Cost analysis for CPT J9312 — Injection, rituximab, 10 mg
Average Medicare Payment
$61.92
2023 data
Total Payments (2023)
$74.4M
Services (2023)
1.2M
Price Change (2019–2023)
-15.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2019 | $73.40 | $380.1M | 5.2M | — |
| 2020 | $72.75 | $241.4M | 3.3M | -0.9% |
| 2021 | $69.45 | $139.5M | 2.0M | -4.5% |
| 2022 | $65.22 | $94.2M | 1.4M | -6.1% |
| 2023 | $61.92 | $74.4M | 1.2M | -5.1% |
The most expensive state pays 1.2x more than the cheapest for this procedure. MI averages $63.65 vs NH at $51.90.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| MI | $63.65 | $136.8K | 2.1K | 1 |
| AK | $63.57 | $673.8K | 10.6K | 4 |
| VT | $63.55 | $672.4K | 10.6K | 2 |
| ME | $63.54 | $343.1K | 5.4K | 1 |
| MS | $63.54 | $1.6M | 24.4K | 6 |
| NE | $63.51 | $637.0K | 10.0K | 2 |
| CT | $63.50 | $146.0K | 2.3K | 1 |
| SD | $63.49 | $476.2K | 7.5K | 3 |
| AL | $63.45 | $1.1M | 16.6K | 4 |
| MN | $63.44 | $927.5K | 14.6K | 4 |
| AR | $63.44 | $2.0M | 31.0K | 5 |
| WI | $63.40 | $1.9M | 29.6K | 8 |
| NJ | $63.25 | $728.2K | 11.5K | 3 |
| MA | $63.23 | $1.2M | 19.3K | 5 |
| TN | $63.00 | $620.5K | 9.8K | 3 |
| KS | $62.91 | $1.8M | 27.9K | 9 |
| CO | $62.90 | $2.1M | 33.9K | 11 |
| PA | $62.74 | $2.5M | 39.8K | 13 |
| MT | $62.66 | $467.0K | 7.5K | 2 |
| IA | $62.64 | $793.7K | 12.7K | 4 |
| SC | $62.60 | $4.3M | 68.1K | 22 |
| FL | $62.56 | $8.1M | 129.5K | 32 |
| AZ | $62.55 | $3.2M | 51.0K | 15 |
| NY | $62.54 | $3.1M | 50.4K | 18 |
| LA | $62.33 | $699.6K | 11.2K | 3 |
| NC | $62.11 | $3.2M | 51.6K | 18 |
| GA | $62.02 | $3.4M | 54.5K | 11 |
| MO | $61.95 | $2.8M | 45.9K | 9 |
| ID | $61.93 | $452.2K | 7.3K | 1 |
| DE | $61.79 | $942.0K | 15.2K | 3 |
| OK | $61.53 | $1.5M | 24.1K | 6 |
| TX | $61.44 | $5.2M | 84.9K | 21 |
| CA | $61.36 | $6.1M | 99.6K | 16 |
| IL | $61.32 | $908.8K | 14.8K | 7 |
| MD | $61.13 | $2.1M | 34.2K | 8 |
| KY | $61.08 | $348.1K | 5.7K | 2 |
| NM | $60.75 | $677.4K | 11.2K | 3 |
| OR | $60.62 | $1.5M | 25.4K | 7 |
| WA | $60.60 | $1.6M | 26.8K | 8 |
| VA | $60.51 | $1.0M | 17.1K | 4 |
| OH | $60.19 | $833.7K | 13.8K | 5 |
| UT | $58.16 | $354.7K | 6.1K | 2 |
| IN | $55.77 | $836.6K | 15.0K | 4 |
| NH | $51.90 | $397.0K | 7.7K | 1 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Barry Eibschutz | Rheumatology | CA | $1.5M | 23.2K | $63.52 |
| Sona Kamat | Internal Medicine | MO | $1.2M | 18.5K | $62.89 |
| Shariar Cohen-Gadol | Rheumatology | CA | $889.7K | 14.1K | $63.33 |
| Bob Wodecki | Rheumatology | NC | $674.3K | 10.9K | $61.81 |
| Yi Li | Rheumatology | CA | $658.9K | 10.4K | $63.42 |
| Howard Hauptman | Rheumatology | MD | $657.9K | 10.9K | $60.35 |
| Adam Rosen | Rheumatology | FL | $642.8K | 10.1K | $63.39 |
| Richard Houk | Rheumatology | AR | $616.7K | 9.7K | $63.52 |
| Daniel Watrous | Rheumatology | CA | $582.7K | 9.2K | $63.61 |
| Leslie Mccasland | Rheumatology | AR | $567.1K | 8.9K | $63.36 |
| Jeffrey Weber | Gastroenterology | WI | $566.3K | 8.9K | $63.34 |
| Richard Jones | Rheumatology | AL | $542.1K | 8.6K | $63.40 |
| Marta Bognar | Rheumatology | GA | $539.4K | 8.5K | $63.36 |
| Adam Bagley | Rheumatology | FL | $517.1K | 8.7K | $59.78 |
| Jose Roldan | Rheumatology | TX | $514.6K | 8.1K | $63.40 |
| Paul Sutej | Rheumatology | GA | $485.2K | 7.7K | $63.37 |
| Eugenia Rullan Bidot | Rheumatology | FL | $483.9K | 7.6K | $63.66 |
| Gary Gabor | Rheumatology | FL | $472.5K | 7.7K | $61.45 |
| Timothy Shaver | Rheumatology | KS | $472.5K | 7.5K | $63.42 |
| Elvin Garcia | Rheumatology | TX | $470.2K | 7.4K | $63.45 |
Based on the data, CPT J9312 shows a 1.2x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 15.6% since 2019. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.