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 HCC 401 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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