspecified displaced fracture of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.300B Unspecified displaced fracture of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.301A Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.301B Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.330A Unspecified traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.330B Unspecified traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.331A Unspecified traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.331B Unspecified traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.34XA Type III traumatic spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.34XB Type III traumatic spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.350A Other traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.350B Other traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.351A Other traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.351B Other traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.390A Other displaced fracture of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.390B Other displaced fracture of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.391A Other nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.391B Other nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.400A Unspecified displaced fracture of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.400B Unspecified displaced fracture of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.401A Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.401B Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.430A Unspecified traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.430B Unspecified traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.431A Unspecified traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.431B Unspecified traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.44XA Type III traumatic spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.44XB Type III traumatic spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.450A Other traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.450B Other traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.451A Other traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.451B Other traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.490A Other displaced fracture of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.490B Other displaced fracture of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.491A Other nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.491B Other nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.500A Unspecified displaced fracture of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.500B Unspecified displaced fracture of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.501A Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.501B Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.530A Unspecified traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.530B Unspecified traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.531A Unspecified traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.531B Unspecified traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.54XA Type III traumatic spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.54XB Type III traumatic spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.550A Other traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.550B Other traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.551A Other traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.551B Other traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.590A Other displaced fracture of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.590B Other displaced fracture of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.591A Other nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.591B Other nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.600A Unspecified displaced fracture of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.600B Unspecified displaced fracture of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.601A Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.601B Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.630A Unspecified traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.630B Unspecified traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.631A Unspecified traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.631B Unspecified traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.64XA Type III traumatic spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.64XB Type III traumatic spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.650A Other traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.650B Other traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.651A Other traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.651B Other traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.690A Other displaced fracture of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.690B Other displaced fracture of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.691A Other nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture from V24 HCC 169
  • S12.691B Other nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture from V24 HCC 169
  • S12.8XXA Fracture of other parts of neck, initial encounter from V24 HCC 169
  • S12.9XXA Fracture of neck, unspecified, initial encounter from V24 HCC 169
  • S22.000A Wedge compression fracture of unspecified thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.000B Wedge compression fracture of unspecified thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.001A Stable burst fracture of unspecified thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.001B Stable burst fracture of unspecified thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.002A Unstable burst fracture of unspecified thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.002B Unstable burst fracture of unspecified thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.008A Other fracture of unspecified thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.008B Other fracture of unspecified thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.009A Unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.009B Unspecified fracture of unspecified thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.010A Wedge compression fracture of first thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.010B Wedge compression fracture of first thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.011A Stable burst fracture of first thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.011B Stable burst fracture of first thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.012A Unstable burst fracture of first thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.012B Unstable burst fracture of first thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.018A Other fracture of first thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.018B Other fracture of first thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.019A Unspecified fracture of first thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.019B Unspecified fracture of first thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.020A Wedge compression fracture of second thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.020B Wedge compression fracture of second thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.021A Stable burst fracture of second thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.021B Stable burst fracture of second thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.022A Unstable burst fracture of second thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.022B Unstable burst fracture of second thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.028A Other fracture of second thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.028B Other fracture of second thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.029A Unspecified fracture of second thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.029B Unspecified fracture of second thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.030A Wedge compression fracture of third thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.030B Wedge compression fracture of third thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.031A Stable burst fracture of third thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.031B Stable burst fracture of third thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.032A Unstable burst fracture of third thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.032B Unstable burst fracture of third thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.038A Other fracture of third thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.038B Other fracture of third thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.039A Unspecified fracture of third thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.039B Unspecified fracture of third thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.040A Wedge compression fracture of fourth thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.040B Wedge compression fracture of fourth thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.041A Stable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.041B Stable burst fracture of fourth thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.042A Unstable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.042B Unstable burst fracture of fourth thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.048A Other fracture of fourth thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.048B Other fracture of fourth thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.049A Unspecified fracture of fourth thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.049B Unspecified fracture of fourth thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.050A Wedge compression fracture of T5-T6 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.050B Wedge compression fracture of T5-T6 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.051A Stable burst fracture of T5-T6 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.051B Stable burst fracture of T5-T6 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.052A Unstable burst fracture of T5-T6 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.052B Unstable burst fracture of T5-T6 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.058A Other fracture of T5-T6 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.058B Other fracture of T5-T6 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.059A Unspecified fracture of T5-T6 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.059B Unspecified fracture of T5-T6 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.060A Wedge compression fracture of T7-T8 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.060B Wedge compression fracture of T7-T8 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.061A Stable burst fracture of T7-T8 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.061B Stable burst fracture of T7-T8 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.062A Unstable burst fracture of T7-T8 