K80.20: Calculus of gallbladder without cholecystitis without obstruction

The ICD-10-CM code for cholelithiasis when the stones sit in the gallbladder and the record documents neither cholecystitis nor obstruction.

Billable

FY2027

TABLE OF CONTENTS

Example H2

Medical scribe app interface showing a recording waveform, a list of patient notes, and a SOAP note for John Doe.

Stop looking up codes.

Scribe auto-generates them for you.

Try Commure Scribe →

At a glance

Code Family

K80: Cholelithiasis

DRG Grouping

MS-DRG 444, 445 or 446, Disorders of the biliary tract, under the FY2027 MS-DRG v44 grouper. A cholecystectomy on the same admission moves the case to a surgical DRG in MDC 07.

HCC Mapping (v28)

None. No code in category K80 appears in the CMS-HCC v28 payment HCC list.

Condition

Cholelithiasis

Family Specificity

Forty billable codes across nine subcategories, structured on three independent axes: stone location, accompanying inflammation, and obstruction.

Effective Date

Valid in the FY2026 code set and unchanged in the FY2027 update.

Which K80 code do I assign?

The K80 family splits on three axes at once: where the stones sit, what inflammation the provider documents alongside them, and whether obstruction is documented. Work the axes in that order. Stone location sets the subcategory. The final character carries the obstruction axis alone: 0 is without obstruction and 1 is with obstruction.

When documentation says…

Code

Gallstones seen on ultrasound, no cholecystitis, no obstruction

K80.20

Calculus of gallbladder without cholecystitis without obstruction. The note must place the stones in the gallbladder or the cystic duct. Incidental stones found on imaging in an asymptomatic patient land here.

Symptomatic cholelithiasis with biliary colic, no cholecystitis

K80.20

The code does not change. Subcategory K80.2 carries the inclusion term Colic (recurrent) of gallbladder (without cholecystitis). Biliary colic does not add a cholecystitis code. It does not establish obstruction either.

Impacted gallstone in the cystic duct with documented obstruction

K80.21

Calculus of gallbladder without cholecystitis with obstruction. The provider must state that obstruction is present. Gallstone (impacted) of cystic duct is itself an inclusion term at K80.2. Impaction alone does not move the final character.

Acute calculous cholecystitis, no obstruction

K80.00

Calculus of gallbladder with acute cholecystitis without obstruction. Category K81 carries an Excludes1 note for cholecystitis with cholelithiasis. A single K80 combination code replaces the pair.

Chronic cholecystitis with gallstones, no obstruction

K80.10

Calculus of gallbladder with chronic cholecystitis without obstruction. Use K80.12 when the provider documents acute and chronic cholecystitis together.

Choledocholithiasis, stone in the common bile duct, no cholangitis or cholecystitis

K80.50

Calculus of bile duct without cholangitis or cholecystitis without obstruction. Bile duct stones leave the K80.2 subcategory entirely.

Stones in both the gallbladder and the common bile duct, no cholecystitis

K80.70

Calculus of gallbladder and bile duct without cholecystitis without obstruction. The combined location has its own subcategories at K80.6 and K80.7.

Tabular notes

EXCLUDES1

Retained cholelithiasis following cholecystectomy (K91.86).

This is the only Excludes note the FY2027 tabular carries at category K80. An Excludes1 note means the two codes are never reported together for the same condition.

Stones identified in the biliary tract after the gallbladder has been removed are reported with K91.86 rather than with a K80 code.

The reciprocal note appears at three points elsewhere in the same block. Category K81, Cholecystitis, carries an Excludes1 note for cholecystitis with cholelithiasis (the K80 codes). Code K82.0, Obstruction of gallbladder, carries an Excludes1 note for obstruction of gallbladder with cholelithiasis (the K80 codes). Code K83.1, Obstruction of bile duct, carries an Excludes1 note for obstruction of bile duct with cholelithiasis (the K80 codes).

FY2027: EFFECTIVE 1 OCTOBER 2026

K80.20 is valid in the FY2026 code set and unchanged in the FY2027 update, which took effect on 1 October 2026. The FY2027 code and tabular addenda add, delete or revise nothing in category K80. The Excludes1 note for retained cholelithiasis following cholecystectomy is unchanged.

