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. 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.