R60.0: Localized edema

The ICD-10-CM code for localized edema, including edema of the legs or lower extremities, when the provider records edema confined to a body region and no definitive diagnosis explains it at this encounter.

Billable

FY2027

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At a glance

Code Family

R60: Edema, not elsewhere classified.

DRG Grouping

MS-DRG 947 or 948, Signs and symptoms, when R60.0 is the principal diagnosis under the FY2027 MS-DRG v44 grouper.

HCC Mapping (v28)

None. R60.0 does not map to a payment HCC in the CMS-HCC v28 crosswalk.

Family Specificity

Three billable codes sit in R60, split by the extent of the edema: localized, generalized or unspecified.

Billable

Yes. R60.0 is a complete code in the FY2027 billable code list.

Effective Date

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

Which R60 code do I assign?

Category R60 splits edema by extent: localized edema at R60.0, generalized edema at R60.1 and edema with no stated extent at R60.9. The Alphabetic Index sends edema with a named cause, such as heart failure, venous obstruction or lymphatic obstruction, out of R60 to the code for that cause.

When documentation says…

Code

Leg edema" or "lower extremity edema

R60.0

Localized edema. The Index sends Edema, legs to R60.0 and cross-refers Edema, extremities, lower and Edema, lower limbs to it. One code covers edema of one leg or both legs.

Peripheral edema" at a named site such as the ankles or feet

R60.0

Edema confined to a body region. The Index sends Edema, localized to R60.0. The Index has no peripheral subterm. The note should name the site.

Anasarca" or "generalized edema

R60.1

Generalized edema. The Index sends Anasarca and Edema, generalized here. R60.1 carries an Excludes2 note for nutritional edema (E40-E46).

Edema" or "fluid retention" with no site or extent

R60.9

Edema, unspecified. The main term Edema with no subterm goes here. Fluid retention NOS is its inclusion term.

Edema due to heart failure

I50.9

Heart failure, unspecified. The Index sends Edema, cardiac and Edema, heart to Failure, heart, congestive. A documented type of heart failure moves the code to the typed I50 code.

Lymphedema" or "edema due to lymphatic obstruction

I89.0

Lymphedema, not elsewhere classified. The Index sends Edema, lymphatic and secondary lymphedema here. Lymphedema due to mastectomy is I97.2. Hereditary lymphedema is Q82.0.

Leg edema from chronic venous insufficiency

I87.2

Venous insufficiency (chronic) (peripheral). The provider must diagnose the venous insufficiency. Stasis edema is an inclusion term at I87.3. Edema of the legs due to venous obstruction indexes to I87.1.

Tabular notes

EXCLUDES1

Category R60 carries an Excludes1 note for angioneurotic edema (T78.3), ascites (R18.-), cerebral edema (G93.6), cerebral edema due to birth injury (P11.0), edema of larynx (J38.4), edema of nasopharynx (J39.2), edema of pharynx (J39.2), gestational edema (O12.0-), pulmonary edema (J81.-), hereditary edema (Q82.0), hydrops fetalis NOS (P83.2), newborn edema (P83.3) and hydrothorax (J94.8).

None of these is reported with R60.0 for the same condition. Guideline I.A.12.a allows both codes of an Excludes1 pair when the two conditions are unrelated to each other.

The tabular divides P83.3 into P83.30 and P83.39. The Index sends Edema, newborn to P83.30.

R60.0 carries no Excludes1 note of its own.

EXCLUDES2

R60.0 and category R60 carry no Excludes2 note. Its sibling R60.1 carries an Excludes2 note for nutritional edema (E40-E46).

Chapter 18 carries an Excludes2 note for abnormal findings on antenatal screening of mother (O28.-), certain conditions originating in the perinatal period (P04-P96), signs and symptoms classified in the body system chapters and signs and symptoms of breast (N63, N64.5).

USE ADDITIONAL

R60.0 carries no use additional code instruction. None sits above it at R60, block R50-R69 or Chapter 18.