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.062B Unstable burst fracture of T7-T8 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.068A Other fracture of T7-T8 thoracic vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.068B Other fracture of T7-T8 thoracic vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.069A Unspecified fracture of T7-T8 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.069B Unspecified fracture of T7-T8 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.070A Wedge compression fracture of T9-T10 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.070B Wedge compression fracture of T9-T10 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.071A Stable burst fracture of T9-T10 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.071B Stable burst fracture of T9-T10 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.072A Unstable burst fracture of T9-T10 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.072B Unstable burst fracture of T9-T10 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.078A Other fracture of T9-T10 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.078B Other fracture of T9-T10 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.079A Unspecified fracture of T9-T10 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.079B Unspecified fracture of T9-T10 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.080A Wedge compression fracture of T11-T12 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.080B Wedge compression fracture of T11-T12 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.081A Stable burst fracture of T11-T12 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.081B Stable burst fracture of T11-T12 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.082A Unstable burst fracture of T11-T12 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.082B Unstable burst fracture of T11-T12 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.088A Other fracture of T11-T12 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.088B Other fracture of T11-T12 vertebra, initial encounter for open fracture from V24 HCC 169
  • S22.089A Unspecified fracture of T11-T12 vertebra, initial encounter for closed fracture from V24 HCC 169
  • S22.089B Unspecified fracture of T11-T12 vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.000A Wedge compression fracture of unspecified lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.000B Wedge compression fracture of unspecified lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.001A Stable burst fracture of unspecified lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.001B Stable burst fracture of unspecified lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.002A Unstable burst fracture of unspecified lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.002B Unstable burst fracture of unspecified lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.008A Other fracture of unspecified lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.008B Other fracture of unspecified lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.009A Unspecified fracture of unspecified lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.009B Unspecified fracture of unspecified lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.010A Wedge compression fracture of first lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.010B Wedge compression fracture of first lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.011A Stable burst fracture of first lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.011B Stable burst fracture of first lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.012A Unstable burst fracture of first lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.012B Unstable burst fracture of first lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.018A Other fracture of first lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.018B Other fracture of first lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.019A Unspecified fracture of first lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.019B Unspecified fracture of first lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.020A Wedge compression fracture of second lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.020B Wedge compression fracture of second lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.021A Stable burst fracture of second lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.021B Stable burst fracture of second lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.022A Unstable burst fracture of second lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.022B Unstable burst fracture of second lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.028A Other fracture of second lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.028B Other fracture of second lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.029A Unspecified fracture of second lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.029B Unspecified fracture of second lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.030A Wedge compression fracture of third lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.030B Wedge compression fracture of third lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.031A Stable burst fracture of third lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.031B Stable burst fracture of third lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.032A Unstable burst fracture of third lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.032B Unstable burst fracture of third lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.038A Other fracture of third lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.038B Other fracture of third lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.039A Unspecified fracture of third lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.039B Unspecified fracture of third lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.040A Wedge compression fracture of fourth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.040B Wedge compression fracture of fourth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.041A Stable burst fracture of fourth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.041B Stable burst fracture of fourth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.042A Unstable burst fracture of fourth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.042B Unstable burst fracture of fourth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.048A Other fracture of fourth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.048B Other fracture of fourth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.049A Unspecified fracture of fourth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.049B Unspecified fracture of fourth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.050A Wedge compression fracture of fifth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.050B Wedge compression fracture of fifth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.051A Stable burst fracture of fifth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.051B Stable burst fracture of fifth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.052A Unstable burst fracture of fifth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.052B Unstable burst fracture of fifth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.058A Other fracture of fifth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.058B Other fracture of fifth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.059A Unspecified fracture of fifth lumbar vertebra, initial encounter for closed fracture from V24 HCC 169
  • S32.059B Unspecified fracture of fifth lumbar vertebra, initial encounter for open fracture from V24 HCC 169
  • S32.10XA Unspecified fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.10XB Unspecified fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.110A Nondisplaced Zone I fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.110B Nondisplaced Zone I fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.111A Minimally displaced Zone I fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.111B Minimally displaced Zone I fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.112A Severely displaced Zone I fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.112B Severely displaced Zone I fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.119A Unspecified Zone I fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.119B Unspecified Zone I fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.120A Nondisplaced Zone II fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.120B Nondisplaced Zone II fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.121A Minimally displaced Zone II fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.121B Minimally displaced Zone II fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.122A Severely displaced Zone II fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.122B Severely displaced Zone II fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.129A Unspecified Zone II fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.129B Unspecified Zone II fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.130A Nondisplaced Zone III fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.130B Nondisplaced Zone III fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.131A Minimally displaced Zone III fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.131B Minimally displaced Zone III fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.132A Severely displaced Zone III fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.132B Severely displaced Zone III fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.139A Unspecified Zone III fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.139B Unspecified Zone III fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.14XA Type 1 fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.14XB Type 1 fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.15XA Type 2 fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.15XB Type 2 fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.16XA Type 3 fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.16XB Type 3 fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.17XA Type 4 fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.17XB Type 4 fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.19XA Other fracture of sacrum, initial encounter for closed fracture from V24 HCC 169
  • S32.19XB Other fracture of sacrum, initial encounter for open fracture from V24 HCC 169
  • S32.2XXA Fracture of coccyx, initial encounter for closed fracture from V24 HCC 169
  • S32.2XXB Fracture of coccyx, initial encounter for open fracture from V24 HCC 169

Every code above carries the full HCC 401 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 401

What is HCC 401 in the CMS-HCC model?

HCC 401 is CMS-HCC Category 401 (Vertebral Fractures without Spinal Cord Injury) in the V28 risk adjustment model. It covers 339 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 401?

For payment year 2026, HCC 401 adds 0.522 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 0.231 to 0.622 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.