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ICD-10-CM · FY 2026 APRIL UPDATE

M97

Periprosthetic fracture around internal prosthetic joint

Diagnosis reference

Nonbillable category

This entry is a category or subcategory. Choose the appropriate billable descendant based on the clinical documentation.

Effective periodOctober 1, 2026–September 30, 2027
SourceCMS ICD-10-CM order file
ClassificationDiagnosis · clinical modification

Related entries

Up to 30 descendants in this category

CODEDESCRIPTIONTYPE
M97.0Periprosthetic fracture around internal prosthetic hip jointCategory
M97.01Periprosthetic fracture around internal prosthetic right hip jointCategory
M97.01XAPeriprosthetic fracture around internal prosthetic right hip joint, initial encounterBillable
M97.01XDPeriprosthetic fracture around internal prosthetic right hip joint, subsequent encounterBillable
M97.01XSPeriprosthetic fracture around internal prosthetic right hip joint, sequelaBillable
M97.02Periprosthetic fracture around internal prosthetic left hip jointCategory
M97.02XAPeriprosthetic fracture around internal prosthetic left hip joint, initial encounterBillable
M97.02XDPeriprosthetic fracture around internal prosthetic left hip joint, subsequent encounterBillable
M97.02XSPeriprosthetic fracture around internal prosthetic left hip joint, sequelaBillable
M97.1Periprosthetic fracture around internal prosthetic knee jointCategory
M97.11Periprosthetic fracture around internal prosthetic right knee jointCategory
M97.11XAPeriprosthetic fracture around internal prosthetic right knee joint, initial encounterBillable
M97.11XDPeriprosthetic fracture around internal prosthetic right knee joint, subsequent encounterBillable
M97.11XSPeriprosthetic fracture around internal prosthetic right knee joint, sequelaBillable
M97.12Periprosthetic fracture around internal prosthetic left knee jointCategory
M97.12XAPeriprosthetic fracture around internal prosthetic left knee joint, initial encounterBillable
M97.12XDPeriprosthetic fracture around internal prosthetic left knee joint, subsequent encounterBillable
M97.12XSPeriprosthetic fracture around internal prosthetic left knee joint, sequelaBillable
M97.2Periprosthetic fracture around internal prosthetic ankle jointCategory
M97.21Periprosthetic fracture around internal prosthetic right ankle jointCategory
M97.21XAPeriprosthetic fracture around internal prosthetic right ankle joint, initial encounterBillable
M97.21XDPeriprosthetic fracture around internal prosthetic right ankle joint, subsequent encounterBillable
M97.21XSPeriprosthetic fracture around internal prosthetic right ankle joint, sequelaBillable
M97.22Periprosthetic fracture around internal prosthetic left ankle jointCategory
M97.22XAPeriprosthetic fracture around internal prosthetic left ankle joint, initial encounterBillable
M97.22XDPeriprosthetic fracture around internal prosthetic left ankle joint, subsequent encounterBillable
M97.22XSPeriprosthetic fracture around internal prosthetic left ankle joint, sequelaBillable
M97.3Periprosthetic fracture around internal prosthetic shoulder jointCategory
M97.31Periprosthetic fracture around internal prosthetic right shoulder jointCategory
M97.31XAPeriprosthetic fracture around internal prosthetic right shoulder joint, initial encounterBillable

Use the complete reference

This reference does not reproduce the full tabular hierarchy, inclusion notes, Excludes1/2 notes, sequencing instructions, or seventh-character rules. Review the official tables and coding guidelines.

Open official CMS files

ICD-10-CM codes describe diagnoses. They do not have an independent Medicare PFS reimbursement amount, and billability alone does not establish coverage.