I87.2, the code for venous insufficiency, carries a use additional code note, if applicable, for the site and severity of ulcer (L97.-) and a code also note for associated hypertensive conditions such as I10.

CODE FIRST

R60.0 carries no code first instruction. None sits above it at R60, block R50-R69 or Chapter 18.

Category I50 carries a code first note for heart failure due to hypertension (I11.0) and heart failure due to hypertension with chronic kidney disease (I13.-), among others. It applies when the edema is coded to heart failure.

CODE ALSO

R60.0 carries no code also instruction. None sits above it at R60, block R50-R69 or Chapter 18.

FY2027: EFFECTIVE 1 OCTOBER 2026

The FY2027 codes addenda make no addition, deletion or revision in category R60. R60.0 is in the FY2027 billable code list.

The FY2027 tabular and index addenda make no change to the R60 instructional notes or to the Index entries under Edema.

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+)

R60.0, R60.1 and R60.9 do not map to a payment HCC in the CMS-HCC v28 diagnosis crosswalk.

In the same crosswalk, I50.9 maps to HCC 226: Heart Failure, Except End-Stage and Acute.

I87.2, I87.1, I89.0, I97.2 and Q82.0 do not map to a payment HCC in the same crosswalk.

MS-DRG v44 (FY2027)

MS-DRG 947: Signs and symptoms with MCC.

MS-DRG 948: Signs and symptoms without MCC.

R60.0 as principal diagnosis groups to one of these two DRGs in MDC 23, per the CMS MS-DRG v44.0 Definitions Manual, Appendix B.

I50.9 as principal diagnosis groups to MS-DRG 291, 292 or 293, Heart failure and shock, in the same appendix.

Section II.A bars R60.0 as the principal diagnosis once a related definitive diagnosis is established.

WHERE SPECIFICITY IS LOST

Reporting R60.0 when the provider attributes the edema to heart failure replaces a diagnosis with a symptom. The symptom carries no HCC and groups to MS-DRG 947 or 948 rather than MS-DRG 291 to 293.

Reporting R60.0 for edema of the larynx, pharynx, lung or brain, for ascites or for gestational edema conflicts with the R60 Excludes1 note.

Reporting R60.0 for lymphedema misses the Index routes to I89.0, I97.2 and Q82.0.

Reporting R60.9 when the note names the legs or another site drops the localized extent that R60.0 records.

SEVERITY DESIGNATION (MS-DRG V44, FY2027)

R60.0 is on neither list. It carries no CC or MCC designation as a secondary diagnosis.

No code in category R60 carries a CC or MCC designation.

Per Table 6I (Complete MCC List) and Table 6J (Complete CC List) of the FY2027 IPPS final rule (CMS-1849-F), MS-DRG v44.

Documentation checklist to support R60.0

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

The provider's own term and the site, such as edema of the legs, ankles, feet or hands. Edema, legs and Edema, localized index to R60.0.

Whether the edema is localized or generalized. Anasarca and generalized edema index to R60.1.

A statement that no definitive diagnosis accounts for the edema, or that the workup is still pending (Guideline I.B.4).

Any cause the provider names, such as heart failure, venous insufficiency, venous obstruction or lymphatic obstruction. Each moves the code out of category R60.

The word edema when edema is meant. The Index sends Swelling, leg to M79.89 and Swelling, ankle to the M25.47 joint effusion codes.

Pregnancy status. Gestational edema is coded in the O12.0 codes, which the R60 Excludes1 note names.

The drug and the provider's link to it when the edema is an adverse effect of a correctly prescribed medication. Guideline I.C.19.e.5.(a) places the T36-T50 code after the code for the nature of the effect.

For outpatient encounters, the symptom rather than a probable, suspected or rule out diagnosis (Section IV.H).

FAQ

Is R60.0 billable in FY2027?

Yes. R60.0 is a complete code with no further characters. It appears in the FY2027 billable code list. Its parent R60 is a category and cannot be reported. The FY2027 codes addenda, effective 1 October 2026, make no addition, deletion or revision in category R60.

