HCPCS code Q5111: Udenyca injection, per 0.5 mg2026 Medicare rate & RVUs in Illinois
Pegfilgrastim-cbqv is a long-acting growth factor reported for chemotherapy-related neutropenia support, with each billing unit representing 0.5 mg.
CMS doesn’t publish an office rate for Q5111 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | Unavailable |
| East St. Louis, IL | Unavailable | Unavailable |
| Rest of Illinois | Unavailable | Unavailable |
| Suburban Chicago, IL | Unavailable | Unavailable |
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
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
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Q5111 isn’t priced in this setting.
Q5111 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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