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HCPCS code Q5111: Udenyca injection, per 0.5 mg2026 Medicare rate & RVUs

Pegfilgrastim-cbqv is a long-acting growth factor reported for chemotherapy-related neutropenia support, with each billing unit representing 0.5 mg.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · Q5111

Udenyca injection, per 0.5 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for Q5111 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What Q5111 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What Q5111 covers

This code identifies Udenyca (pegfilgrastim-cbqv), a long-acting granulocyte colony-stimulating factor used to reduce the risk of infection associated with febrile neutropenia in patients receiving myelosuppressive chemotherapy. It is administered subcutaneously, typically as a dose following a chemotherapy cycle. Oncology practices and hospital outpatient departments commonly report the drug when they furnish it to a patient; the code identifies the medication, not the injection service.

Each unit represents 0.5 mg of pegfilgrastim-cbqv, so a 6 mg dose corresponds to 12 units. CMS assigns this code physician fee schedule status E, meaning it is excluded from the physician fee schedule; when Medicare covers it, payment is under another method. CMS classifies it as a Part B drug, generally priced from the quarterly ASP drug pricing files when covered. Coverage is left to the Medicare contractor’s judgment.

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 Q5111 pays more and less

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

109 of 109 payment localities

Q5111 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

Q5111 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
Q5111 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the Q5111 rate is calculated

Each of Q5111’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 · Q5111

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 Q5111

Q5111 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 · Q5111

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

Q5111 isn’t priced in this setting.

Q5111 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • Q5111

    Udenyca injection, per 0.5 mg0 wRVU

    Not priced

  • Q5108

    Fulphila injection, per 0.5 mg0 wRVU

    Not priced

  • Q5120

    Pegfilgrastim-bmez, per 0.5 mg0 wRVU

    Not priced

  • Q5101

    Zarxio injection, per 1 mcg0 wRVU

    Not priced

How to choose

Q5108Fulphila injectionPer 0.5 mg
Q5108 identifies pegfilgrastim-jmdb (Fulphila); use Q5111 for pegfilgrastim-cbqv (Udenyca).
Q5120Pegfilgrastim-bmezPer 0.5 mg
Q5120 identifies pegfilgrastim-bmez, rather than Udenyca’s pegfilgrastim-cbqv.
Q5101Zarxio injectionPer 1 mcg
Q5101 identifies filgrastim-sndz, a shorter-acting product; Q5111 identifies long-acting pegfilgrastim-cbqv.

Codes related to Q5111

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to Q5111
CodeHow it relatesNational office range
Used instead
Q5108Fulphila injection, per 0.5 mgPegfilgrastim-jmdb (Fulphila), a different pegfilgrastim biosimilar for a similar clinical need.No office rate
Q5120Pegfilgrastim-bmez, per 0.5 mgPegfilgrastim-bmez is another pegfilgrastim biosimilar product.No office rate
Q5122Nyvepria injection, per 0.5 mgPegfilgrastim-apgf (Nyvepria) is another pegfilgrastim biosimilar product.No office rate
Q5101Zarxio injection, per 1 mcgFilgrastim-sndz is a shorter-acting growth factor used for neutropenia support.No office rate
Q5110Nivestym, per 1 mcgFilgrastim-aafi is a shorter-acting growth factor product, not pegfilgrastim.No office rate

Q5111 billing questions

How many units are reported for a 6 mg dose?

Report 12 units because each unit represents 0.5 mg. The drug amount furnished should support the units billed.

How does this code differ from Q5108?

Both identify pegfilgrastim biosimilar products, but Q5111 is for pegfilgrastim-cbqv (Udenyca), while Q5108 identifies pegfilgrastim-jmdb (Fulphila).

Is this code paid under the physician fee schedule?

No. CMS assigns status E, excluding it from the physician fee schedule. When Medicare covers the drug, it generally uses the Part B drug pricing method based on quarterly ASP files.

Does the drug code include the injection service?

The code represents the drug amount, not the act of administering it. Report a separately reportable administration service using the applicable administration code.

What documentation supports the units billed?

Document the product administered, the dose, and the quantity furnished. The dose determines the units at 0.5 mg per unit.

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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