| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J9017 | Arsenic Trioxide | Trisenox | 1 mg | Chemotherapy | Miscellaneous Agent | PML/RARa | No | 2000 | Jan 1, 2002 | In Use | ||
| Maribavir | Livtencity | 200mg | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Yes | 2021 | In Use | ||||
| S0176 | Hydroxyurea | Hydrea | 500 mg | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Yes | 1967 | Jan 1, 2002 | In Use | ||
| J9021 | Asparaginase Erwinia Chrysanthemi (recombinant)-rywn | Rylaze | 0.1mg | Chemotherapy | Miscellaneous Agent | Enzyme | No | 2021 | Jan 26, 2022 | In Use | ||
| J9020 | Asparaginase | Erwinaze | 10, 000 units (I.U.) | Chemotherapy | Miscellaneous Agent | Enzyme | No | 1994 | Jan 1, 1984 | Jan 12, 2026 | In Use | |
| J9019 | Asparaginase | Erwinaze | 10, 000 units (I.U.) | Chemotherapy | Miscellaneous Agent | Enzyme | No | 2011 | Jan 1, 2013 | Jan 12, 2026 | In Use | |
| C9012 | Arsenic Trioxide | Trisenox | unspecified | Chemotherapy | Miscellaneous Agent | PML/RARa | No | 2000 | Jan 1, 2001 | Dec 31, 2001 | No Longer Used | |
| C9289 | Asparaginase | Erwinaze | 1,000 units (I.U.) | Chemotherapy | Miscellaneous Agent | Enzyme | No | 2011 | Apr 4, 2012 | Dec 31, 2014 | No Longer Used | |
| NA | Mitotane | Lysodren | unspecified | Chemotherapy | Miscellaneous Agent | Adrenal Suppressant | Yes | 1970 | In Use | |||
| NA | Pilocarpine Hydrochloride | Pilocarpine | 5mg, 10mg | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agent | Yes | 2020 | In Use | |||
| J9356 | Trastuzumab and Hyaluronidase-oysk | Herceptin hylecta | 10mg | Immunotherapy | Monoclonal Antibody | HER2 | No | 2019 | Jul 1, 2019 | In Use | ||
| J9286 | Glofitamab-gxbm | Columvi | 2.5mg | Immunotherapy | Monoclonal Antibody | CD20, CD3 | No | 2023 | Dec 7, 2023 | In Use | ||
| S0116 | Bevacizumab | Avastin | 100 mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2004 | Jul 1, 2004 | Jun 30, 2006 | 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 | ||
| J9601 | Linvoseltamab-gcpt | Lynozyfic | 1mg | Immunotherapy | Monoclonal Antibody | BCMA, CD3 | No | 2025 | Mar 18, 2026 | In Use | ||
| C9110 | Alemtuzumab | Lemtrada | 10 mg | Immunotherapy | Monoclonal Antibody | CD52 | No | 2001 | Jan 1, 2001 | Dec 31, 2007 | No Longer Used | |
| J9055 | Cetuximab | Erbitux | 10 mg | Immunotherapy | Monoclonal Antibody | EGFR | No | 2004 | Jan 1, 2005 | In Use | ||
| C9215 | Cetuximab | Erbitux | 10 mg | Immunotherapy | Monoclonal Antibody | EGFR | No | 2004 | Feb 12, 2004 | Dec 31, 2004 | No Longer Used | |
| C9142 | Bevacizumab-maly | Alymsys | 10mg | Immunotherapy | Monoclonal Antibody | VEGF | No | 2022 | Sep 27, 2022 | Dec 21, 2022 | No Longer Used | |
| Q5126 | Bevacizumab-maly | Alymsys | 10mg | Immunotherapy | Monoclonal Antibody | VEGF | No | 2022 | Nov 28, 2022 | In Use | ||
| Q5107 | Bevacizumab-awwb | Mvasi | 10mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2018 | Jan 1, 2019 | In Use | ||
| C9214 | Bevacizumab | Avastin | 10 mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2004 | Feb 26, 2004 | Dec 31, 2004 | No Longer Used | |
| C9257 | Bevacizumab | Avastin | 0.25 mg | Immunotherapy | Monoclonal Antibody | VEGFR | No | 2004 | Jan 1, 2010 | In Use | ||
| J9204 | Mogamulizumab-kpkc | Poteligeo | 1mg | Immunotherapy | Monoclonal Antibody | CCR4 | No | 2018 | 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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