HCPCS code J9316 — Pertuzu, trastuzu, 10 mg. Status: Active. Effective Jan 1, 2021. Source: CMS HCPCS Level II.

J9316

Active

Pertuzu, trastuzu, 10 mg

Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Jan 1, 2021
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 9390

MUE — Medically Unlikely Edits

Maximum units of J9316 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
Outpatient Hospital 180
Practitioner Services 180

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

National Drug Codes (NDCs) mapped to this HCPCS code.

NDC Drug Name
50242-0245-01 Phesgo
50242-0260-01 Phesgo

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2021-Q1
    Pertuzu, trastuzu, 10 mg