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Free tool · CMS-HCC V28 · PY2026

RAF score calculator, built on verified V28 numbers.

Pick a member's age band and sex, check the documented conditions, and watch the CMS-HCC V28 risk score build in real time: demographic factor, HCC coefficients with hierarchies applied, disease interactions, and the payment HCC count factor. Every coefficient traces to a CMS Rate Announcement table cited at the bottom of this page.

Model
V28
Payment year
2026 · 100%
Segment
CNA only
HCCs included
40 of 115
Denominator
$10, 402
Sources
cms.gov

Plain languageWhat a RAF score actually is.

A RAF (Risk Adjustment Factor) score is the multiplier CMS puts on a Medicare Advantage member's payment. A member scoring 1.0 is expected to cost the average. A member scoring 2.0 is expected to cost about twice the average, so the plan is paid about twice as much to care for them. The score is not a judgment call: it is an additive formula with published coefficients, and this page runs the real ones.

Base
1.0
Average expected cost for the reference population
Payment HCCs
115
Condition categories in the V28 model
Mapped codes
~7, 700
ICD-10-CM codes that carry payment weight in V28
Reset
Jan 1
HCCs must be re-documented every service year
FORMULA RAF = demographic factor + sum of payment HCC coefficients (after hierarchies) + disease interactions + payment HCC count factor.

Three mechanics trip people up, and this calculator models all three. First, hierarchies: if a member has both CKD stage 4 and CKD stage 3, only stage 4 pays; the lower category is dropped. Second, interactions: certain combinations, like diabetes plus heart failure, add an extra coefficient on top of the individual HCCs. Third, count factors: a member with 5 or more payment HCCs gets an additional factor that grows with the count. Skip these and your RAF math is wrong in both directions.

The toolBuild a member's V28 RAF score.

Everything runs in your browser. Nothing you enter is stored or sent anywhere. Coefficients are the Community, NonDual, Aged (CNA) column of Table VIII-1 in the CY2024 Rate Announcement, the model CMS uses for 100 percent of payment year 2026 risk scores.

STEP 1

Demographics

Sex
SEGMENT LOCKED This calculator scores the Community, NonDual, Aged (CNA) segment only, which is why age starts at 65. Dual-eligible, under-65 disabled, institutional, new enrollee, PACE, and ESRD segments use different published coefficient columns and are out of scope here.
STEP 2

Documented conditions (HCCs)

0 selected
No conditions match that search. Try an HCC number (like 37) or an ICD-10 stem (like E11).

ICD-10 codes shown are common examples, not the full mapping list. The complete V28 code-to-HCC mappings are published in the CMS model software files linked in the sources below. If a selected condition is greyed out, a more severe HCC in the same hierarchy supersedes it and only the severe one pays.

Live result · CMS-HCC V28 · CNA
Demographic factor0.395
HCC coefficients (0)0.000
Disease interactions (0)0.000
Payment HCC count factor0.000
Total RAF0.395
Revenue illustration (editable)
Base rate $per member per month
$4, 740Estimated risk-adjusted revenue per member per year (RAF x base x 12)
What a 0.1 RAF gap costs
Acrossmembers
$1, 200, 000Per year, at 0.1 RAF x base rate x 12 x members
Educational estimate only. This tool uses the verified CNA column of the 2024 CMS-HCC model (V28), the model used for 100 percent of PY2026 risk scores. It covers 40 of 115 payment HCCs and 4 of the model's disease interactions (those whose component HCCs are in the curated set). It excludes the frailty adjustment, new enrollee and ESRD models, dual and institutional segments, normalization factors, and the MA coding pattern adjustment. It is not reimbursement, coding, or actuarial advice.

Worked exampleOne member, every mechanic in play.

An 86-year-old woman with documented type 2 diabetes with chronic complications, morbid obesity, major depression, COPD, CKD stage 4, chronic heart failure, and atrial fibrillation. Eight codes go in; seven HCCs pay, because the diabetes hierarchy drops the less severe category.

ComponentDetailFactor
DemographicFemale, 85 to 89, CNA segment0.624
HCC 37Diabetes with chronic complications (HCC 38 documented too, dropped by hierarchy)0.166
HCC 48Morbid obesity0.186
HCC 155Major depression, moderate or severe0.299
HCC 280COPD and other chronic lung disorders0.319
HCC 327Chronic kidney disease, severe (stage 4)0.514
HCC 226Heart failure, except end-stage and acute0.360
HCC 238Specified heart arrhythmias (atrial fibrillation)0.299
InteractionsDiabetes x HF (0.112) + HF x chronic lung (0.078) + HF x kidney (0.176) + HF x arrhythmias (0.077)0.443
Count factor7 payment HCCs (D7)0.188
Total RAFSum of all components3.398
NOTICE Interactions plus the count factor add 0.631 RAF here, more than the heart failure itself. Documentation that captures combinations, not just conditions, is where V28 revenue hides.

At an illustrative $1, 000 per member per month base rate, this member's 3.398 RAF represents about $40, 776 per year of risk-adjusted revenue. If the chart had said only "diabetes" and "heart failure" with no other specificity, the score drops to 1.262 (demographic 0.624 + HCC 38 at 0.166 + HCC 226 at 0.360 + the 0.112 Diabetes x Heart Failure interaction, with no count factor at 2 payment HCCs), leaving roughly $25, 632 per member per year on the table. That is the RAF gap, and it compounds across every member of the panel.

