2026 ICD-10-CM Diagnosis Code K43.9Ventral hernia without obstruction or gangrene

ICD-10-CM Codes›K00–K95›K40-K46›K43

ICD-10-CM K43.9
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

K43.9 is a billable ICD-10-CM diagnosis code for ventral hernia without obstruction or gangrene. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 393 through 395. Coders also document this condition as epigastric hernia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Abdominal hernia.

Code Identity

ICD-10-CM Code
K43.9
Billable Status
Yes — Valid for Submission
Code Describes
Ventral hernia without obstruction or gangrene
Short Description
Ventral hernia without obstruction or gangrene
Same as the full description in the CMS dataset.
Parent Code
K43
Ventral hernia

Code Classification

ChapterK00–K95Diseases of the digestive system
SectionK40-K46Hernia
CategoryK43Ventral hernia
This CodeK43.9Ventral hernia without obstruction or gangrene

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Epigastric hernia
  • Hernia of anterior abdominal wall
  • Recurrent epigastric hernia
  • Recurrent hernia of anterior abdominal wall
  • Recurrent spigelian hernia
  • Rupture of hernia of abdominal wall
  • Spigelian hernia
  • Spigelian hernia with cryptorchidism syndrome

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Epigastric hernia
  • Ventral hernia NOS

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Hernia, hernial(acquired) (recurrent)
      • epigastric
    • Hernia, hernial(acquired) (recurrent)
      • ventral
    • Hernia, hernial(acquired) (recurrent)
      • ventral
        • specified NEC

Clinical ClassificationClinical

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

CCSR DIG010
Abdominal hernia
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Epigastric Hernia

    protrusion of abdominal cavity contents or pre-peritoneal fat through the abdominal wall between the umbilicus and the xiphoid process.

Patient EducationClinical

Hernia

A hernia happens when part of an internal organ or tissue bulges through a weak area of muscle. Most hernias are in the abdomen.

Read the full article at MedlinePlus

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

Convert K43.9 to ICD-9-CMHistory

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

ICD-9-CM
553.20 Ventral hernia NOS
Approximate The match is approximate rather than exact.
ICD-9-CM
553.29 Ventral hernia NEC
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About K43.9Overview

Is K43.9 (Ventral hernia) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report ventral hernia without obstruction or gangrene on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does K43.9 group to?

When ventral hernia without obstruction or gangrene is the principal diagnosis on an inpatient stay, it groups to MS-DRG 393, 394, 395, with relative weights from 0.6490 to 1.5993 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of K43.9?

Under the General Equivalence Mappings, ventral hernia without obstruction or gangrene converts to ICD-9-CM 553.20 (ventral hernia NOS) and 553.29 (ventral hernia NEC). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.