Home › Drug Codes › J Codes › J9356 · HERCEPTIN HYLECTA
Updated July 1st, 2026

HERCEPTIN HYLECTA J Code: J9356

Injection, trastuzumab, 10 mg and hyaluronidase-oysk

Login to unlock all benchmarks

Q4 2026 Medicare Payment Limit for J9356, effective October 1, 2026: $58.038 per HCPCS billing unit, down 0.5% from $58.344. From CMS's final file.

?
Medicare Payment Limit ?
$58.344
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$58.344
/ HCPCS billing unit · APC 9314
ASP ?
$•••.••
Login to view
WAC · AWP ?
$•••.••
Login to view
NDCs Crosswalked ?
1
View NDC crosswalk →

Drug & Product Overview

HCPCS Descriptor Injection, trastuzumab, 10 mg and hyaluronidase-oysk
HCPCS Added Date July 1, 2019
Manufacturer Genentech
Route of Administration Subcutaneous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Solution

About HERCEPTIN HYLECTA

Herceptin Hylecta is a medication aligned to the HCPCS J Code: J9356 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology, it is administered via the subcutaneous route and manufactured by Genentech.

According to CMS Drug Use Information: Trastuzumab is used to treat breast cancer. Trastuzumab belongs to a class of medications known as monoclonal antibodies. It works by slowing or stopping the growth of cancer cells. This product also contains hyaluronidase, which helps your body absorb trastuzumab given by injection under the skin. This monograph is about the following trastuzumab products: trastuzumab (subcutaneous) and trastuzumab-hyaluronidase-oysk. These products are not the same as other trastuzumab products, including trastuzumab emtansine, or trastuzumab given by injection into a vein, and should not be used in place of each other.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
50242-0077-01 Herceptin Hylecta Genentech, Inc. 60 600 MG / 5 ML
Login for the full NDC crosswalk View pricing, complete NDC-to-HCPCS alignments, and package details.
Login →

HERCEPTIN HYLECTA Pricing & Reimbursement

J9356 Private Payer Reimbursement
$63.56 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →
UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

HERCEPTIN HYLECTA Claims Performance

Claims from Jan 2026 – Aug 2026
Claim Denial Rate 15.32%
Avg. Days to File 6.4days
Avg. Days to Pay 23.3days

Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.

Explore J9356 claims analytics on FocalPoint →
OnPoint Oncology

HERCEPTIN HYLECTA CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96401 Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic
JW / JZ modifiers apply

CMS has identified Herceptin Hylecta (J9356) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

HERCEPTIN HYLECTA Medically Unlikely Edits (MUE)

The most billing units of J9356 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.

Practitioner Office & Hospital Outpatient
60 units / day
= 600 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

HERCEPTIN HYLECTA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Breast Cancer Metastatic Breast Cancer
Drug Class
Endoglycosidase [EPC]Glycoside Hydrolases [CS]HER2/Neu/cerbB2 Antagonists [MoA]HER2/neu Receptor Antagonist [EPC]

Login for BuyandBill.com Analytics

Unlock deeper insights with BuyandBill’s Comparative Report!

  • Compare ASP, WAC, and AWP across drugs.
  • Visualize Drug Price Movement Over Time
  • Tailor reports to drug class, manufacturer, or HCPCS Code.
  • Compare Biosimilar and 505(b)(2) products.
Access Full Report →

Frequently Asked Questions

Is there an available Herceptin Hylecta billing and coding guide?
Billing and coding information for HERCEPTIN HYLECTA can be found through Genentech. Visit Here →
Are there any available Herceptin Hylecta patient assistance programs?
HERCEPTIN HYLECTA patient assistance information can be found through Genentech. Visit Here →
Where can I find Herceptin Hylecta prescribing information?
HERCEPTIN HYLECTA prescribing information can be found at the link below: Visit Here →
Where can I find Herceptin Hylecta side effect information?
Information regarding HERCEPTIN HYLECTA's side effects can be found at MedlinePlus Visit Here →
Does billing HERCEPTIN HYLECTA require JZ/JW wastage modifiers?
CMS has identified HERCEPTIN HYLECTA(J9356) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.

Related Drug Codes

Explore billing, coding, and pricing for drugs related to HERCEPTIN HYLECTA.

J9000ADRIAMYCINInjection, doxorubicin hydrochloride, 10 mgMultiple ManufacturersAdded January 1, 1984J9267PaclitaxelInjection, paclitaxel, 1 mgMultiple ManufacturersAdded January 1, 2015Q5112ONTRUZANTInjection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mgOrganonAdded July 1, 2019Q5113HERZUMAInjection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mgTevaAdded July 1, 2019Q5114OGIVRIInjection, trastuzumab-dkst, biosimilar, (ogivri), 10 mgBiocon Biologics IncAdded July 1, 2019Q5116TrazimeraInjection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mgPfizerAdded October 1, 2019Q5117KANJINTIInjection, trastuzumab-anns, biosimilar, (kanjinti), 10 mgAmgenAdded October 1, 2019J8522XELODACapecitabine, oral, 50 mgMultiple ManufacturersAdded October 1, 2024J9171DOCETAXELInjection, docetaxel, 1 mgMultiple ManufacturersAdded January 1, 2010J9174BEIZRAYInjection, docetaxel (beizray), 1 mgZydus PharmaceuticalsAdded July 1, 2025