G9410 HCPCS Reimbursement & Policy

HCPCS Level II code G9410 denotes inpatient or procedural care for patients admitted within 180 days after cardiac implantable electronic device (CIED) implantation, replacement, or revision who develop an infection requiring device removal or surgical revision. Nationally, this code flags clinically significant postoperative infections that drive resource use, inpatient procedures, and coordination across surgical and infectious disease teams. It is relevant to hospital billing, quality measurement, and post-procedural surveillance.

Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical scenario this code captures, typical sites of service, and the operational implications for inpatient and procedural billing. The publication provides benchmarks where available, discusses policy and coverage considerations affecting payment and authorization, and explains how G9410 is used in claims to denote device-related infections requiring operative management. This summary is intended for coding professionals, billing managers, revenue cycle stakeholders, and clinicians involved in perioperative care and device management.

Billing Code Overview

HCPCS Level II code G9410 describes a patient admitted within 180 days who is status post cardiac implantable electronic device (CIED) implantation, replacement, or revision and who has an infection that requires device removal or surgical revision. This code represents care tied to a postoperative infectious complication of a CIED that necessitates operative management.

Service type: Surgical management related to CIED infection, including device removal or revision
Typical site of service: Inpatient hospital or same-day surgical facility where device explantation, revision, or related operative procedures are performed

Clinical Context

A 68-year-old male with ischemic cardiomyopathy who underwent cardiac implantable electronic device (CIED) implantation two months earlier presents to the emergency department with fever, erythema and purulent drainage at the device pocket site and systemic signs of infection. Blood cultures are positive for Staphylococcus aureus. The patient is admitted and evaluated by cardiology and cardiothoracic surgery. Imaging and device interrogation suggest pocket infection and possible lead involvement. The clinical workflow includes initial stabilization, targeted intravenous antibiotics, documentation of informed consent for device extraction, scheduling of transvenous lead and generator removal in the operating room or electrophysiology lab under monitored anesthesia care or general anesthesia, and coordination of temporary pacing support if needed. After device removal, cultures are obtained from the pocket and leads; the wound is managed with primary closure or delayed closure depending on contamination; plans for reimplantation are deferred until infection is cleared, typically after a course of antibiotics and negative blood cultures. Discharge planning includes outpatient infectious disease follow-up and documentation of device removal and infection-related diagnosis codes for billing under G9410.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typically required (e.g., complex extraction with extensive adhesions).

Taxonomy Code	Specialty	Notes
`331K00000X`	Cardiovascular Electrophysiology	Electrophysiologists perform device extraction and reimplantation decisions.
`207RC0000X`	Cardiothoracic Surgery	Surgeons manage complex extractions and lead-associated endocarditis requiring surgical intervention.
`208D00000X`	Cardiology	Interventional/clinical cardiologists coordinate device management and follow-up.
`363L00000X`	Infectious Disease	Infectious disease specialists direct antimicrobial therapy and clearance for reimplantation.
`207L00000X`	Thoracic Surgery	May be involved for open surgical approaches or complications.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter	Directly represents infection of a CIED requiring removal.
`T82.89XA`	Other complications of cardiac and vascular devices, implants and grafts, initial encounter	Used for other device-related complications when infection is present or suspected.
`I33.0`	Acute and subacute infective endocarditis	Used when lead-associated endocarditis is diagnosed, often necessitating device extraction.
`A41.9`	Sepsis, unspecified organism	Used if systemic infection or sepsis is present in the context of device infection.
`B95.6`	Staphylococcus aureus as the cause of diseases classified elsewhere	Coded as an organism identifier when cultures identify Staphylococcus aureus associated with the device infection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33233`	Removal of permanent pacemaker pulse generator with or without replacement; with removal of existing lead(s) (separate procedure)	Performed when the generator is removed and leads are extracted or replaced during the same operative session.
`33234`	Removal of pacemaker pulse generator only; without replacement, complicated (e.g., infected field)	Used when generator removal is performed in the setting of infection without immediate replacement.
`33244`	Insertion of new or replacement of permanent pacemaker with transvenous single lead, single chamber	Performed when reimplantation of a new device is done after clearance of infection, sometimes during same admission if clinically appropriate.
`33262`	Removal of pacing or defibrillation lead(s) by transvenous extraction, single lead	CPT code for lead extraction by transvenous methods; often billed for lead removal procedures associated with infection.
`33340`	Insertion or replacement of implantable cardioverter-defibrillator (ICD) pulse generator with or without lead revision	Relevant when an ICD system is involved and generator exchange or replacement is required after infection management.
`36556`	Insertion of non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump	Performed for administration of prolonged intravenous antibiotics during hospitalization for device-related infection.

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Summary & Overview

HCPCS G9410: CIED Infection Requiring Device Removal or Surgical Revision