The V28 shiftWhy 2026 scores feel lower.

Payment year 2026 is the first year risk scores are calculated on 100 percent V28, closing the three-year phase-in that started in 2024. The model was rebuilt: more categories, fewer paying codes, recalibrated weights. If your capture strategy was tuned for V24, this is the year the tide fully goes out.

Payment HCCs
86 → 115
Renumbered and restructured categories
Paying codes
~9, 700 → ~7, 700
ICD-10-CM codes that map to a payment HCC
Phase-in
33 / 67 / 100
Percent V28 in PY2024, PY2025, PY2026
Calibration
2018-19
Medicare 100% data underlying V28 factors
Go deeper

Two playbooks and a practice page for the V28 era.

The V28 HCC Migration Playbook maps what moved between V24 and V28 and how to re-baseline capture. The V28 RAF Optimization Playbook covers the compliant-capture workflow: suspecting, point-of-care prompts, and coder QA. And AI for HCC coding shows how ASP-RCM runs chart-to-code review at 100 percent volume instead of samples.

SourcesEvery number, traced.

No coefficient on this page is estimated or interpolated. Each one is read directly from a CMS document. Where a factor could not be verified against a CMS table, it was excluded rather than approximated.

What it verifiesCMS documentYear
All demographic factors, HCC coefficients, disease interactions, payment HCC count factors, and the $10, 402.34 denominator (CNA column)Announcement of CY2024 MA Capitation Rates and Part C/D Payment Policies, Attachment VIII, Table VIII-1 · cms.govApr 2023
Disease hierarchies (which HCC drops which)Same document, Table VIII-4 · cms.govApr 2023
PY2026 risk scores use 100 percent of the 2024 CMS-HCC model (V28)Announcement of CY2026 MA Capitation Rates and Part C/D Payment Policies · cms.govApr 2025
ICD-10-CM to V28 HCC mappings (full list; examples on this page are illustrative)CMS Risk Adjustment page: model software and mappings · cms.govCurrent
Model scope: 2024 CMS-HCC model (V28), Community, NonDual, Aged segment, continuing enrollees. Excluded by design: dual and institutional segments, new enrollee model, ESRD model, PACE, RxHCC (Part D), frailty adjustment, the Chronic Lung x Cardiorespiratory Failure interaction (its component HCCs 211-213 are outside the curated set), normalization factors, and the MA coding pattern adjustment (statutory minimum 5.9 percent).

FAQRAF scores, answered.

What is a RAF score?
A RAF (Risk Adjustment Factor) score is the number CMS uses to scale Medicare Advantage payment to how sick a member is expected to be. A score of 1.0 represents average expected cost; 2.0 predicts roughly double the average. It is built from demographic factors (age, sex, eligibility segment) plus coefficients for each Hierarchical Condition Category (HCC) documented during the service year, plus disease interaction and payment HCC count factors.
How is a RAF score calculated under CMS-HCC V28?
The score is additive: demographic factor + one coefficient per payment HCC after hierarchies (only the most severe HCC in each hierarchy counts) + disease interaction factors (for example, Diabetes x Heart Failure adds 0.112 in the CNA segment) + a payment HCC count factor once a member has 5 or more payment HCCs. Payment year 2026 calculates risk scores on 100 percent V28, per the CY2026 Rate Announcement.
What changed from V24 to V28?
V28 grew the model from 86 to 115 payment HCCs, renumbered them, and cut the paying ICD-10-CM code list from roughly 9, 700 to roughly 7, 700 codes. Coefficients were recalibrated on 2018-2019 Medicare data. Many commonly coded conditions lost weight or dropped out entirely, which is why identical documentation frequently scores lower under V28. The model phased in at 33 percent (2024), 67 percent (2025), and 100 percent (2026).
Why does documentation drive the RAF score?
HCCs reset every January 1: a condition only pays if it is documented, coded to the required specificity, and supported by a face-to-face encounter in each service year. A chart that says "diabetes" captures HCC 38 (0.166), but a chart that documents "type 2 diabetes with diabetic CKD stage 4" captures HCC 37 plus HCC 327 plus, if heart failure is also present, the interaction factors on top. Under V28's smaller code list, vague documentation converts directly into unearned but unclaimable revenue.
What does a 0.1 RAF gap cost?
Revenue scales linearly with the score, so the cost is 0.1 x monthly base rate x 12 per member per year. At an illustrative $1, 000 per member per month, that is $1, 200 per member per year: $1.2 million across 1, 000 members, $12 million across 10, 000. Use the panel in the calculator above to run your own membership and base rate. Actual dollars vary with county benchmarks, bids, normalization, and coding pattern adjustments.

Now run the same math on your whole panel.

This calculator scores one member at a time. ASP-RCM's HCC coding practice runs chart-level V28 review across your full population: recapture rates, suspect lists, coder QA at 100 percent volume, and a quantified RAF gap with the revenue attached. First look is free.

See the full engine: HCC risk adjustment AI — V28 mapping, MEAT evidence on every suspect, and RADV-ready documentation.