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ICD-10-CM 2027 diagnosis code

M96.65Fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate

✓ Billable / specificCC — complication/comorbidity

M96.65 is a valid, billable ICD-10-CM code for fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.Short description: Fx pelvis following insrt ortho implnt/prosth/bone plt

Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About M96.65

M96.65 is the ICD-10-CM diagnosis code for fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate. It belongs to category M96 (intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified), block M96 (intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified) and chapter 13 (diseases of the musculoskeletal system and connective tissue). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within M96.6 (fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate), M96.65 is specifically for fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate. Related codes cover humerus following insertion of orthopedic implant, joint prosthesis, or bone plate (M96.62), radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate (M96.63), femur following insertion of orthopedic implant, joint prosthesis, or bone plate (M96.66), tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate (M96.67) and other bone following insertion of orthopedic implant, joint prosthesis, or bone plate (M96.69).

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 559 (Aftercare, Musculoskeletal System and Connective Tissue with MCC, relative weight 1.8088), DRG 560 (Aftercare, Musculoskeletal System and Connective Tissue with CC, relative weight 1.1238) and DRG 561 (Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC, relative weight 0.8258), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 996.49 (other mechanical complication of other internal orthopedic device, implant, and graft).

Notes that apply from higher levels

Instructions written at a parent level also apply to M96.65.

› From M96.6 Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate
Excludes2
  • complication of internal orthopedic devices, implants or grafts (T84.-)
› From M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
Excludes2
  • arthropathy following intestinal bypass (M02.0-)
  • complications of internal orthopedic prosthetic devices, implants and grafts (T84.-)
  • disorders associated with osteoporosis (M80)
  • periprosthetic fracture around internal prosthetic joint (M97.-)
  • presence of functional implants and other devices (Z96-Z97)

Broader instructions also apply from Chapter 13: Diseases of the musculoskeletal system and connective tissue.

Alphabetic index entries

2 entries

Terms in the official ICD-10-CM index that lead to M96.65.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

ICD-9-CM equivalent

Converter →
  • 996.49Other mechanical complication of other internal orthopedic device, implant, and graftapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • No changes since FY2016.

Common questions about M96.65

Is M96.65 billable?

Yes. M96.65 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can M96.65 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict M96.65 as a principal diagnosis.

Is M96.65 a CC or MCC?

M96.65 is a CC (complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.

What DRG does M96.65 group to?

M96.65 is used in the MS-DRG v44.0 logic for MS-DRG 559 (Aftercare, Musculoskeletal System and Connective Tissue with MCC), MS-DRG 560 (Aftercare, Musculoskeletal System and Connective Tissue with CC) and MS-DRG 561 (Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.

What is the ICD-9 code for M96.65?

The CMS General Equivalence Mappings map M96.65 to ICD-9-CM 996.49.