2027 ICD-10-CM Diagnosis Code J36Peritonsillar abscess

ICD-10-CM Codes›J00–J99›J30-J39›J36

ICD-10-CM J36
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

J36 is a billable ICD-10-CM diagnosis code for peritonsillar abscess. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 11 through 13, 152 through 153. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 9 closely related codes. Coders also document this condition as abscess of pharynx. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Acute and chronic tonsillitis.

Code Identity

ICD-10-CM Code
J36
Billable Status
Yes — Valid for Submission
Code Describes
Peritonsillar abscess
Short Description
Peritonsillar abscess
Same as the full description in the CMS dataset.
Chapter
J30-J39
Other diseases of upper respiratory tract

Code Classification

ChapterJ00–J99Diseases of the respiratory system
SectionJ30-J39Other diseases of upper respiratory tract
CategoryJ36Peritonsillar abscess
This CodeJ36Peritonsillar abscess

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Abscess of pharynx
  • Abscess of tonsil
  • Cellulitis of pharynx
  • Peritonsillar abscess
  • Peritonsillar cellulitis
  • Recurrent abscess
  • Recurrent peritonsillar abscess

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to J36: its own notes plus those printed at Chapter 10. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

  • abscess of tonsil
  • peritonsillar cellulitis
  • quinsy

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • acute tonsillitis (J03.-)
  • chronic tonsillitis (J35.0)
  • retropharyngeal abscess (J39.0)
  • tonsillitis NOS (J03.9-)

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 10 (J00-J99) Diseases of the respiratory system applies to 366 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)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • smoke inhalation (T59.81-)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

On J36 itself
  • code (B95-B97) to identify infectious agent.
From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • code, where applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Notes

General instructions on how these codes are used.

From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).

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

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name J36, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming J36: they are not reported together with it, unless the two conditions are unrelated.

  • J02 Acute pharyngitis
    peritonsillar abscess (J36)
  • J03 Acute tonsillitis
    peritonsillar abscess (J36)
  • J39.0 Retropharyngeal and parapharyngeal abscess
    peritonsillar abscess (J36)

Excludes2 1

These codes carry an Excludes2 note naming J36: its condition is not part of those codes, and both may be reported when the patient has both.

  • K12.2 Cellulitis and abscess of mouth
    peritonsillar abscess (J36)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

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

CCSR RSP004
Acute and chronic tonsillitis
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Peritonsillar Abscess

    an accumulation of purulent material in the area between the palatine tonsil and its capsule.

Patient EducationClinical

Abscess

An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area of your body becomes infected, your body's immune system tries to fight the infection. White blood cells go to the infected area, collect within the damaged tissue, and cause inflammation. During this process, pus forms.

Read the full article at MedlinePlus

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

Convert J36 to ICD-9-CMHistory

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

ICD-9-CM
475 Peritonsillar abscess
Exact Match The mapping is direct, with no qualifiers.

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 J36Overview

What is the ICD-10 code for peritonsillar abscess?

The ICD-10-CM code for peritonsillar abscess is J36. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is J36 (Peritonsillar abscess) a billable code?

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

What MS-DRG does J36 group to?

When peritonsillar abscess is the principal diagnosis on an inpatient stay, it groups to MS-DRG 12, 11, 152, 153, 13, with relative weights from 0.7420 to 5.6129 depending on complications. Higher weights mean higher Medicare reimbursement.

Is J36 a CC or MCC?

CMS lists J36 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 9 closely related codes in its exclusion list.

Can J36 be reported with a code from J03?

Not as a rule. The Excludes1 note on J36 lists "acute tonsillitis (J03.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).