HCPCS code J9312: Rituximab injection, per 10 mg2026 Medicare rate & RVUs in Georgia
Reports intravenous rituximab supplied for treatment of certain lymphomas, chronic lymphocytic leukemia, autoimmune conditions, and related indications, in 10 mg units.
CMS doesn’t publish an office rate for J9312 in Georgia.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What J9312 covers
This code represents rituximab given by intravenous infusion. It is used in treatment regimens for conditions including non-Hodgkin lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, granulomatosis with polyangiitis, microscopic polyangiitis, and pemphigus vulgaris. Oncology, hematology, and rheumatology practices commonly report the drug when furnishing it in outpatient infusion settings. The subcutaneous rituximab-and-hyaluronidase product is reported with a different code.
The physician fee schedule assigns status E, excluding the code from that schedule by CMS regulation. When Medicare covers the drug, payment is under another payment method; HCPCS classifies it as a Part B drug generally priced using CMS quarterly Average Sales Price files. Special Medicare coverage instructions apply. Report one unit for each 10 mg of rituximab furnished, based on the documented dose.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where J9312 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta, GA | Unavailable | Unavailable |
| Rest of Georgia | Unavailable | Unavailable |
How the J9312 rate is calculated
Each of J9312’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · J9312
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for J9312
J9312 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · J9312
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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J9312 isn’t priced in this setting.
J9312 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- J9311Rituximab-hyaluronidasePer 10 mg
- Use J9312 for intravenous rituximab. J9311 identifies the rituximab-hyaluronidase product administered subcutaneously.
- J9301ObinutuzumabPer 10 mg
- J9301 identifies obinutuzumab, a different drug. Select the code for the drug actually furnished rather than treating it as a rituximab formulation.
- J9302Ofatumumab injectionPer 10 mg
- J9302 identifies ofatumumab, not rituximab. The administered drug and treatment regimen determine which drug code applies.
J9312 billing questions
How many units should be reported?
Each unit represents 10 mg of rituximab. Calculate units from the documented amount furnished.
How does this differ from J9311?
J9312 represents intravenous rituximab. J9311 represents rituximab combined with hyaluronidase for subcutaneous administration.
Is the infusion administration included?
This code identifies the drug, not the infusion administration service. Report a separately identifiable administration service when applicable.
Does status E mean Medicare never covers rituximab?
No. Status E excludes the code from the physician fee schedule; when Medicare covers the drug, payment is under another method. Special Medicare coverage instructions apply.
What documentation supports the units?
Document the rituximab dose furnished and the drug product administered so the reported 10 mg units can be reconciled to the dose.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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