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    HCPCS Details

    HCPC J9203
    Short Description Gemtuzumab ozogamicin 0.1 mg
    Long Description Injection, gemtuzumab ozogamicin, 0.1 mg
    Pricing indicator 51
    Coverage code C
    ASC payment group code YY
    BETOS2 code O1D
    Action code N
    Type of service 1
    Effective date 2018-01-01
    Date Added 2018-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00008451001 J9203 Gemtuzumab ozogamicin 0.1 mg Mylotarg PFIZER INC. 0.1 MG 1 1 45 45
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    Drug Details

    • Gemtuzumab ozogamicin injection is used alone or in combination with other chemotherapy medications to treat a certain type of acute myeloid leukemia (AML; a type of cancer that begins in the white blood cells) in adults and children 1 month of age and older who were recently found to have this cancer. It is also used alone to treat a certain type of AML in adults and children 2 years of age and older whose cancer worsened during or after treatment with other chemotherapy medications. Gemtuzumab ozogamicin injection is in a class of medications called monoclonal antibodies. It works by helping to kill cancer cells.