CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 108 Codes

HCC 405: Traumatic Amputations and Complications ICD-10-CM

CMS-HCC Category 405 (Traumatic Amputations and Complications) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.284 and 0.844 to a beneficiary's RAF score depending on the payment segment (0.598 for a community, non-dual, aged enrollee). 108 ICD-10-CM diagnosis codes map to HCC 405. 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
+0.598
RAF, Community Non-Dual Aged
108
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, aged0.598
Community, partial-benefit dual, aged0.639
Community, full-benefit dual, aged0.799
Community, non-dual, disabled0.577
Community, partial-benefit dual, disabled0.698
Community, full-benefit dual, disabled0.844
Institutional0.284

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 405 in turn supersedes HCC 409 (Amputation Status, Lower Limb/Amputation Complications).

ICD-10-CM

ICD-10-CM Codes That Map to HCC 405 108 codes

108 of 108 shown
  • S48.011A Complete traumatic amputation at right shoulder joint, initial encounter from V24 HCC 173
  • S48.012A Complete traumatic amputation at left shoulder joint, initial encounter from V24 HCC 173
  • S48.019A Complete traumatic amputation at unspecified shoulder joint, initial encounter from V24 HCC 173
  • S48.021A Partial traumatic amputation at right shoulder joint, initial encounter from V24 HCC 173
  • S48.022A Partial traumatic amputation at left shoulder joint, initial encounter from V24 HCC 173
  • S48.029A Partial traumatic amputation at unspecified shoulder joint, initial encounter from V24 HCC 173
  • S48.111A Complete traumatic amputation at level between right shoulder and elbow, initial encounter from V24 HCC 173
  • S48.112A Complete traumatic amputation at level between left shoulder and elbow, initial encounter from V24 HCC 173
  • S48.119A Complete traumatic amputation at level between unspecified shoulder and elbow, initial encounter from V24 HCC 173
  • S48.121A Partial traumatic amputation at level between right shoulder and elbow, initial encounter from V24 HCC 173
  • S48.122A Partial traumatic amputation at level between left shoulder and elbow, initial encounter from V24 HCC 173
  • S48.129A Partial traumatic amputation at level between unspecified shoulder and elbow, initial encounter from V24 HCC 173
  • S48.911A Complete traumatic amputation of right shoulder and upper arm, level unspecified, initial encounter from V24 HCC 173
  • S48.912A Complete traumatic amputation of left shoulder and upper arm, level unspecified, initial encounter from V24 HCC 173
  • S48.919A Complete traumatic amputation of unspecified shoulder and upper arm, level unspecified, initial encounter from V24 HCC 173
  • S48.921A Partial traumatic amputation of right shoulder and upper arm, level unspecified, initial encounter from V24 HCC 173
  • S48.922A Partial traumatic amputation of left shoulder and upper arm, level unspecified, initial encounter from V24 HCC 173
  • S48.929A Partial traumatic amputation of unspecified shoulder and upper arm, level unspecified, initial encounter from V24 HCC 173
  • S58.011A Complete traumatic amputation at elbow level, right arm, initial encounter from V24 HCC 173
  • S58.012A Complete traumatic amputation at elbow level, left arm, initial encounter from V24 HCC 173
  • S58.019A Complete traumatic amputation at elbow level, unspecified arm, initial encounter from V24 HCC 173
  • S58.021A Partial traumatic amputation at elbow level, right arm, initial encounter from V24 HCC 173
  • S58.022A Partial traumatic amputation at elbow level, left arm, initial encounter from V24 HCC 173
  • S58.029A Partial traumatic amputation at elbow level, unspecified arm, initial encounter from V24 HCC 173
  • S58.111A Complete traumatic amputation at level between elbow and wrist, right arm, initial encounter from V24 HCC 173
  • S58.112A Complete traumatic amputation at level between elbow and wrist, left arm, initial encounter from V24 HCC 173
  • S58.119A Complete traumatic amputation at level between elbow and wrist, unspecified arm, initial encounter from V24 HCC 173
  • S58.121A Partial traumatic amputation at level between elbow and wrist, right arm, initial encounter from V24 HCC 173
  • S58.122A Partial traumatic amputation at level between elbow and wrist, left arm, initial encounter from V24 HCC 173
  • S58.129A Partial traumatic amputation at level between elbow and wrist, unspecified arm, initial encounter from V24 HCC 173
  • S58.911A Complete traumatic amputation of right forearm, level unspecified, initial encounter from V24 HCC 173