What is the ICD-10 code for peripheral edema?

R60.0, when the note places the edema in the legs, ankles, feet or another named region. The Index sends Edema, legs and Edema, localized to R60.0. The Index has no subterm for peripheral edema. With no site and no extent documented, the main term Edema goes to R60.9. Pitting is a nonessential modifier on Edema and does not change the code.

What is the ICD-10 code for bilateral lower extremity edema?

R60.0. The Index cross-refers Edema, extremities, lower and Edema, lower limbs to Edema, legs, which goes to R60.0. R60.0 carries no laterality. One code reports edema of one leg or both legs. When the provider attributes the leg edema to venous obstruction, the Index sends it to I87.1 instead.

What is the difference between R60.0, R60.1 and R60.9?

The difference is extent. R60.0 is edema confined to a body region, such as the legs. R60.1 is generalized edema. The Index sends Anasarca there. R60.9 is edema with no stated extent and includes fluid retention NOS. Subcategory E87.7, fluid overload, carries an Excludes1 note for edema NOS and fluid retention (R60.9).

Is leg swelling coded to R60.0?

Only when the provider documents edema. The Index sends Swelling, leg to M79.89 and Swelling, ankle to Effusion, joint, ankle in the M25.47 codes. A localized lump or mass of the lower limb indexes to the R22.4 codes. The R22 Excludes1 note names edema (R60.-) among the conditions not coded there.

Does R60.0 map to an HCC under CMS-HCC v28?

No. R60.0 does not appear in the CMS-HCC v28 diagnosis crosswalk. R60.1 and R60.9 do not appear either. When the provider diagnoses heart failure as the cause, I50.9 maps to HCC 226, Heart Failure, Except End-Stage and Acute. I87.2, I87.1 and I89.0 do not map to a payment HCC.

Is edema coded separately when the patient has heart failure?

Not when the provider attributes the edema to the heart failure. The Index sends Edema, cardiac and Edema, heart to Failure, heart, congestive, which is I50.9. Signs and symptoms "associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification" (Guideline I.B.5). When hypertension is also documented, the code first note at category I50 places I11.0 or an I13 code ahead of the I50 code.

How is R60.0 sequenced in inpatient and outpatient settings?

In the outpatient setting, R60.0 may be first-listed when no diagnosis has been established (Section IV.D). Probable or suspected diagnoses are not coded there (Section IV.H). In inpatient admissions, a Chapter 18 code is not the principal diagnosis once a related definitive diagnosis is established (Section II.A). An uncertain diagnosis documented at discharge is coded as if it existed (Section II.H).

Related codes

Codes in the same family as R60.0. Only codes with a published page render as links.

Sibling codes in the R60 family

R60.1: Generalized edema, when the provider documents generalized edema or anasarca.
R60.9: Edema, unspecified, when edema or fluid retention is documented without a site or extent.

Additional codes to consider

Codes outside the R60 family considered alongside R60.0.

Consider instead

I50.9: Heart failure, unspecified, when the provider attributes the edema to heart failure and documents no type.
I87.2: Venous insufficiency (chronic) (peripheral), when the provider diagnoses venous insufficiency as the cause.
I87.309: Chronic venous hypertension (idiopathic) without complications of unspecified lower extremity, when stasis edema is documented without a side.
I87.1: Compression of vein, for edema of the legs or localized edema due to venous obstruction.
I89.0: Lymphedema, not elsewhere classified, for lymphatic edema, secondary lymphedema or edema due to lymphatic obstruction.
I97.2: Postmastectomy lymphedema syndrome, for lymphedema due to mastectomy.
Q82.0: Hereditary lymphedema, for hereditary edema of the legs or Milroy's disease.
O12.00: Gestational edema, unspecified trimester, for edema in pregnancy when the trimester is not documented.
M79.89: Other specified soft tissue disorders, when the provider documents leg swelling rather than edema.

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