Background: Administrative database provides valuable information for large cohort studies,especially when tissue diagnosis is rather difficult such as the diagnosis for bile duct cancer (BDC). The aim of this study was to evaluate the diagnostic accuracy of administrative database for BDC by International Classification of Diseases (ICD)-10 codes in a tertiary institute.Methods: BDC and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital. Cases of BDC were identified in the National Health Insurance Service (NHIS) database by ICD 10-code supported by V code. The control group was selected from cases without ICD-10 codes for BDC. A definite or possible diagnosis was defined according to pathologic reports. Medical records,images,and pathology reports were analyzed to evaluate ICD-10 codes for BDC. Sensitivity,specificity,positive predictive value,and negative predictive value for BDC were analyzed according to diagnostic criteria and cancer locations. Results: A total of 1707 patients with BDC and 1707 controls were collected. Among those with BDC,1320 (77.3％) were diagnosed by definite criteria. Most (99.4％) of them had adenocarcinoma. Rate of defi-nite diagnosis was the highest for ampulla of Vater (88.9％),followed by that for extrahepatic (84.9％) and intrahepatic (68.3％) BDCs. False positive cases commonly had hepatocellular carcinomas. For overall diag-nosis of BDC,sensitivity,specificity,positive predictive value,and negative predictive value were 99.94％,98.33％,98.30％,and 99.94％,respectively. Diagnostic accuracies were similar regardless of diagnostic cri-teria or tumor locations. Conclusions: Administrative database for BDC collected according to ICD-10 code with V code shows good accuracy.