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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
C9082 Dostarlimab-gxly Jemperli 100mg Immunotherapy Checkpoint Inhibitor PD-1 No 2021 Sep 27, 2021 Jan 26, 2022 No Longer Used
C9284 Ipilimumab Yervoy 1mg Immunotherapy Checkpoint Inhibitor CTLA-4 No 2011 Jul 1, 2011 Dec 31, 2011 No Longer Used
J9271 Pembrolizumab Keytruda 1 mg Immunotherapy Checkpoint Inhibitor PD-1 No 2014 Jan 1, 2016 In Use
J9277 Pembrolizumab and berahyaluronidase alfa-pmph KEYTRUDA QLEX 1mg Immunotherapy Checkpoint Inhibitor PD-1 No 2025 Mar 18, 2026 In Use
C9483 Atezolizumab Tecentriq 10 mg Immunotherapy Checkpoint Inhibitor PD-1 No 2016 Oct 1, 2016 In Use
J9173 Durvalumab Imfinzi 10mg Immunotherapy Checkpoint Inhibitor PD-L1 No 2017 Jan 1, 2019 In Use
J9272 Dostarlimab-gxly Jemperli 10mg Immunotherapy Checkpoint Inhibitor PD-1 No 2021 Jan 26, 2022 In Use
J3263 Toripalimab-tpzi Loqtorzi 1mg Immunotherapy Checkpoint Inhibitor PD-1 No 2023 Jun 10, 2024 In Use
J9289 Nivolumab and hyaluronidase-nvhy OPDIVO QVANTIG 2mg Immunotherapy Checkpoint Inhibitor PD-1 No 2025 Jul 9, 2025 In Use
C9453 Nivolumab Opdivo 1 mg Immunotherapy Checkpoint Inhibitor PD-1 No 2014 Jul 1, 2015 In Use
J9275 Cosibelimab-ipdl UNLOXCYT 2mg Immunotherapy Checkpoint Inhibitor PD-L1 No 2025 Jul 9, 2025 In Use
J9329 Tislelizumab-jsgr Tevimbra 1mg Immunotherapy Checkpoint Inhibitor PD-1 No 2024 Sep 11, 2024 In Use
J0641 Levoleucovorin Fusilev, Levoleucovorin 0.5 mg Ancillary Therapy Chemoprotective Antidote No 2008 Oct 1, 2019 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
C9310 Leucovorin calcium ( avyxa) Vykoura 1mg Ancillary Therapy Chemoprotective Antidote No 2026 Jun 17, 2026 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 15 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan 1, 1997 In Use
J1190 Dexrazoxane Zinecard 250 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1995 Jan 1, 2007 In Use
C9428 Mesna Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan 200 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1988 Jan 1, 2004 Dec 31, 2005 No Longer Used
J0207 Amifostine Ethyol 500 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1995 Jan 1, 1998 In Use
NA Mesna Mesnex 400 mg Ancillary Therapy Chemoprotective Detoxifying Agent Yes 2002 In Use
J9209 Mesna Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan 200 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1988 Jan 1, 1990 In Use
NA Uridine Triacetate Vistogard 10 g Ancillary Therapy Chemoprotective Antidote Yes 2015 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 15 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan 1, 1997 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 10 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan 1, 1997 In Use
N/A Calcium folinate Lederle Leucovorin 5mg Ancillary Therapy Chemoprotective Antidote Yes 2025 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.