Rxcurve
Medicare Part B payment limits Effective October 1 – December 31, 2026 Posted by CMS September 17, 2026
HCPCS J9316 · per 10 MG

Pertuzu, trastuzu, 10 mg

Products billed under this code include Phesgo.

Payment limit per 10 MG, by effective quarter, 2Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.

Products billed under J9316

From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.

ProductLabelerNDCUnits / pkgLimit / pkg
Phesgo Genentech, Inc. 50242-0245-01 180 $10,708.38
Phesgo Genentech, Inc. 50242-0260-01 120 $7,138.92

Every quarter

QuarterPayment limitChangeBilling unitDescriptionSource file
4Q26 $59.491 −$0.404 10 MG Pertuzu, trastuzu, 10 mg v1, posted September 17, 2026
3Q26 $59.895 −$0.33 10 MG Pertuzu, trastuzu, 10 mg v1, posted September 15, 2026
2Q26 $60.225 −$0.735 10 MG Pertuzu, trastuzu, 10 mg v1, posted September 15, 2026
1Q26 $60.96 −$1.138 10 MG Pertuzu, trastuzu, 10 mg v1, posted September 15, 2026
4Q25 $62.098 −$1.289 10 MG Pertuzu, trastuzu, 10 mg v1, posted September 8, 2026
3Q25 $63.387 +$0.394 10 MG Pertuzu, trastuzu, 10 mg v1, posted March 10, 2026
2Q25 $62.993 −$0.887 10 MG Pertuzu, trastuzu, 10 mg v1, posted March 10, 2026
1Q25 $63.88 −$0.696 10 MG Pertuzu, trastuzu, 10 mg v1, posted December 19, 2025
4Q24 $64.576 −$1.743 10 MG Pertuzu, trastuzu, 10 mg v1, posted June 11, 2025
3Q24 $66.319 +$0.995 10 MG Pertuzu, trastuzu, 10 mg v1, posted June 11, 2025
2Q24 $65.324 −$1.727 10 MG Pertuzu, trastuzu, 10 mg v1, posted March 11, 2025
1Q24 $67.051 −$0.855 10 MG Pertuzu, trastuzu, 10 mg v1, posted December 19, 2024
4Q23 $67.906 −$0.304 10 MG Pertuzu, trastuzu, 10 mg v1, posted October 10, 2024
3Q23 $68.21 −$0.23 10 MG Pertuzu, trastuzu, 10 mg v1, posted June 5, 2024
2Q23 $68.44 −$0.621 10 MG Pertuzu, trastuzu, 10 mg v1, posted February 23, 2024
1Q23 $69.061 −$0.789 10 MG Pertuzu, trastuzu, 10 mg v1, posted December 6, 2023
4Q22 $69.85 −$0.521 10 MG Pertuzu, trastuzu, 10 mg v1, posted June 22, 2023
3Q22 $70.371 −$0.489 10 MG Pertuzu, trastuzu, 10 mg v1, posted June 9, 2023
2Q22 $70.86 −$0.791 10 MG Pertuzu, trastuzu, 10 mg v1, posted December 14, 2022
1Q22 $71.651 −$0.498 10 MG Pertuzu, trastuzu, 10 mg v1, posted June 8, 2022
4Q21 $72.149 −$0.485 10 MG Pertuzu, trastuzu, 10 mg v1, posted June 2, 2022
3Q21 $72.634 −$0.901 10 MG Pertuzu, trastuzu, 10 mg v1, posted June 2, 2022
2Q21 $73.535 – 10 MG Pertuzu, trastuzu, 10 mg v1, posted March 1, 2022

“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.

CMS source files