Summary & Overview
HCPCS G9307: No Return to Operating Room Within 30 Days
HCPCS Level II code G9307 denotes a quality/outcome measure: no return to the operating room for complications of the principal operative procedure within 30 days. Nationally, such measures are used to track postoperative safety, inform payers and health systems about surgical performance, and support quality improvement and value-based payment programs.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, its clinical and operational context in surgical settings, and the implications for claims and quality reporting. The publication outlines common modifiers and related billing elements provided in the input (for reference), notes where additional data is not available, and situates the code within typical hospital inpatient and outpatient surgical workflows.
This overview provides benchmarks and policy-relevant context for stakeholders interested in surgical quality metrics, payer reporting expectations, and the administrative classification of postoperative complication outcomes. Data not available in the input is noted where appropriate.
Billing Code Overview
HCPCS Level II code G9307 indicates 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. This measure captures the absence of reoperation related to postoperative complications within a 30-day window following the original surgical intervention.
-
Service type: Surgical complication outcome measure
-
Typical site of service: Hospital inpatient or outpatient surgical settings where the principal operative procedure was performed
Clinical & Coding Specifications
Clinical Context
A 62-year-old male undergoes an elective open sigmoid colectomy for diverticulitis with planned bowel resection and primary anastomosis. The procedure is completed successfully without intraoperative complications. During the postoperative inpatient stay the patient has routine monitoring, pain control, and return of bowel function. There are no wound dehiscence, abscess, anastomotic leak, postoperative hemorrhage, or other complications requiring surgical intervention within 30 days of the principal operative procedure. The care team documents the absence of any return to the operating room. Typical workflow includes operative documentation by the surgeon, daily postoperative progress notes by the inpatient team, nursing and anesthesia records, and a 30-day postoperative assessment in clinic or via telephone to confirm no reoperation occurred. Service setting is inpatient surgical care with inpatient or ambulatory postoperative follow-up visits as applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work required to manage the case was substantially greater than typically required. |
23 | Unusual anesthesia |