HCPCS drug code for the subcutaneous rituximab product combined with hyaluronidase, billed per 10 mg of rituximab, used for certain blood cancers.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Oncology diagnosis supporting the subcutaneous product
- Rituximab mg given and units billed
- Subcutaneous administration documented
- NDC, lot, and discarded amount
- Date of last dose in ortho pre-op notes
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
J9311 reports rituximab and hyaluronidase (Rituxan Hycela) per 10 mg. This is the subcutaneous oncology product for certain lymphomas and leukemias. It is not approved for rheumatoid arthritis, so rheumatology rituximab infusions are billed with J9312 or a biosimilar Q code instead.
An orthopedic practice will not bill J9311, but it matters in the chart. Lymphoma patients on rituximab show up with pathologic fractures, bone lesions, and joint complaints, and B-cell depletion raises infection risk for any procedure. Surgeons should know about recent doses before booking elective surgery.
If you are coding records for a multispecialty group, a few points: units are total rituximab mg divided by 10, the hyaluronidase is included in the code, and the admin is a subcutaneous injection, not an IV infusion. Single-dose vials need JW or JZ. Do not confuse this product with IV rituximab on the claim.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
HOPD (APC 9467) Hospital outpatient department | $36.87 |
Common denial reasons
The recurring reasons claims for CPT J9311 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed for rheumatoid arthritis, which is not an approved use
- IV rituximab billed under J9311
- Units calculated on total volume instead of rituximab mg
- Missing JW or JZ modifier
- No prior authorization
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What is the difference between J9311 and J9312?
02Can J9311 be used for rheumatoid arthritis?
03Why should an orthopedic surgeon know about rituximab?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02CMS Medicare Part B Drug Average Sales Price files
- 03cms.govhttps://www.cms.gov/medicare/payment/fee-schedules/physician
Mira Scribe
Mira Scribe notes capture active cancer treatment and recent rituximab doses at the ortho visit, so infection risk is visible before a procedure is planned.
See how Mira captures CPT J9311 documentation