CMS-HCC Risk Adjustment · Retired V24 Model 63 Codes
V24 HCC 85 (Archived Category) ICD-10-CM
HCC 85 is a payment category of the retired CMS-HCC V24 model, which last determined Medicare Advantage payment in 2025. The 63 ICD-10-CM codes below are its final mappings, kept for lookback analysis and RADV audit reference. Each code shows where it maps in the live V28 model; 1 of them no longer risk-adjust at all.
✗ Retired model · not used for current Medicare Advantage paymentLast paid PY 2025 · kept for lookback and RADV reference
63
ICD-10-CM Codes
62
Still Risk-Adjust in V28
1
No V28 Successor
PY 2025
Last Paid Year
CMS-HCC V24
Archived Codes of V24 HCC 85 63 codes
63 of 63 shown
- A36.81 Diphtheritic cardiomyopathy now HCC 227
- B33.24 Viral cardiomyopathy now HCC 227
- I09.81 Rheumatic heart failure now HCC 226
- I11.0 Hypertensive heart disease with heart failure now HCC 226
- I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease now HCC 226
- I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease now HCC 226 now HCC 326
- I26.01 Septic pulmonary embolism with acute cor pulmonale now HCC 267
- I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale now HCC 267
- I26.03 Cement embolism of pulmonary artery with acute cor pulmonale now HCC 267
- I26.04 Fat embolism of pulmonary artery with acute cor pulmonale now HCC 267
- I26.09 Other pulmonary embolism with acute cor pulmonale now HCC 267
- I27.0 Primary pulmonary hypertension now HCC 226
- I27.1 Kyphoscoliotic heart disease now HCC 226
- I27.20 Pulmonary hypertension, unspecified now HCC 226
- I27.21 Secondary pulmonary arterial hypertension now HCC 226
- I27.22 Pulmonary hypertension due to left heart disease now HCC 226
- I27.23 Pulmonary hypertension due to lung diseases and hypoxia now HCC 226
- I27.24 Chronic thromboembolic pulmonary hypertension now HCC 226
- I27.29 Other secondary pulmonary hypertension now HCC 226
- I27.81 Cor pulmonale (chronic) now HCC 226
- I27.83 Eisenmenger's syndrome now HCC 226
- I27.89 Other specified pulmonary heart diseases now HCC 226
- I27.9 Pulmonary heart disease, unspecified now HCC 226
- I28.0 Arteriovenous fistula of pulmonary vessels now HCC 226
- I28.1 Aneurysm of pulmonary artery now HCC 226
- I28.8 Other diseases of pulmonary vessels now HCC 226
- I28.9 Disease of pulmonary vessels, unspecified now HCC 226
- I42.0 Dilated cardiomyopathy now HCC 227
- I42.1 Obstructive hypertrophic cardiomyopathy now HCC 227
- I42.2 Other hypertrophic cardiomyopathy now HCC 227
- I42.3 Endomyocardial (eosinophilic) disease now HCC 227
- I42.4 Endocardial fibroelastosis now HCC 227
- I42.5 Other restrictive cardiomyopathy now HCC 227
- I42.6 Alcoholic cardiomyopathy now HCC 227
- I42.7 Cardiomyopathy due to drug and external agent no V28 successor
- I42.8 Other cardiomyopathies now HCC 227
- I42.9 Cardiomyopathy, unspecified now HCC 227
- I43 Cardiomyopathy in diseases classified elsewhere now HCC 227
- I50.1 Left ventricular failure, unspecified now HCC 226
- I50.20 Unspecified systolic (congestive) heart failure now HCC 226
- I50.21 Acute systolic (congestive) heart failure now HCC 225
- I50.22 Chronic systolic (congestive) heart failure now HCC 226
- I50.23 Acute on chronic systolic (congestive) heart failure now HCC 224
- I50.30 Unspecified diastolic (congestive) heart failure now HCC 226
- I50.31 Acute diastolic (congestive) heart failure now HCC 225
- I50.32 Chronic diastolic (congestive) heart failure now HCC 226
- I50.33 Acute on chronic diastolic (congestive) heart failure now HCC 224
- I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure now HCC 226
- I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure now HCC 225
- I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure now HCC 226
- I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure now HCC 224
- I50.810 Right heart failure, unspecified now HCC 226
- I50.811 Acute right heart failure now HCC 225
- I50.812 Chronic right heart failure now HCC 226
- I50.813 Acute on chronic right heart failure now HCC 225
- I50.814 Right heart failure due to left heart failure now HCC 226
- I50.82 Biventricular heart failure now HCC 226
- I50.83 High output heart failure now HCC 226
- I50.84 End stage heart failure now HCC 222
- I50.89 Other heart failure now HCC 226
- I50.9 Heart failure, unspecified now HCC 226
- I51.4 Myocarditis, unspecified now HCC 227
- I51.5 Myocardial degeneration now HCC 227
Questions About This Archived Category
Is V24 HCC 85 still paid?
No. The CMS-HCC V24 model last determined Medicare Advantage payment in 2025; from payment year 2026 the V28 model pays 100% of the risk score. This page exists for lookback analysis and RADV audit periods that predate the transition.
Where did these codes go in V28?
Each row above names the code's live V28 category, or marks it as having no V28 successor. The category-level picture, with destination counts for every V24 category, is on V24 to V28: What Changed.
Related References
Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28; CMS-HCC V24 from the last published V24 mappings, payment year 2025), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.
