The paper discusses development issues of surgical procedures coding systems for use at the national and international levels within the health information systems. The work was carried out using the Russian and foreign experiences, including international standard ISO/FDIS 1828:2012. The development system structure contains basic categories of medical entities (axes): surgical deed and surgical subdeed, objects, site and interventional equipment. Abdominal surgeries (528 procedures) were entered in the coding system database and structured according defined categories.