HCPCS Range Chemotherapy Drugs

• 1 Injection, doxorubicin hydrochloride, 10 mg ( J9000 )

• 2 Injection, aldesleukin, per single use vial ( J9015 )

• 3 Injection, arsenic trioxide, 1 mg ( J9017 )

• 4 Injection, asparaginase (Erwinaze), 1, 000 IU ( J9019 )

• 5 Injection, asparaginase, not otherwise specified, 10, 000 units ( J9020 )

• 6 Injection, azacitidine, 1 mg ( J9025 )

• 7 Injection, clofarabine, 1 mg ( J9027 )

• 8 Injection, bendamustine HCL (treanda), 1 mg ( J9033 )

• 9 Injection, bevacizumab, 10 mg ( J9035 )

• 10 Injection, bleomycin sulfate, 15 units ( J9040 )

• 11 Injection, bortezomib, 0.1 mg ( J9041 )

• 12 Injection, brentuximab vedotin, 1 mg ( J9042 )

• 13 Injection, cabazitaxel, 1 mg ( J9043 )

• 14 Injection, carboplatin, 50 mg ( J9045 )

• 15 Injection, carfilzomib, 1 mg ( J9047 )

• 16 Injection, carmustine, 100 mg ( J9050 )

• 17 Injection, cetuximab, 10 mg ( J9055 )

• 18 Injection, cisplatin, powder or solution, 10 mg ( J9060 )

• 19 Injection, cladribine, per 1 mg ( J9065 )

• 20 Injection, cytarabine liposome, 10 mg ( J9098 )

• 21 Injection, cytarabine, 100 mg ( J9100 )

• 22 Injection, dactinomycin, 0.5 mg ( J9120 )

• 23 Dacarbazine, 100 mg ( J9130 )

• 24 Injection, daunorubicin, 10 mg ( J9150 )

• 25 Injection, daunorubicin Citrate, liposomal formulation, 10 mg ( J9151 )

• 26 Injection, degarelix, 1 mg ( J9155 )

• 27 Injection, diethylstilbestrol diphosphate, 250 mg ( J9165 )

• 28 Injection, docetaxel, 1 mg ( J9171 )

• 29 Injection, epirubicin HCl, 2 mg ( J9178 )

• 30 Injection, eribulin mesylate, 0.1 mg ( J9179 )

• 31 Injection, etoposide, 10 mg ( J9181 )

• 32 Injection, fludarabine phosphate, 50 mg ( J9185 )

• 33 Injection, fluorouracil, 500 mg ( J9190 )

• 34 Injection, floxuridine, 500 mg ( J9200 )

• 35 Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg ( J9201 )

• 36 Goserelin acetate implant, per 3.6 mg ( J9202 )

• 37 Injection, irinotecan, 20 mg ( J9206 )

• 38 Injection, ixabepilone, 1 mg ( J9207 )

• 39 Injection, ifosfamide, 1 gram ( J9208 )

• 40 Injection, mesna, 200 mg ( J9209 )

• 41 Injection, idarubicin hydrochloride, 5 mg ( J9211 )

• 42 Injection, interferon alfacon-1, recombinant, 1 microgram ( J9212 )

• 43 Injection, interferon, alfa-2a, recombinant, 3 million units ( J9213 )

• 44 Injection, interferon, alfa-2b, recombinant, 1 million units ( J9214 )

• 45 Injection, interferon, alfa-N3, (human leukocyte derived), 250, 000 IU ( J9215 )

• 46 Injection, interferon, gamma 1-b, 3 million units ( J9216 )

• 47 Leuprolide acetate (for depot suspension), 7.5 mg ( J9217 )

• 48 Leuprolide acetate, per 1 mg ( J9218 )

• 49 Leuprolide acetate implant, 65 mg ( J9219 )

• 50 Histrelin implant (Vantas), 50 mg ( J9225 )

• 51 Histrelin implant (Supprelin LA), 50 mg ( J9226 )

• 52 Injection, ipilimumab, 1 mg ( J9228 )

• 53 Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg ( J9230 )

• 54 Injection, melphalan hydrochloride, not otherwise specified, 50 mg ( J9245 )

• 55 Injection, methotrexate sodium, 50 mg ( J9260 )

• 56 Injection, nelarabine, 50 mg ( J9261 )

• 57 Injection, omacetaxine mepesuccinate, 0.01 mg ( J9262 )

• 58 Injection, oxaliplatin, 0.5 mg ( J9263 )

• 59 Injection, paclitaxel protein-bound particles, 1 mg ( J9264 )

• 60 Injection, pegaspargase, per single dose vial ( J9266 )

• 61 Injection, pentostatin, 10 mg ( J9268 )

• 62 Injection, plicamycin, 2.5 mg ( J9270 )

• 63 Injection, mitomycin, 5 mg ( J9280 )

