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 HCC 51 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.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. 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.
