2027 ICD-10-CM Diagnosis Code H57.11Ocular pain, right eye

ICD-10-CM Codes›H00–H59›H55-H57›H57

ICD-10-CM H57.11
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H57.11 is a billable ICD-10-CM diagnosis code for ocular pain, right eye. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 124 through 125. Coders also document this condition as pain around eye. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified eye disorders.

Code Identity

ICD-10-CM Code
H57.11
Billable Status
Yes — Valid for Submission
Code Describes
Ocular pain, right eye
Short Description
Ocular pain, right eye
Same as the full description in the CMS dataset.
Parent Code
H57.1
Ocular pain

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH55-H57Other disorders of eye and adnexa
CategoryH57Other disorders of eye and adnexa
This CodeH57.11Ocular pain, right eye

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Pain around eye
  • Pain in eye
  • Pain of right eye
  • Periorbital pain of right eye

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H57.11: its own notes plus those printed at Chapter 7. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury (trauma) of eye and orbit (S05.-)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)

Notes

General instructions on how these codes are used.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name H57.11, its category, or a range that includes it.

Applicable To 1

These notes mention H57.11.

  • Z83.51 Family history of eye disorders
    Conditions classifiable to H00-H53, H55-H59 names H55-H59, which includes this code

Excludes1 1

These codes carry an Excludes1 note naming H57.11: they are not reported together with it, unless the two conditions are unrelated.

  • R52 Pain, unspecified
    eye pain (H57.1) names H57.1, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming H57.11: its condition is not part of those codes, and both may be reported when the patient has both.

  • G89 Pain, not elsewhere classified
    eye pain (H57.1) names H57.1, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EYE012
Other specified eye disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Eye Diseases

Even if your eyes feel healthy, you could have a problem and not know it. That's why regular eye exams are so important. Refractive errors are the most common type of vision problem that makes it hard to see clearly. But some eye conditions or diseases don't have any symptoms and can lead to a permanent loss of vision.

The full article covers:

  • What diseases can affect the eye?
  • What are the symptoms of eye diseases?
  • Who is more likely to develop eye diseases?
  • What are the treatments for eye diseases?
  • Can eye diseases be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert H57.11 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
379.91 Pain in or around eye
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About H57.11Overview

What is the ICD-10 code for ocular pain, right eye?

The ICD-10-CM code for ocular pain, right eye is H57.11 (sometimes written as H5711). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H57.11 (Ocular pain) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report ocular pain, right eye on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H57.11 group to?

When ocular pain, right eye is the principal diagnosis on an inpatient stay, it groups to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of H57.11?

Under the General Equivalence Mappings, ocular pain, right eye converts to ICD-9-CM 379.91 (pain in or around eye). The mapping is approximate, so confirm the match fits the documentation.