| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NA | Mesna | Mesnex | 400 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Yes | 2002 | In Use | |||
| C9310 | Leucovorin calcium ( avyxa) | Vykoura | 1mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2026 | Jun 17, 2026 | In Use | ||
| J0640 | Leucovorin Calcium | Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin | 50 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 1952 | Jan 1, 1997 | In Use | ||
| J1190 | Dexrazoxane | Zinecard | 250 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 2007 | In Use | ||
| J0642 | Levoleucovorin | Khapzory | 0.5mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2018 | Oct 1, 2019 | In Use | ||
| J9209 | Mesna | Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan | 200 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1988 | Jan 1, 1990 | In Use | ||
| J0641 | Levoleucovorin | Fusilev, Levoleucovorin | 0.5 mg | Ancillary Therapy | Chemoprotective | Antidote | No | 2008 | Oct 1, 2019 | In Use | ||
| J0207 | Amifostine | Ethyol | 500 mg | Ancillary Therapy | Chemoprotective | Detoxifying Agent | No | 1995 | Jan 1, 1998 | In Use | ||
| C9293 | Glucarpidase | Voraxaze | 10 units | Ancillary Therapy | Chemoprotective | Antidote | No | 2012 | Jan 1, 2012 | In Use | ||
| J9173 | Durvalumab | Imfinzi | 10mg | Immunotherapy | Checkpoint Inhibitor | PD-L1 | No | 2017 | Jan 1, 2019 | In Use | ||
| J9299 | Nivolumab | Opdivo | 1 mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2014 | Jan 1, 2016 | In Use | ||
| J9113 | Cemiplimab-rwlc | Libtayo | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2018 | Oct 1, 2019 | In Use | ||
| J9228 | Ipilimumab | Yervoy | 1mg | Immunotherapy | Checkpoint Inhibitor | CTLA-4 | No | 2011 | Jan 1, 2012 | In Use | ||
| C9491 | Avelumab | Bavencio | 10 mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2017 | Oct 1, 2017 | In Use | ||
| J9277 | Pembrolizumab and berahyaluronidase alfa-pmph | KEYTRUDA QLEX | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2025 | Mar 18, 2026 | In Use | ||
| J9329 | Tislelizumab-jsgr | Tevimbra | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2024 | Sep 11, 2024 | In Use | ||
| J9023 | Avelumab | Bavencio | 10mg | Immunotherapy | Checkpoint Inhibitor | PD-L1 | No | 2017 | Jan 1, 2018 | In Use | ||
| J9272 | Dostarlimab-gxly | Jemperli | 10mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2021 | Jan 26, 2022 | In Use | ||
| J9275 | Cosibelimab-ipdl | UNLOXCYT | 2mg | Immunotherapy | Checkpoint Inhibitor | PD-L1 | No | 2025 | Jul 9, 2025 | In Use | ||
| J9022 | Atezolizumab | Tecentriq | 10mg | Immunotherapy | Checkpoint Inhibitor | PD-L1 | No | 2016 | Jan 1, 2018 | In Use | ||
| C9027 | Pembrolizumab | Keytruda | 1 mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2014 | Jan 1, 2015 | Dec 31, 2015 | No Longer Used | |
| NA | Dostarlimab | Jemperli | 50mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | Yes | 2021 | In Use | |||
| C9483 | Atezolizumab | Tecentriq | 10 mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2016 | Oct 1, 2016 | In Use | ||
| J9024 | Atezolizumab, hyaluronidase-tqjs | Tecentriq Hybreza | 5mg | Immunotherapy | Checkpoint Inhibitor | PD-L1 | No | 2024 | Mar 26, 2025 | In Use | ||
| J9345 | Retifanlimab-dlwr | Zynyz | 1mg | Immunotherapy | Checkpoint Inhibitor | PD-1 | No | 2023 | Aug 28, 2023 | 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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