G9301 – Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet
HCPCS Level II code · G codes: Procedures / Professional Services (Temporary)
HCPCS codeG9301
- Long description
- Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet
- Short description
- Doc compl inf antibio
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
M5BSpecialist - psychiatry- Added
- January 1, 2014
- Last change
- January 1, 2021 – No change
- Termination date
- December 31, 2020
Frequently asked questions
What is HCPCS code G9301?
G9301 is a HCPCS Level II code for patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet. It was discontinued on December 31, 2020.
Does Medicare cover G9301?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby G codes
- G9293 – Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
- G9294 – Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
- G9295 – Specimen site other than anatomic cutaneous location
- G9296 – Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure
- G9297 – Shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure, not documented, reason not given
- G9298 – Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke)
- G9299 – Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke, reason not given)
- 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)
- 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
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.