The FY2027 inclusion terms at subcategory K80.2 are Cholecystolithiasis without cholecystitis, Cholelithiasis (without cholecystitis), Colic (recurrent) of gallbladder (without cholecystitis), Gallstone (impacted) of cystic duct (without cholecystitis), and Gallstone (impacted) of gallbladder (without cholecystitis).

Operational & financial impact

Why specificity matters beyond the chart: risk adjustment, DRG assignment and denial exposure all follow from which code is selected.

CMS-HCC v28 (PY2024+)

K80.20 does not map to a CMS-HCC v28 payment category. No code in category K80 appears in the v28 payment HCC list.

The nearest v28 category is HCC 68: Cholangitis and Obstruction of Bile Duct Without Gallstones. That category is defined for bile duct obstruction in the absence of stones. Calculous disease falls outside it.

CMS-HCC v28 is used at 100 percent for payment year 2026. CMS completed the three-year phase-in from v24 in the CY2026 Rate Announcement of 7 April 2025.

Choosing a more specific K80 code does not change a Medicare Advantage risk score. The effect sits in DRG assignment and in medical necessity support instead.

MS-DRG v44 (FY2027)

MS-DRG 444: Disorders of the biliary tract with MCC.

MS-DRG 445: Disorders of the biliary tract with CC.

MS-DRG 446: Disorders of the biliary tract without CC/MCC.

All three are medical DRGs in MDC 07, Diseases and Disorders of the Hepatobiliary System and Pancreas. An admission with K80.20 and no operating room procedure groups to MS-DRG 444, 445 or 446 under the FY2027 MS-DRG v44 grouper.

A cholecystectomy on the same admission moves the case to a surgical DRG in MDC 07. Laparoscopic cholecystectomy without common duct exploration groups to MS-DRG 417 with MCC, MS-DRG 418 with CC, or MS-DRG 419 without CC/MCC.

Medicare and commercial payers

A National Coverage Determination exists for the procedure rather than for the diagnosis: NCD 100.13, Laparoscopic Cholecystectomy. No National Coverage Determination governs assignment of the K80 diagnosis codes.

Documented symptoms are what separate the surgical candidate from the incidental finding. The diagnosis code itself does not carry that distinction, because K80.20 covers both.

These coding and risk adjustment rules apply to Medicare Fee-for-Service and to Medicare Advantage plans using CMS-HCC v28 for payment year 2026.

WHERE SPECIFICITY IS LOST

Assigning K80.21 when obstruction is not documented. The final character is the obstruction axis alone: 0 is without obstruction and 1 is with obstruction. Confirm the direction against the tabular descriptor before the claim goes out.

Reporting a K81 cholecystitis code alongside a K80 code. Category K81 carries an Excludes1 note for cholecystitis with cholelithiasis (the K80 codes). When the record documents both, only the K80 combination code is assigned.

Defaulting to K80.80, Other cholelithiasis without obstruction, when the record places the stones in the gallbladder. The Alphabetic Index routes Calculus, gallbladder to K80.20. K80.80 is reserved for cholelithiasis specified as other.

Missing choledocholithiasis. A stone in the common bile duct takes the case out of subcategory K80.2 and into the K80.5- codes, or into the K80.7- codes when gallbladder stones are documented as well.

Coding K80.20 after cholecystectomy. Retained stones go to K91.86 under the Excludes1 note. Cholecystectomy status itself goes to Z90.49.

Documentation checklist to support K80.20

Chart elements that support code selection and reduce specificity-driven denials.

The diagnosis stated as cholelithiasis, cholecystolithiasis, gallstones or calculus of gallbladder.

The stone location named as the gallbladder or the cystic duct. This is what separates K80.2 from the bile duct subcategory K80.5 and the combined subcategory K80.7.

An explicit statement that there is no cholecystitis, or the absence of any cholecystitis finding in the note.

An explicit statement that there is no obstruction. The final character stays at 0 only while obstruction is undocumented.

