ICD-10-CM 2027
ICD-10 code for macula edema
From the official ICD-10-CM alphabetic index entry “Edema, edematous (infectious) (pitting) (toxic) › macula”. Page updated September 29, 2026.
About coding macula edema
The ICD-10-CM code for macula edema is H35.81 (Retinal edema).
Within H35.8 (other specified retinal disorders), H35.81 is specifically for retinal edema. Related codes cover retinal ischemia (H35.82) and other specified retinal disorders (H35.89).
It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.
In MS-DRG v44.0, it is part of the grouping logic for DRG 124 (Other Disorders of the Eye with MCC or Thrombolytic Agent, relative weight 1.2471) and DRG 125 (Other Disorders of the Eye without MCC, relative weight 0.7702), in MDC 02 (Diseases and Disorders of the Eye), 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 macula edema codes (official index)
- cystoid, following cataract surgery
- diabetic
Common questions about macula edema ICD-10 codes
What is the ICD-10 code for macula edema?
- H35.81 — Retinal edema.
Is H35.81 billable?
- Yes. H35.81 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can H35.81 be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict H35.81 as a principal diagnosis.
Is H35.81 a CC or MCC?
- No. H35.81 is neither a CC nor an MCC under MS-DRG v44.0.