  • S58.912A Complete traumatic amputation of left forearm, level unspecified, initial encounter from V24 HCC 173
  • S58.919A Complete traumatic amputation of unspecified forearm, level unspecified, initial encounter from V24 HCC 173
  • S58.921A Partial traumatic amputation of right forearm, level unspecified, initial encounter from V24 HCC 173
  • S58.922A Partial traumatic amputation of left forearm, level unspecified, initial encounter from V24 HCC 173
  • S58.929A Partial traumatic amputation of unspecified forearm, level unspecified, initial encounter from V24 HCC 173
  • S68.411A Complete traumatic amputation of right hand at wrist level, initial encounter from V24 HCC 173
  • S68.412A Complete traumatic amputation of left hand at wrist level, initial encounter from V24 HCC 173
  • S68.419A Complete traumatic amputation of unspecified hand at wrist level, initial encounter from V24 HCC 173
  • S68.421A Partial traumatic amputation of right hand at wrist level, initial encounter from V24 HCC 173
  • S68.422A Partial traumatic amputation of left hand at wrist level, initial encounter from V24 HCC 173
  • S68.429A Partial traumatic amputation of unspecified hand at wrist level, initial encounter from V24 HCC 173
  • S68.711A Complete traumatic transmetacarpal amputation of right hand, initial encounter from V24 HCC 173
  • S68.712A Complete traumatic transmetacarpal amputation of left hand, initial encounter from V24 HCC 173
  • S68.719A Complete traumatic transmetacarpal amputation of unspecified hand, initial encounter from V24 HCC 173
  • S68.721A Partial traumatic transmetacarpal amputation of right hand, initial encounter from V24 HCC 173
  • S68.722A Partial traumatic transmetacarpal amputation of left hand, initial encounter from V24 HCC 173
  • S68.729A Partial traumatic transmetacarpal amputation of unspecified hand, initial encounter from V24 HCC 173
  • S78.011A Complete traumatic amputation at right hip joint, initial encounter from V24 HCC 173
  • S78.012A Complete traumatic amputation at left hip joint, initial encounter from V24 HCC 173
  • S78.019A Complete traumatic amputation at unspecified hip joint, initial encounter from V24 HCC 173
  • S78.021A Partial traumatic amputation at right hip joint, initial encounter from V24 HCC 173
  • S78.022A Partial traumatic amputation at left hip joint, initial encounter from V24 HCC 173
  • S78.029A Partial traumatic amputation at unspecified hip joint, initial encounter from V24 HCC 173
  • S78.111A Complete traumatic amputation at level between right hip and knee, initial encounter from V24 HCC 173
  • S78.112A Complete traumatic amputation at level between left hip and knee, initial encounter from V24 HCC 173
  • S78.119A Complete traumatic amputation at level between unspecified hip and knee, initial encounter from V24 HCC 173
  • S78.121A Partial traumatic amputation at level between right hip and knee, initial encounter from V24 HCC 173
  • S78.122A Partial traumatic amputation at level between left hip and knee, initial encounter from V24 HCC 173
  • S78.129A Partial traumatic amputation at level between unspecified hip and knee, initial encounter from V24 HCC 173
  • S78.911A Complete traumatic amputation of right hip and thigh, level unspecified, initial encounter from V24 HCC 173
  • S78.912A Complete traumatic amputation of left hip and thigh, level unspecified, initial encounter from V24 HCC 173
  • S78.919A Complete traumatic amputation of unspecified hip and thigh, level unspecified, initial encounter from V24 HCC 173
  • S78.921A Partial traumatic amputation of right hip and thigh, level unspecified, initial encounter from V24 HCC 173
  • S78.922A Partial traumatic amputation of left hip and thigh, level unspecified, initial encounter from V24 HCC 173
  • S78.929A Partial traumatic amputation of unspecified hip and thigh, level unspecified, initial encounter from V24 HCC 173
  • S88.011A Complete traumatic amputation at knee level, right lower leg, initial encounter from V24 HCC 173
  • S88.012A Complete traumatic amputation at knee level, left lower leg, initial encounter from V24 HCC 173
  • S88.019A Complete traumatic amputation at knee level, unspecified lower leg, initial encounter from V24 HCC 173
  • S88.021A Partial traumatic amputation at knee level, right lower leg, initial encounter from V24 HCC 173
  • S88.022A Partial traumatic amputation at knee level, left lower leg, initial encounter from V24 HCC 173
  • S88.029A Partial traumatic amputation at knee level, unspecified lower leg, initial encounter from V24 HCC 173
