HCPCS code Q5110: Nivestym, per 1 mcg2026 Medicare rate & RVUs in California

Q5110 reports Nivestym, a filgrastim biosimilar, by microgram for covered treatment or prevention of neutropenia and related indications.

CMS RVU26DEffective Oct 1, 202629 payment localities

CMS doesn’t publish an office rate for Q5110 in California.

—Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in California
  2. What Q5110 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What Q5110 covers

Q5110 identifies Nivestym (filgrastim-aafi), a biosimilar granulocyte colony-stimulating factor. Oncology practices commonly use filgrastim products to reduce infection risk from neutropenia associated with cancer treatment. Filgrastim is also used in settings such as bone marrow transplantation and stem-cell mobilization. It is administered by subcutaneous injection or intravenous infusion, depending on clinical use. Q5110 identifies the drug, not the administration service.

CMS assigns Q5110 to the Part B drug pricing method; when Medicare covers it, payment generally uses CMS’s quarterly Average Sales Price drug pricing files. Its physician fee schedule status is E, meaning CMS excludes it from the physician fee schedule and, when covered, pays under another method. CMS also assigns special Medicare coverage instructions to this code. One unit represents 1 microgram of filgrastim-aafi, so reported units correspond to the total microgram dose furnished.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where Q5110 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

Q5110 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CAUnavailableUnavailable
Chico, CAUnavailableUnavailable
El Centro, CAUnavailableUnavailable
Fresno, CAUnavailableUnavailable
Hanford, CAUnavailableUnavailable
Los Angeles, CAUnavailableUnavailable
Madera, CAUnavailableUnavailable
Marin County, CAUnavailableUnavailable
Merced, CAUnavailableUnavailable
Modesto, CAUnavailableUnavailable

How the Q5110 rate is calculated

Each of Q5110’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · Q5110

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for Q5110

Q5110 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · Q5110

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

Q5110 isn’t priced in this setting.

Q5110 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • Q5110

    Nivestym, per 1 mcg0 wRVU

    Not priced

  • Q5101

    Zarxio injection, per 1 mcg0 wRVU

    Not priced

  • Q5125

    Releuko injection, per 1 mcg0 wRVU

    Not priced

  • Q5111

    Udenyca injection, per 0.5 mg0 wRVU

    Not priced

How to choose

Q5101Zarxio injectionPer 1 mcg
Q5101 is for filgrastim-sndz (Zarxio); Q5110 is for filgrastim-aafi (Nivestym). Select the code for the specific product administered.
Q5125Releuko injectionPer 1 mcg
Q5125 identifies filgrastim-ayow (Releuko), not Nivestym. Both are filgrastim biosimilars, but each product has its own code.
Q5111Udenyca injectionPer 0.5 mg
Q5111 is for pegfilgrastim-cbqv (Udenyca), a longer-acting pegfilgrastim product. Q5110 is for filgrastim-aafi (Nivestym), reported per microgram.

Q5110 billing questions

What does one Q5110 unit represent?

One unit represents 1 microgram of filgrastim-aafi. Report units based on the total Nivestym dose furnished.

How is Q5110 different from Q5101?

Q5110 is for filgrastim-aafi (Nivestym), while Q5101 is for filgrastim-sndz (Zarxio). Select the code matching the product administered.

How is Q5110 different from Q5125?

Q5125 identifies filgrastim-ayow (Releuko), while Q5110 identifies filgrastim-aafi (Nivestym). Both are filgrastim biosimilars, but each has a product-specific code.

Does Q5110 include the injection or infusion service?

Q5110 reports the drug amount, not the act of administering it.

How does Medicare price Q5110?

CMS excludes Q5110 from the physician fee schedule (status E). When Medicare covers the drug, it generally uses the quarterly ASP drug pricing files under the Part B drug pricing method.

Does Q5110 have Medicare coverage instructions?

Yes. CMS assigns special Medicare coverage instructions to Q5110.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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