G9361 — 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 a 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)]. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for G9361
- Long descriptor
- 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
- Added
- January 1, 2014
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G9361
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9361 is not quite right, the correct code is very often within a few positions of it.
- G9353More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (eg, patients with complications, second ct obtained prior to surgery, other medical reasons)
- G9354One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis
- G9355Elective delivery (without medical indication) by cesarean birth or induction of labor not performed (<39 weeks of gestation)
- G9356Elective delivery (without medical indication) by cesarean birth or induction of labor performed (<39 weeks of gestation)
- G9357Post-partum screenings, evaluations and education performed
- G9358Post-partum screenings, evaluations and education not performed
- G9359Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to treatment with a biologic immune response modifierterminated
- G9360No documentation of negative or managed positive tb screenterminated
- G9362Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia recordterminated
- G9363Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia recordterminated
- G9364Sinusitis caused by, or presumed to be caused by, bacterial infection
- G9365One high-risk medication orderedterminated
- G9366One high-risk medication not orderedterminated
- G9367At least two orders for high-risk medications from the same drug class
- G9368At least two orders for high-risk medications from the same drug class not ordered
- G9369Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greaterterminated
Questions about G9361
What is HCPCS code G9361?
G9361 is a 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)]. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9361?
The CMS HCPCS file marks G9361 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G9361 paid under the physician fee schedule?
G9361 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.