HCPCS Code Details - Q5120

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q5120
Description

Long description:
Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg

Short description:
Inj pegfilgrastim-bmez 0.5mg

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 Jul 01, 2020 - 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 Jul 01, 2020
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 - Q5120

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
0.5 MG 30.049 20% - - - - -
0.5 MG 80.062 20% - - - - -
0.5 MG 89.942 - - - - - -
0.5 MG 135.548 - - - - - -
0.5 MG 153.333 - - - - - -

See also

  • HCPCS Q5119 · Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg

  • HCPCS Q5121 · Injection, infliximab-axxq, biosimilar, (avsola), 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”