K80.64
BillableCalculus of gallbladder and bile duct with chronic cholecystitis without obstruction
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is K80.64 an HCC code?
No. K80.64 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
K80.64 is the ICD-10-CM diagnosis code for calculus of gallbladder and bile duct with chronic cholecystitis without obstruction. Gallstones in both the gallbladder and bile duct with chronic (long-term) inflammation of the gallbladder, without blockage. K80.64 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering disorders of gallbladder, biliary tract and pancreas (k80-k87).
K80.64 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Distinguish between acute and chronic cholecystitis; chronic implies long-standing inflammation without current acute symptoms.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for K80.64 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish between acute and chronic cholecystitis; chronic implies long-standing inflammation without current acute symptoms
- •Ensure documentation supports chronic rather than acute presentation