ICD-10-CM 2027
ICD-10 code for appendix perforation
Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess
From the official ICD-10-CM alphabetic index entry “Perforation, perforated (nontraumatic) (of) › appendix”. Page updated September 29, 2026.
About coding appendix perforation
The ICD-10-CM code for appendix perforation is K35.32 (Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess). The official index lists 1 more specific code, so check the documentation for details such as type, cause, site or severity before settling on K35.32.
Within K35.3, choose K35.32 (perforation, localized peritonitis, and gangrene, without abscess) only when documentation doesn't support a more specific option: without perforation or gangrene (K35.30), and gangrene, without perforation (K35.31) and perforation, localized peritonitis, and gangrene, with abscess (K35.33).
As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" 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 371 (Major Gastrointestinal Disorders and Peritoneal Infections with MCC, relative weight 1.7089), DRG 372 (Major Gastrointestinal Disorders and Peritoneal Infections with CC, relative weight 0.9964) and DRG 373 (Major Gastrointestinal Disorders and Peritoneal Infections without CC/MCC, relative weight 0.6941), in MDC 06 (Diseases and Disorders of the Digestive System), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
More specific appendix perforation codes (official index)
- with localized peritonitis K35.32 — Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess
Common questions about appendix perforation ICD-10 codes
What is the ICD-10 code for appendix perforation?
- K35.32 — Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess. More specific codes apply when the documentation supports them: K35.32.
Is K35.32 billable?
- Yes. K35.32 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can K35.32 be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict K35.32 as a principal diagnosis.
Is K35.32 a CC or MCC?
- K35.32 is an MCC (major complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.