The imaging that identified the stones, such as a right upper quadrant ultrasound, with the report in the record.

Any biliary colic or right upper quadrant pain, recorded as a symptom rather than as a diagnosis. Symptomatic stones without documented inflammation still code to K80.20.

Whether the gallbladder is still present. Stones documented after cholecystectomy are reported with K91.86.

For a pregnant patient, the trimester. Subcategory O26.6 is sequenced first and carries an instruction to use an additional code to identify the specific disorder.

For outpatient encounters, a confirmed diagnosis. Probable or suspected cholelithiasis is not coded in the outpatient setting. An uncertain diagnosis documented at discharge may be coded as confirmed on the inpatient side.

FAQ

Is K80.20 a billable code?

Yes. K80.20 is a five-character billable code with the FY2027 descriptor Calculus of gallbladder without cholecystitis without obstruction. It is valid in the FY2026 code set and unchanged in the FY2027 update. The parent K80.2 is not billable. Two child codes below it carry greater specificity.

What is the ICD-10 code for cholelithiasis?

Cholelithiasis codes to K80.20. The FY2027 tabular lists Cholelithiasis (without cholecystitis) as an inclusion term under subcategory K80.2. The Alphabetic Index routes Calculus, gallbladder to K80.20. Cholelithiasis documented with no inflammation and no obstruction is the K80.20 default.

Does symptomatic cholelithiasis or biliary colic change the code?

No. Subcategory K80.2 carries the inclusion term Colic (recurrent) of gallbladder (without cholecystitis). Biliary colic does not by itself add a cholecystitis code. It does not establish obstruction either. One index caution applies. The term Biliary colic is cross-referenced to Calculus, bile duct, which defaults to K80.50. Code from the documented stone location rather than from the phrase the clinician used.

What is the difference between K80.20 and K80.21?

The final character is the obstruction axis. K80.20 is without obstruction. K80.21 is with obstruction. The provider must document obstruction before K80.21 can be assigned. Gallstone (impacted) of cystic duct and Gallstone (impacted) of gallbladder are inclusion terms at K80.2. The word impacted alone does not move the final character to 1.

Does K80.20 map to an HCC?

No. K80.20 does not map to a CMS-HCC v28 payment category. No code in category K80 does. The nearest v28 category is HCC 68, Cholangitis and Obstruction of Bile Duct Without Gallstones, which is defined for bile duct obstruction in the absence of stones.

Can I report a cholecystitis code from K81 alongside K80.20?

A K81 cholecystitis code is not reported with K80.20 for the same condition. Category K81 carries an Excludes1 note for cholecystitis with cholelithiasis (the K80 codes). When the record documents both stones and cholecystitis, a single K80 combination code is assigned. Acute calculous cholecystitis without obstruction is K80.00. Chronic calculous cholecystitis without obstruction is K80.10. Acute with chronic, without obstruction, is K80.12.

How does K80.20 group on an inpatient stay compared with an outpatient encounter?

An inpatient admission with K80.20 and no operating room procedure groups to MS-DRG 444, 445 or 446, Disorders of the biliary tract, under the FY2027 MS-DRG v44 grouper. A cholecystectomy on the same admission moves the case to a surgical DRG in MDC 07, such as MS-DRG 417, 418 or 419 for laparoscopic cholecystectomy without common duct exploration. On the outpatient side the diagnosis must be confirmed. Suspected and rule-out conditions are not coded outside the inpatient setting.

What changed for K80.20 in FY2027?

K80.20 is unchanged in the FY2027 update, effective 1 October 2026, which adds, deletes or revises nothing in category K80. The FY2026 release effective 1 October 2025 added and deleted no codes in category K80. The Excludes1 note for retained cholelithiasis following cholecystectomy (K91.86) stayed in place. The April 1, 2026 mid-year update introduced no new ICD-10-CM diagnosis codes. No April 2026 change affecting category K80 was identified.

Related codes

Codes in the same family as K80.20. Only codes with a published page render as links.