  • S88.111A Complete traumatic amputation at level between knee and ankle, right lower leg, initial encounter from V24 HCC 173
  • S88.112A Complete traumatic amputation at level between knee and ankle, left lower leg, initial encounter from V24 HCC 173
  • S88.119A Complete traumatic amputation at level between knee and ankle, unspecified lower leg, initial encounter from V24 HCC 173
  • S88.121A Partial traumatic amputation at level between knee and ankle, right lower leg, initial encounter from V24 HCC 173
  • S88.122A Partial traumatic amputation at level between knee and ankle, left lower leg, initial encounter from V24 HCC 173
  • S88.129A Partial traumatic amputation at level between knee and ankle, unspecified lower leg, initial encounter from V24 HCC 173
  • S88.911A Complete traumatic amputation of right lower leg, level unspecified, initial encounter from V24 HCC 173
  • S88.912A Complete traumatic amputation of left lower leg, level unspecified, initial encounter from V24 HCC 173
  • S88.919A Complete traumatic amputation of unspecified lower leg, level unspecified, initial encounter from V24 HCC 173
  • S88.921A Partial traumatic amputation of right lower leg, level unspecified, initial encounter from V24 HCC 173
  • S88.922A Partial traumatic amputation of left lower leg, level unspecified, initial encounter from V24 HCC 173
  • S88.929A Partial traumatic amputation of unspecified lower leg, level unspecified, initial encounter from V24 HCC 173
  • S98.011A Complete traumatic amputation of right foot at ankle level, initial encounter from V24 HCC 173
  • S98.012A Complete traumatic amputation of left foot at ankle level, initial encounter from V24 HCC 173
  • S98.019A Complete traumatic amputation of unspecified foot at ankle level, initial encounter from V24 HCC 173
  • S98.021A Partial traumatic amputation of right foot at ankle level, initial encounter from V24 HCC 173
  • S98.022A Partial traumatic amputation of left foot at ankle level, initial encounter from V24 HCC 173
  • S98.029A Partial traumatic amputation of unspecified foot at ankle level, initial encounter from V24 HCC 173
  • S98.311A Complete traumatic amputation of right midfoot, initial encounter from V24 HCC 173
  • S98.312A Complete traumatic amputation of left midfoot, initial encounter from V24 HCC 173
  • S98.319A Complete traumatic amputation of unspecified midfoot, initial encounter from V24 HCC 173
  • S98.321A Partial traumatic amputation of right midfoot, initial encounter from V24 HCC 173
  • S98.322A Partial traumatic amputation of left midfoot, initial encounter from V24 HCC 173
  • S98.329A Partial traumatic amputation of unspecified midfoot, initial encounter from V24 HCC 173
  • S98.911A Complete traumatic amputation of right foot, level unspecified, initial encounter from V24 HCC 173
  • S98.912A Complete traumatic amputation of left foot, level unspecified, initial encounter from V24 HCC 173
  • S98.919A Complete traumatic amputation of unspecified foot, level unspecified, initial encounter from V24 HCC 173
  • S98.921A Partial traumatic amputation of right foot, level unspecified, initial encounter from V24 HCC 173
  • S98.922A Partial traumatic amputation of left foot, level unspecified, initial encounter from V24 HCC 173
  • S98.929A Partial traumatic amputation of unspecified foot, level unspecified, initial encounter from V24 HCC 173
  • T87.0X1 Complications of reattached (part of) right upper extremity from V24 HCC 173
  • T87.0X2 Complications of reattached (part of) left upper extremity from V24 HCC 173
  • T87.0X9 Complications of reattached (part of) unspecified upper extremity from V24 HCC 173
  • T87.1X1 Complications of reattached (part of) right lower extremity from V24 HCC 173
  • T87.1X2 Complications of reattached (part of) left lower extremity from V24 HCC 173
  • T87.1X9 Complications of reattached (part of) unspecified lower extremity from V24 HCC 173

Every code above carries the full HCC 405 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 405

What is HCC 405 in the CMS-HCC model?

HCC 405 is CMS-HCC Category 405 (Traumatic Amputations and Complications) in the V28 risk adjustment model. It covers 108 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 405?

For payment year 2026, HCC 405 adds 0.598 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 0.284 to 0.844 across the seven payment segments shown above.

Related References

All HCC CategoriesHCC 409 CodesV24 to V28: What ChangedICD-10-CM Code Lookup

Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.