HCC 51: Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders ICD-10-CM
CMS-HCC Category 51 (Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.313 and 0.654 to a beneficiary's RAF score depending on the payment segment (0.510 for a community, non-dual, aged enrollee). 11 ICD-10-CM diagnosis codes map to HCC 51. 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 | 0.510 |
| Community, partial-benefit dual, aged | 0.313 |
| Community, full-benefit dual, aged | 0.634 |
| Community, non-dual, disabled | 0.606 |
| Community, partial-benefit dual, disabled | 0.393 |
| Community, full-benefit dual, disabled | 0.654 |
| Institutional | 0.620 |
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 HCC 51 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.
ICD-10-CM Codes That Map to HCC 51 11 codes
- E22.0 Acromegaly and pituitary gigantism from V24 HCC 23
- E24.0 Pituitary-dependent Cushing's disease from V24 HCC 23
- E27.1 Primary adrenocortical insufficiency from V24 HCC 23
- E31.0 Autoimmune polyglandular failure from V24 HCC 23
- E31.1 Polyglandular hyperfunction from V24 HCC 23
- E31.20 Multiple endocrine neoplasia [MEN] syndrome, unspecified from V24 HCC 23
- E31.21 Multiple endocrine neoplasia [MEN] type I from V24 HCC 23
- E31.22 Multiple endocrine neoplasia [MEN] type IIA from V24 HCC 23
- E31.23 Multiple endocrine neoplasia [MEN] type IIB from V24 HCC 23
- E31.8 Other polyglandular dysfunction from V24 HCC 23
- E31.9 Polyglandular dysfunction, unspecified from V24 HCC 23
Every code above carries the full HCC 51 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 51
What is HCC 51 in the CMS-HCC model?
HCC 51 is CMS-HCC Category 51 (Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders) in the V28 risk adjustment model. It covers 11 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 51?
For payment year 2026, HCC 51 adds 0.510 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 0.313 to 0.654 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.
