G9361 HCPCS code: Medical indication for delivery by cesarean birth or induction of labor (<39 weeks of gestation) [documentation of reason(s) for elective delivery (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes (premature or prolonged), maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]
G9361 is the HCPCS Level II code for medical indication for delivery by cesarean birth or induction of labor (<39 weeks of gestation) [documentation of reason(s) for elective delivery (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes (premature or prolonged), maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2014-01-01 |
| Last action effective | 2022-01-01 |
What changed for G9361
- 2014-01-01: G9361 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G9361?
G9361 is the HCPCS Level II code for medical indication for delivery by cesarean birth or induction of labor (<39 weeks of gestation) [documentation of reason(s) for elective delivery (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes (premature or prolonged), maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]. Short descriptor: "Doc rsn elect c-sec/induct".
Does Medicare cover G9361?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G93 codes
- G9300 — Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)
- G9301 — Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet
- G9302 — Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given
- G9303 — Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given
- G9304 — Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant
- G9305 — Intervention for presence of leak of endoluminal contents through an anastomosis not required
- G9306 — Intervention for presence of leak of endoluminal contents through an anastomosis required
- G9307 — No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure
- G9308 — Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure
- G9309 — No unplanned hospital readmission within 30 days of principal procedure
- G9310 — Unplanned hospital readmission within 30 days of principal procedure
- G9311 — No surgical site infection
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Next steps
- Run a reimbursement report for a device billed under G9361
- Watch G9361 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9361
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.