• 64 Injection, mitoxantrone hydrochloride, per 5 mg ( J9293 )

• 65 Injection, ofatumumab, 10 mg ( J9302 )

• 66 Injection, panitumumab, 10 mg ( J9303 )

• 67 Injection, pemetrexed, not otherwise specified, 10 mg ( J9305 )

• 68 Injection, pertuzumab, 1 mg ( J9306 )

• 69 Injection, pralatrexate, 1 mg ( J9307 )

• 70 Injection, streptozocin, 1 gram ( J9320 )

• 71 Injection, temozolomide, 1 mg ( J9328 )

• 72 Injection, temsirolimus, 1 mg ( J9330 )

• 73 Injection, thiotepa, 15 mg ( J9340 )

• 74 Injection, mosunetuzumab-axgb, 1 mg ( J9350 )

• 75 Injection, topotecan, 0.1 mg ( J9351 )

• 76 Injection, ado-trastuzumab emtansine, 1 mg ( J9354 )

• 77 Injection, trastuzumab, excludes biosimilar, 10 mg ( J9355 )

• 78 Injection, valrubicin, intravesical, 200 mg ( J9357 )

• 79 Injection, vinblastine sulfate, 1 mg ( J9360 )

• 80 Vincristine sulfate, 1 mg ( J9370 )

• 81 Injection, teclistamab-cqyv, 0.5 mg ( J9380 )

• 82 Injection, vinorelbine tartrate, 10 mg ( J9390 )

• 83 Injection, fulvestrant, 25 mg ( J9395 )

• 84 Injection, ziv-aflibercept, 1 mg ( J9400 )

• 85 Injection, porfimer sodium, 75 mg ( J9600 )

• 86 Not otherwise classified, antineoplastic drugs ( J9999 )

• 87 Injection, Elliotts' B solution, 1 ml ( J9175 )

• 88 BCG live intravesical instillation, 1 mg ( J9030 )

• 89 Injection, emapalumab-lzsg, 1 mg ( J9210 )

• 90 Injection, teplizumab-mzwv, 5 mcg ( J9381 )

• 91 Injection, necitumumab, 1 mg ( J9295 )

• 92 Injection, ramucirumab, 5 mg ( J9308 )

• 93 Injection, paclitaxel, 1 mg ( J9267 )

• 94 Injection, obinutuzumab, 10 mg ( J9301 )

• 95 Injection, belinostat, 10 mg ( J9032 )

• 96 Injection, blinatumomab, 1 microgram ( J9039 )

• 97 Injection, pembrolizumab, 1 mg ( J9271 )

• 98 Injection, nivolumab, 1 mg ( J9299 )

• 99 Injection, bendamustine HCL (bendeka), 1 mg ( J9034 )

• 100 Injection, daratumumab, 10 mg ( J9145 )

• 101 Injection, elotuzumab, 1 mg ( J9176 )

• 102 Injection, irinotecan liposome, 1 mg ( J9205 )

• 103 Injection, talimogene laherparepvec, per 1 million plaque forming units ( J9325 )

• 104 Injection, trabectedin, 0.1 mg ( J9352 )

• 105 Injection, atezolizumab, 10 mg ( J9022 )

• 106 Injection, avelumab, 10 mg ( J9023 )

• 107 Injection, gemtuzumab ozogamicin, 0.1 mg ( J9203 )

• 108 Injection, olaratumab, 10 mg ( J9285 )

• 109 Injection, copanlisib, 1 mg ( J9057 )

• 110 Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine ( J9153 )

• 111 Injection, durvalumab, 10 mg ( J9173 )

• 112 Injection, inotuzumab ozogamicin, 0.1 mg ( J9229 )

• 113 Injection, rituximab 10 mg and hyaluronidase ( J9311 )

• 114 Injection, rituximab, 10 mg ( J9312 )

• 115 Injection, bendamustine hydrochloride, (Belrapzo), 1 mg ( J9036 )

• 116 Injection, trastuzumab, 10 mg and Hyaluronidase-oysk ( J9356 )

• 117 Injection, moxetumomab pasudotox-tdfk, 0.01 mg ( J9313 )

• 118 Injection, cemiplimab-rwlc, 1 mg ( J9119 )

• 119 Injection, tagraxofusp-erzs, 10 micrograms ( J9269 )

• 120 Injection, mogamulizumab-kpkc, 1 mg ( J9204 )

• 121 Injection, calaspargase pegol-mknl, 10 units ( J9118 )

• 122 Injection, polatuzumab vedotin-piiq, 1 mg ( J9309 )

• 123 Injection, enfortumab vedotin-ejfv, 0.25 mg ( J9177 )

• 124 Injection, gemcitabine hydrochloride, (infugem), 100 mg ( J9198 )

• 125 Injection, melphalan (evomela), 1 mg ( J9246 )