Sibling codes in the K80 family

K80.21: Calculus of gallbladder without cholecystitis with obstruction.
K80.00: Calculus of gallbladder with acute cholecystitis without obstruction.
K80.01: Calculus of gallbladder with acute cholecystitis with obstruction.
K80.10: Calculus of gallbladder with chronic cholecystitis without obstruction.
K80.11: Calculus of gallbladder with chronic cholecystitis with obstruction.
K80.12: Calculus of gallbladder with acute and chronic cholecystitis without obstruction.
K80.13: Calculus of gallbladder with acute and chronic cholecystitis with obstruction.
K80.18: Calculus of gallbladder with other cholecystitis without obstruction.
K80.19: Calculus of gallbladder with other cholecystitis with obstruction.
K80.30: Calculus of bile duct with cholangitis, unspecified, without obstruction.
K80.32: Calculus of bile duct with acute cholangitis without obstruction.
K80.40: Calculus of bile duct with cholecystitis, unspecified, without obstruction.
K80.42: Calculus of bile duct with acute cholecystitis without obstruction.
K80.50: Calculus of bile duct without cholangitis or cholecystitis without obstruction.
K80.51: Calculus of bile duct without cholangitis or cholecystitis with obstruction.
K80.60: Calculus of gallbladder and bile duct with cholecystitis, unspecified, without obstruction.
K80.62: Calculus of gallbladder and bile duct with acute cholecystitis without obstruction.
K80.70: Calculus of gallbladder and bile duct without cholecystitis without obstruction.
K80.71: Calculus of gallbladder and bile duct without cholecystitis with obstruction.
K80.80: Other cholelithiasis without obstruction.
K80.81: Other cholelithiasis with obstruction.

Additional codes to consider

Codes outside the K80 family considered alongside K80.20.

Companion: code alongside when documented

O26.61-: Liver and biliary tract disorders in pregnancy, with the trimester at the sixth character, sequenced first under the O26.6 instruction to use an additional code to identify the specific disorder.
O26.62: Liver and biliary tract disorders in childbirth.
O26.63: Liver and biliary tract disorders in the puerperium.

Consider instead

K80.21: Calculus of gallbladder without cholecystitis with obstruction, where the provider documents obstruction.
K80.50: Calculus of bile duct without cholangitis or cholecystitis without obstruction, where the stone is in the bile duct.
K80.70: Calculus of gallbladder and bile duct without cholecystitis without obstruction, where stones are documented in both.
K80.80: Other cholelithiasis without obstruction, where cholelithiasis is specified as other.
K81.0: Acute cholecystitis, where no stones are documented.
K81.1: Chronic cholecystitis, where no stones are documented.
K81.9: Cholecystitis, unspecified, where no stones are documented.
K82.0: Obstruction of gallbladder, where the occlusion, stenosis or stricture is without cholelithiasis.
K82.4: Cholesterolosis of gallbladder, for strawberry gallbladder without stones or cholecystitis.
K82.9: Disease of gallbladder, unspecified.
K83.1: Obstruction of bile duct, where the obstruction is without cholelithiasis.
K83.9: Disease of biliary tract, unspecified.
K91.5: Postcholecystectomy syndrome.
K91.86: Retained cholelithiasis following cholecystectomy.
Z90.49: Acquired absence of other specified parts of digestive tract, the indexed code for status post cholecystectomy.
R10.11: Right upper quadrant pain, where the workup has not confirmed stones.

Sources

All claims on this page derive from government and professional-standards sources.

National Center for Health Statistics. (2026). International classification of diseases, tenth revision, clinical modification (ICD-10-CM) FY2027 files. https://www.cdc.gov/nchs/icd/icd-10-cm/files.html
Centers for Medicare & Medicaid Services and National Center for Health Statistics. (2026). ICD-10-CM official guidelines for coding and reporting FY2027. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2027/ICD-10-CM-October-1-2026-FY27-Guidelines.pdf
Centers for Medicare & Medicaid Services. (2025). 2026 model software/ICD-10 mappings. https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2026-model-software-icd-10-mappings
Centers for Medicare & Medicaid Services. (2026). MS-DRG classifications and software, version 44. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ms-drg-classifications-and-software