Summary & Overview
HCPCS Level II J9306: Injection, pertuzumab, 1 mg
HCPCS Level II code J9306 denotes the injectable biologic pertuzumab measured per milligram (1 mg unit) and is used in oncology treatment regimens. As a billed drug code separate from chemotherapy administration, it is central to cost reporting, prior authorization workflows, and drug-specific billing practices across outpatient hospital and physician office settings. Nationally, accurate use of this code affects drug cost transparency, inventory management, and claims adjudication for biologic cancer therapies.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find an overview of payer coverage considerations, common billing pairings with infusion administration codes, and contextual clinical use for pertuzumab in oncology care. The publication covers coding benchmarks and billing practices relevant to chemotherapy and biologic drug administration, common modifiers and related administration codes, and how J9306 typically appears on outpatient facility and office claims. Clinical context outlining the role of pertuzumab in cancer treatment is provided to aid accurate clinical-to-billing linkage.
Where required input elements were missing, the publication notes “Data not available in the input.” The content is intended for national audiences involved in oncology billing, revenue cycle, and clinical coding.
Billing Code Overview
HCPCS Level II code J9306 represents an injection of pertuzumab, 1 mg, used as a biologic therapy in oncology. This code denotes the drug product itself rather than the infusion administration service.
Service Type: Oncology—chemotherapy/biologics
Typical Site of Service: Outpatient Hospital or Office (for example, Place of Service 11 or 22).
Clinical & Coding Specifications
Clinical Context
A 56-year-old female diagnosed with invasive breast carcinoma involving the nipple and areola presents to an outpatient oncology clinic for targeted HER2-directed therapy. The clinician orders intravenous pertuzumab administered as an injection dosed per weight; HCPCS Level II code J9306 (Injection, pertuzumab, 1 mg) is used for drug reporting. The patient arrives to an outpatient hospital infusion suite (Place of Service 22) or physician office (Place of Service 11). Nursing verifies orders, obtains baseline vitals and relevant labs (including cardiac function as clinically indicated), prepares and doses the biologic in the pharmacy, and the infusion/bolus is administered with concurrent documentation of lot number, NDC, amount dispensed, and any discarded remainder. The encounter includes chemotherapy administration services billed separately (for example, infusion administration codes), and modifier use is applied when drug waste or distinct procedural services occur.
Coding Specifications
-
Modifiers
-
JW: Used to report the drug amount discarded/not administered to any patient when a portion of a single-use vial is discarded and payor guidance permits reporting of wastage. -
59: Used to report Distinct Procedural Service when a service or procedure is distinct or independent from other services performed on the same day; apply when clinical documentation supports separate and distinct service from other billed procedures. -
Provider Taxonomies