• 126 Injection, fam-trastuzumab deruxtecan-nxki, 1 mg ( J9358 )

• 127 Injection, isatuximab-irfc, 10 mg ( J9227 )

• 128 Injection, pemetrexed (pemfexy), 10 mg ( J9304 )

• 129 Injection, daratumumab, 10 mg and hyaluronidase-fihj ( J9144 )

• 130 Injection, lurbinectedin, 0.1 mg ( J9223 )

• 131 Mitomycin pyelocalyceal instillation, 1 mg ( J9281 )

• 132 Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg ( J9316 )

• 133 Injection, sacituzumab govitecan-hziy, 2.5 mg ( J9317 )

• 134 Injection, belantamab mafodontin-blmf, 0.5 mg ( J9037 )

• 135 Injection, tafasitamab-cxix, 2 mg ( J9349 )

• 136 Injection, naxitamab-gqgk, 1 mg ( J9348 )

• 137 Injection, margetuximab-cmkb, 5 mg ( J9353 )

• 138 Injection, melphalan flufenamide, 1mg ( J9247 )

• 139 Injection, romidepsin, non-lyophilized, 0.1 mg ( J9318 )

• 140 Injection, romidepsin, lyophilized, 0.1 mg ( J9319 )

• 141 Injection, asparaginase, recombinant, (rylaze), 0.1 mg ( J9021 )

• 142 Injection, amivantamab-vmjw, 2 mg ( J9061 )

• 143 Injection, dostarlimab-gxly, 10 mg ( J9272 )

• 144 Injection, cyclophosphamide (auromedics), 5 mg ( J9071 )

• 145 Injection, tisotumab vedotin-tftv, 1 mg ( J9273 )

• 146 Injection, loncastuximab tesirine-lpyl, 0.075 mg ( J9359 )

• 147 Injection, sirolimus protein-bound particles, 1 mg ( J9331 )

• 148 Injection, efgartigimod alfa-fcab, 2mg ( J9332 )

• 149 Injection, tebentafusp-tebn, 1 microgram ( J9274 )

• 150 Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg ( J9298 )

• 151 Injection, bortezomib (dr. reddy's), not therapeutically equivalent to j9041, 0.1 mg ( J9046 )

• 152 Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg ( J9048 )

• 153 Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg ( J9049 )

• 154 Injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg ( J9314 )

• 155 Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg ( J9393 )

• 156 Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg ( J9394 )

• 157 Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg ( J9196 )

• 158 Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg ( J9294 )

• 159 Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg ( J9296 )

• 160 Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg ( J9297 )

• 161 Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose ( J9029 )

• 162 Injection, bendamustine hydrochloride (vivimusta), 1 mg ( J9056 )

• 163 Injection, bendamustine hydrochloride (apotex), 1 mg ( J9058 )

• 164 Injection, bendamustine hydrochloride (baxter), 1 mg ( J9059 )

• 165 Injection, mirvetuximab soravtansine-gynx, 1 mg ( J9063 )

• 166 Injection, paclitaxel protein-bound particles (american regent), not therapeutically equivalent to j9264, 1 mg ( J9259 )

• 167 Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg ( J9322 )

• 168 Injection, pemetrexed ditromethamine, 10 mg ( J9323 )

• 169 Injection, tremelimumab-actl, 1 mg ( J9347 )

• 170 Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg ( J9051 )

• 171 Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg ( J9064 )

• 172 Injection, retifanlimab-dlwr, 1 mg ( J9345 )

• 173 Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg ( J9052 )

• 174 Injection, cyclophosphamide (dr. reddy's), 5 mg ( J9072 )

• 175 Injection, docetaxel (ingenus), not therapeutically equivalent to j9171, 1 mg ( J9172 )

• 176 Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg ( J9255 )

• 177 Injection, paclitaxel protein-bound particles (teva), not therapeutically equivalent to j9264, 1 mg ( J9258 )

• 178 Injection, glofitamab-gxbm, 2.5 mg ( J9286 )

• 179 Injection, epcoritamab-bysp, 0.16 mg ( J9321 )

• 180 Injection, pemetrexed (pemrydi rtu), 10 mg ( J9324 )

• 181 Injection, rozanolixizumab-noli, 1 mg ( J9333 )

• 182 Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc ( J9334 )

• 183 Injection, cyclophosphamide (ingenus), 5 mg ( J9073 )

• 184 Injection, cyclophosphamide (sandoz), 5 mg ( J9074 )

• 185 Injection, cyclophosphamide, not otherwise specified, 5 mg ( J9075 )

• 186 Injection, melphalan (hepzato), 1 mg ( J9248 )

• 187 Injection, melphalan (apotex), 1 mg ( J9249 )

• 188 Injection, pozelimab-bbfg, 1 mg ( J9376 )

• 189 Injection, efbemalenograstim alfa-vuxw, 0.5 mg ( J9361 )