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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j2350-ocrelizumab-injection-1mg-infusion-therapy
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    HCPCS Level II J2350: Ocrelizumab Injection, 1 mg

    Commercial payers pay $391 on average nationally for this procedure.

    HCPCS Level II code J2350 describes the billed drug unit for ocrelizumab, 1 mg, intended for intravenous administration as a disease‑modifying therapy for demyelinating disorders; the service type is injectable biologic drug and the typical site of service is an infusion center or outpatient hospital/clinic where IV biologic therapies are delivered.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only).

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    National Reimbursement Benchmarks

    National commercial reimbursement for HCPCS J2350 centers around the BUCA average commercial rate of $391.40, which provides a useful midpoint against individual payer distributions. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $6.90, Cigna’s spread is $0.30, UnitedHealth Group’s spread is $5.40, Aetna’s spread is $44.30, and BUCA’s spread is $12.20. These spreads indicate Cigna and Blue Cross Blue Shield exhibit the tightest concentration around their midpoints, while Aetna shows a markedly wider dispersion driven by outlier high values that push its P75–P25 range well above peers.

    Comparing central tendency and dispersion, UnitedHealth Group and Blue Cross Blue Shield cluster near the low- to mid-$60s for medians and P50 values, while Cigna sits essentially at $59.40 as its median. Aetna’s very large maximum and broader spread contrast with the steadier patterns at Cigna and Blue Cross Blue Shield; BUCA’s average at $391.40 sits above most payer means but with a moderate interquartile range, reflecting higher overall commercial pricing with less extreme variability than Aetna.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 34-year-old woman with relapsing-remitting multiple sclerosis (G35) established in a neurology infusion clinic. She presents for scheduled intravenous administration of ocrelizumab (J2350) as part of disease-modifying therapy. Pre-infusion evaluation by the neurology nurse or physician includes verification of identity, review of recent labs (including hepatitis B serologies), assessment for infection or recent vaccinations, and documentation of prior infusion reactions. An infusion consent and medication reconciliation are completed. The infusion suite documents the medication lot and dose (billed per milligram using J2350), attaches appropriate infusion-related vital sign monitoring, and administers premedication per clinic protocol when indicated. The initial or maintenance infusion is given via peripheral IV over the recommended infusion time with monitoring for infusion reactions; any return visits for subsequent infusions follow the same workflow. Billing captures the drug with J2350 (unitized per mg), an appropriate infusion CPT code for nursing time and monitoring, and any clinically applicable modifier(s) to indicate circumstances such as professional service, bilateral procedures, or an unrelated procedural care indicator.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2084N0400XNeurology PhysicianA Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, auton…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    322D00000XEmotionally Disturbed Childrens' Residential Treatment FacilityA residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral i…
    3336M0003XManaged Care Organization PharmacyA pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's c…
    261QD1600XDevelopmental Disabilities Clinic/CenterAn entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling …
    183700000XPharmacy TechnicianA person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professi…
    163WC3500XCardiac Rehabilitation Registered NurseNursing Service Providers · Registered Nurse
    111NN1001XNutrition ChiropractorChiropractic Nutrition is that specialty within the chiropractic profession that deals with the overall factors that affect the patient's ability to m…

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    E11.9Type 2 diabetes mellitus without complications
    F32.9Major depressive disorder, single episode, unspecified
    F33.1Major depressive disorder, recurrent, moderate
    G04.81Other encephalitis and encephalomyelitis
    G04.89Other myelitis
    G11.3Cerebellar ataxia with defective DNA repair
    G12.21Amyotrophic lateral sclerosis
    G35
    G36.0Neuromyelitis optica [Devic]
    G36.1Acute and subacute hemorrhagic leukoencephalitis [Hurst]

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Chimeric Antigen Receptor (CAR) T-Cell TherapyColorado Rocky Mountain Health Plans2026-08-01
    Allogeneic Hematopoietic Progenitor Cell TherapyAmbetter Georgia2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Idaho Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for New Jersey Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Ohio Only)UnitedHealthcare2026-08-01
    Reblozyl (luspatercept-aamt) Medical Benefit Drug PolicyUnitedHealthcare2026-08-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    96365
    Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour
    Billed for the initial infusion time and nursing/IV administration associated with ocrelizumab.
    96366Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hourBilled when the infusion time extends beyond the first hour and additional nursing time is required.
    96413Chemotherapy administration, intravenous; 1 hourMay be used by some practices to report monoclonal antibody infusion services when payer guidance indicates chemotherapy administration coding.
    96415Chemotherapy administration, intravenous; each additional hourUsed when infusion administration classified under chemotherapy/antineoplastic infusion extends beyond one hour and payer policy supports this code.