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)

Discontinued December 31, 2020 Carrier judgment

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
00 Not separately priced by Part B (bundled, not covered or Part A only)
Medicare coverage
C Carrier judgment – coverage decided by the Medicare contractor
BETOS category
M5B Specialist - 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

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.