Sipuleucel-t auto cd54+
Products billed under this code include Provenge.
Payment limit per Per infusion (minimum 50 million cells), by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under Q2043
From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Provenge | Dendreon Pharmaceuticals LLC | 30237-8900-06 | 1 | $55,663.131 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $55,663.131 | −$269.296 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted September 17, 2026 |
| 3Q26 | $55,932.427 | −$336.765 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted September 15, 2026 |
| 2Q26 | $56,269.192 | +$1,865.084 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted September 15, 2026 |
| 1Q26 | $54,404.108 | −$868.216 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted September 15, 2026 |
| 4Q25 | $55,272.324 | −$673.647 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted September 8, 2026 |
| 3Q25 | $55,945.971 | −$1,071.132 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted March 10, 2026 |
| 2Q25 | $57,017.103 | +$1,480.605 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted March 10, 2026 |
| 1Q25 | $55,536.498 | +$521.273 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted December 19, 2025 |
| 4Q24 | $55,015.225 | −$497.559 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted June 11, 2025 |
| 3Q24 | $55,512.784 | +$59.217 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted June 11, 2025 |
| 2Q24 | $55,453.567 | +$2,026.911 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted March 11, 2025 |
| 1Q24 | $53,426.656 | −$46.217 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted December 19, 2024 |
| 4Q23 | $53,472.873 | +$410.432 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted October 10, 2024 |
| 3Q23 | $53,062.441 | −$567.928 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted June 5, 2024 |
| 2Q23 | $53,630.369 | −$351.095 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted February 23, 2024 |
| 1Q23 | $53,981.464 | +$475.93 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted December 6, 2023 |
| 4Q22 | $53,505.534 | −$1,609.211 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted June 22, 2023 |
| 3Q22 | $55,114.745 | +$2,198.244 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted June 9, 2023 |
| 2Q22 | $52,916.501 | +$494.922 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted December 14, 2022 |
| 1Q22 | $52,421.579 | −$595.997 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted June 8, 2022 |
| 4Q21 | $53,017.576 | +$1,304.601 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted June 2, 2022 |
| 3Q21 | $51,712.975 | +$349.723 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted June 2, 2022 |
| 2Q21 | $51,363.252 | +$1,713.844 | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted March 1, 2022 |
| 1Q21 | $49,649.408 | – | Per infusion (minimum 50 million cells) | Sipuleucel-t auto cd54+ | v1, posted December 10, 2021 |
“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
- 4Q26: 2026-09-17_october-2026-medicare-part-b-payment-limit-files-final.zipposted September 17, 2026
- 4Q26: 2026-09-17_october-2026-ndc-hcpcs-crosswalk-final.zipposted September 17, 2026
- 3Q26: 2026-09-15_july-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 2Q26: 2026-09-15_april-2026-medicare-part-b-payment-limit-files-final-file.zipposted September 15, 2026
- 1Q26: 2026-09-15_january-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 4Q25: 2026-09-08_october-2025-asp-pricing-final-file.zipposted September 8, 2026
- 3Q25: 2026-03-10_july-2025-asp-pricing-file.zipposted March 10, 2026
- 2Q25: 2026-03-10_april-2025-asp-pricing-file.zipposted March 10, 2026
- 1Q25: 2025-12-19_january-2025-asp-pricing-file-03-11-25-final-file.zipposted December 19, 2025
- 4Q24: 2025-06-11_october-2024-asp-pricing-file.zipposted June 11, 2025
- 3Q24: 2025-06-11_july-2024-asp-pricing-file.zipposted June 11, 2025
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025
- 1Q24: 2024-12-19_january-2024-asp-pricing-file.zipposted December 19, 2024
- 4Q23: 2024-10-10_october-2023-asp-pricing-file.zipposted October 10, 2024
- 3Q23: 2024-06-05_july-2023-asp-pricing-file.zipposted June 5, 2024
- 2Q23: 2024-02-23_april-2023-asp-pricing-file.zipposted February 23, 2024
- 1Q23: 2023-12-06_january-2023-asp-pricing-file.zipposted December 6, 2023
- 4Q22: 2023-06-22_october-2022-asp-pricing-file.zipposted June 22, 2023
- 3Q22: 2023-06-09_july-2022-asp-pricing-file.zipposted June 9, 2023
- 2Q22: 2022-12-14_april-2022-asp-pricing-file.zipposted December 14, 2022
- 1Q22: 2022-06-08_january-2022-asp-pricing-file.zipposted June 8, 2022
- 4Q21: 2022-06-02_october-2021-asp-pricing-file.zipposted June 2, 2022
- 3Q21: 2022-06-02_july-2021-asp-pricing-file.zipposted June 2, 2022
- 2Q21: 2022-03-01_april-2021-asp-pricing-file.zipposted March 1, 2022
- 1Q21: 2021-12-10_january-2021-asp-pricing-file.zipposted December 10, 2021