2026 ICD-10-CM Diagnosis Code J36Peritonsillar abscess
ICD-10-CM Codes›J00–J99›J30-J39›J36
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Not Chronic
J36 is a billable ICD-10-CM diagnosis code for peritonsillar abscess. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) 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
Code Classification
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 peritonsillar abscess
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Includes
- abscess of tonsil
- peritonsillar cellulitis
- quinsy
Use Additional Code
Type 1 Excludes
This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic) L02.91
circumtonsillar J36
intratonsillar J36
tonsil J36
peritonsillar J36
posttonsillar J36
Angina (attack) (cardiac) (chest) (heart) (pectoris) (syndrome) (vasomotor) I20.9
phlegmonous J36
tonsil J36
tonsillaris J36
Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer) See Also: Necrosis; I96
quinsy J36
Peritonsillitis J36
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Peritonsillar Abscess
an accumulation of purulent material in the area between the palatine tonsil and its capsule.Palatine Tonsil
a round-to-oval mass of lymphoid tissue embedded in the lateral wall of the pharynx. there is one on each side of the oropharynx in the fauces between the anterior and posterior pillars of the soft palate.
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.
Code HistoryHistory
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, 2025 through September 30, 2026.
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, 2025 through September 30, 2026.
What MS-DRG does J36 group to?
When peritonsillar abscess is the principal diagnosis on an inpatient stay, it groups to MS-DRG 11, 12, 13, 152, 153, with relative weights from 0.7382 to 5.4541 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 2026. 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.
What is the ICD-9 equivalent of J36?
Under the General Equivalence Mappings, peritonsillar abscess converts to ICD-9-CM 475 (peritonsillar abscess). The mapping is a direct match.
