J9311 HCPCS code: Injection, rituximab 10 mg and hyaluronidase
J9311 is the HCPCS Level II code for injection, rituximab 10 mg and hyaluronidase. In 2024 Medicare paid an average of $28.85 per service for J9311 across 445,872 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 160 per day on outpatient hospital claims. Medicare volume fell 22% from 2022 to 2024 (569,469 to 445,872 services). In 2024, about 684 clinicians billed Medicare for J9311 for 794 beneficiaries; California, Mississippi, Texas accounted for 34% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2019-01-01 |
| Last action effective | 2019-01-01 |
Who bills J9311 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 684 |
| Medicare beneficiaries | 794 |
| States with claims | 20 |
| Share of services in top 3 states (California, Mississippi, Texas) | 34% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9311, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 569,469 | 1,019 | $37.29 | $29.74 |
| 2023 | 460,134 | 870 | $36.47 | $29.03 |
| 2024 | 445,872 | 794 | $36.26 | $28.85 |
States with the most J9311 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 54,020 | $28.99 |
| Mississippi | 42,080 | $28.30 |
| Texas | 37,520 | $29.01 |
| Florida | 35,880 | $29.02 |
| Pennsylvania | 27,860 | $28.97 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 160 | Prescribing Information |
| practitioner claims | 160 | Prescribing Information |
Medicare policy articles for this code
- A56380: Billing and Coding: Rituximab (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (692 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| B27.00 | Gammaherpesviral mononucleosis without complication | 1 |
| C81.00 | Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site | 1 |
| C81.01 | Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of head, face, and neck | 1 |
| C81.02 | Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes | 1 |
| C81.03 | Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes | 1 |
| C81.04 | Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of axilla and upper limb | 1 |
| C81.05 | Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of inguinal region and lower limb | 1 |
| C81.06 | Nodular lymphocyte predominant Hodgkin lymphoma, intrapelvic lymph nodes | 1 |
| C81.07 | Nodular lymphocyte predominant Hodgkin lymphoma, spleen | 1 |
| C81.08 | Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of multiple sites | 1 |
Showing 10 of 692. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J9311
- 2019-01-01: J9311 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J9311?
J9311 is the HCPCS Level II code for injection, rituximab 10 mg and hyaluronidase. Short descriptor: "Inj rituximab, hyaluronidase".
How much does Medicare pay for J9311?
In 2024, the average Medicare payment was $28.85 per service (average allowed $36.26).
Does Medicare cover J9311?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J9311?
Medicare policy articles that cite J9311 list 692 covered ICD-10-CM diagnosis codes across 1 article. The most cited include B27.00 (Gammaherpesviral mononucleosis without complication), C81.00 (Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site), C81.01 (Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of head, face, and neck). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J9311 can be billed per day?
160 on outpatient hospital claims; 160 on practitioner claims (NCCI medically unlikely edits).
Related J93 codes
- J9300 — Injection, gemtuzumab ozogamicin, 5 mg
- J9301 — Injection, obinutuzumab, 10 mg
- J9302 — Injection, ofatumumab, 10 mg
- J9303 — Injection, panitumumab, 10 mg
- J9304 — Injection, pemetrexed (pemfexy), 10 mg
- J9305 — Injection, pemetrexed, not otherwise specified, 10 mg
- J9306 — Injection, pertuzumab, 1 mg
- J9307 — Injection, pralatrexate, 1 mg
- J9308 — Injection, ramucirumab, 5 mg
- J9309 — Injection, polatuzumab vedotin-piiq, 1 mg
- J9310 — Injection, rituximab, 100 mg
- J9312 — Injection, rituximab, 10 mg
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Next steps
- Run a reimbursement report for a device billed under J9311
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Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.