| HCPCS | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Drug Class | Minor Drug Class | Oral (Y/N) | FDA Approval Year | FDA Discontinuation Year | CMS Effective Date | CMS Discontinuation Date | Status |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C9066 | Sacituzumab govitecan-hziy | Trodelvy | 10mg | Immunotherapy | Drug Antibody Conjugate | Trop-2 | No | 2020 | Oct 1, 2020 | Jan 1, 2021 | In Use | |
| C9064 | Mitomycin pyelocalyceal instillation | Jelmyto | 1mg | Chemotherapy | Antitumor Antibiotic | Alkylating Agent/Mitomycin | No | 2020 | Oct 1, 2020 | Jan 1, 2021 | No Longer Used | |
| J0896 | Luspatercept | Reblozyl | 0.25mg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2019 | Jul 1, 2020 | In Use | |||
| Q5120 | Pegfilgratim-bmez | Ziextenzo | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony Stimulating Factor | No | 2019 | Jul 1, 2020 | In Use | ||
| J9358 | Fam-trastuzumab deruxtecan-nxki | Enhertu | 1mg | Immunotherapy | Drug Antibody Conjugate | HER2, topoisomerase, tetrapeptide | No | 2019 | Jul 1, 2020 | In Use | ||
| J9177 | Enfortumab vedotin-ejfv | Padcev | 0.25mg | Immunotherapy | Drug Antibody Conjugate | Nectin-4 | No | 2019 | Jul 1, 2020 | In Use | ||
| J9198 | Gemcitabine HCl | Infugem | 100mg | Chemotherapy | Antimetabolite | Pyrimidine Analog | No | 2018 | Jul 1, 2020 | In Use | ||
| J9246 | Melphalan | Evomela | 1mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | No | 2016 | Jul 1, 2020 | In Use | ||
| Q5119 | Rituximab-pvvr | Ruxience | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | No | 2019 | Jul 1, 2020 | In Use | ||
| C9058 | Pegfilgrastim-bmez | Ziextenzo | 0.5mg | Ancillary Therapy | immunomodulatorne | Granulocyte Colony Stimulating Factor | No | 2019 | Mar 31, 2020 | Jul 1, 2020 | No Longer Used | |
| J9309 | Polatuzumab Vedotin | Polivy | 1mg | Immunotherapy | Drug Antibody Conjugate | CD79b | No | 2019 | Jan 1, 2020 | In Use | ||
| J9044 | Bortezomib | Bortezomib | 0.1mg | Chemotherapy | Proteasome Inhibitor | 26S | No | 2019 | Nov 3, 2019 | Dec 21, 2022 | In Use | |
| J9118 | Calaspargase pegol-mknl | Asparlas | 10 units | Chemotherapy | Miscellaneous Agent | Enzyme | No | 2018 | Oct 1, 2019 | In Use | ||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| Q5118 | Bevacizumab-bvzr | Zirabev | 10mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2019 | Oct 1, 2019 | In Use | ||
| Q5116 | Trastuzumab-qyyp | Trazimera | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2020 | Oct 1, 2019 | In Use | ||
| J9204 | Mogamulizumab-kpkc | Poteligeo | 1mg | Immunotherapy | Monoclonal Antibody | CCR4 | No | 2018 | Oct 1, 2019 | In Use | ||
| Q5117 | Trastuzumab-anns | Kanjinti | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Oct 1, 2019 | In Use | ||
| J9313 | Moxetumomab-pasudotox-tdfk | Lumoxiti | 0.01mg | Immunotherapy | Drug Antibody Conjugate | CD22 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9269 | Tagraxofusp-erzs | Elzonris | 10mcg | Immunotherapy | Recombinant Fusion Protein | IL3/CD123 | No | 2018 | Oct 1, 2019 | In Use | ||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| J9113 | Cemiplimab-rwlc | Libtayo | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2018 | Oct 1, 2019 | In Use | ||
| Q5113 | Trastuzumab-pkrb | Herzuma | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2018 | Jul 1, 2019 | In Use | ||
| J9030 | Bacillus calmette-guerin | BCG Vaccine, Tice BCG | 1mg | Immunotherapy | Biological Response Modifier | Live Vaccine | No | 1990 | Jul 1, 2019 | In Use | ||
| J9036 | Bendamustine HCL | Belrapzo | 1mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | No | 2018 | Jul 1, 2019 | In Use |
The use of NA indicates that the HCPCS code was Not Available. NA may mean that a) the HCPCS code has
not yet been created (new drug), b) the drug is given as an oral drug or alternative route (only in
specific instances are HCPCS assigned to these medications), or c) the HCPCS could not be found or is
truly not available.
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