HCPCS Code Details - Q5111

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q5111
Description

Long description:
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg

Short description:
Injection, udenyca 0.5 mg

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
ASC payment group code Effective Jan 01, 2019 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1E - Other drugs
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Apr 01, 2023
Date added Added Jan 01, 2019
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - Q5111

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
April 1, 2024 - June 30, 2024 0.5 MG 135.486 - - - - - -
January 1, 2024 - March 31, 2024 0.5 MG 122.103 - - - - - -
October 1, 2023 - December 31, 2023 0.5 MG 150.78 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 0.5 MG 124.782 20% - - - - -
April 1, 2023 - June 30, 2023 0.5 MG 141.166 20% - - - - -

See also

  • HCPCS Q5110 · Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram

  • HCPCS Q5112 · Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”