HCPCS drug code · CMS crosswalk
Phesgo J-Code / HCPCS Code
In short
Phesgo is billed under HCPCS J9316 — Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 2 Phesgo NDCs under this code.
Reference
- J9316
- Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mgBilling unit: 10 mg
- Labelers
- Genentech, Inc.
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Phesgo units and claim line
Enter the dose given to get the J9316 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Phesgo NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 50242-0245-01 | J9316 | Genentech, Inc. | 15 | 180 |
| 50242-0260-01 | J9316 | Genentech, Inc. | 10 | 120 |
Phesgo: common questions
- What is the J-code for Phesgo?
- Phesgo is billed under HCPCS J9316 — Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 2 Phesgo NDCs under this code.
- How many J9316 billing units are in a package of Phesgo?
- CMS lists 120 to 180 billing units per package, depending on the NDC, where one unit is 10 mg. Units to report are based on the dose given, not the package.
- Is J9316 a CPT code?
- No. J9316 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.