| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J9281 | Mitomycin Pyelocalyceal Instillation | Jelmyto | 1mg | Chemotherapy | Antitumor Antibiotic | Alkylating Agent/Mitomycin | No | 2020 | Jan 1, 2021 | In Use | ||
| J9223 | Lurbinectedin | Zepzelca | 0.1mg | Chemotherapy | Alkylating Agent | Adduct Forming Agent | No | 2020 | Jan 1, 2021 | In Use | ||
| J9144 | Daratumumab, hyaluronidase-fihj | Darzalex Faspro | 10mg | Immunotherapy | Monoclonal Antibody | CD38 | No | 2020 | Jan 1, 2021 | In Use | ||
| C9069 | Belantamab mafodotin-blmf | Blenrep | 0.5mg | Immunotherapy | Drug Antibody Conjugate | BCMA | No | 2020 | Jan 1, 2021 | No Longer Used | ||
| C9070 | Tafasitamab-cxix | Monjuvi | 2mg | Immunotherapy | Monoclonal Antibody | CD19 | 2020 | Jan 1, 2021 | Apr 1, 2021 | No Longer Used | ||
| C9062 | Daratumumab Hyaluronidase | Darzalex Faspro | 10mg | Immunotherapy | Monoclonal Antibody | CD38 | No | 2020 | Oct 1, 2020 | Jan 1, 2021 | No Longer Used | |
| J9227 | Isatuximab-irtc | Sarclisa | 10mg | Immunotherapy | Monoclonal Antibody | CD38 | No | 2020 | Oct 1, 2020 | In Use | ||
| J9304 | Pemetrexed | Pemfexy | 10mg | Chemotherapy | Antimetabolite | Folic Acid Analog | No | 2020 | Oct 1, 2020 | In Use | ||
| 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 | |
| Q5120 | Pegfilgratim-bmez | Ziextenzo | 0.5mg | Ancillary Therapy | Immunostimulant | Granulocyte Colony Stimulating Factor | No | 2019 | Jul 1, 2020 | In Use | ||
| J0896 | Luspatercept | Reblozyl | 0.25mg | Ancillary Therapy | Erythropoiesis-Stimulating Agent | No | 2019 | Jul 1, 2020 | In Use | |||
| J9246 | Melphalan | Evomela | 1mg | Chemotherapy | Alkylating Agent | Nitrogen Mustard | No | 2016 | 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 | ||
| Q5119 | Rituximab-pvvr | Ruxience | 10mg | Immunotherapy | Monoclonal Antibody | CD20 | 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 | ||
| 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 | |
| Q5118 | Bevacizumab-bvzr | Zirabev | 10mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2019 | Oct 1, 2019 | In Use | ||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| J9313 | Moxetumomab-pasudotox-tdfk | Lumoxiti | 0.01mg | Immunotherapy | Drug Antibody Conjugate | CD22 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9204 | Mogamulizumab-kpkc | Poteligeo | 1mg | Immunotherapy | Monoclonal Antibody | CCR4 | 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 |
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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