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.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.598 |
| Community, partial-benefit dual, aged | 0.639 |
| Community, full-benefit dual, aged | 0.799 |
| Community, non-dual, disabled | 0.577 |
| Community, partial-benefit dual, disabled | 0.698 |
| Community, full-benefit dual, disabled | 0.844 |
| Institutional | 0.284 |
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 Codes That Map to HCC 405 108 codes
- 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. The published weights range from 0.284 to 0.844 across the seven payment segments shown above.
Related References
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.
