HCPCS code Q5112: Ontruzant injection, per 10 mg2026 Medicare rate & RVUs in Missouri
Reports the Ontruzant biosimilar trastuzumab-dttb for intravenous treatment of eligible HER2-positive breast or gastric cancers, in 10 mg units.
CMS doesn’t publish an office rate for Q5112 in Missouri.
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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On this page 9 sections
What Q5112 covers
Q5112 identifies trastuzumab-dttb, marketed as Ontruzant, a biosimilar trastuzumab product given by intravenous infusion. Oncology practices and hospital outpatient departments report the drug when it is administered for HER2-positive breast cancer or certain HER2-positive gastric or gastroesophageal junction cancers. The drug code represents the product; the infusion service is reported separately when applicable.
CMS assigns status E, excluding Q5112 from the physician fee schedule. When Medicare covers the drug, it generally pays under the Part B drug method using CMS quarterly Average Sales Price pricing files. Coverage is left to the Medicare contractor's judgment. Each billing unit represents 10 mg of trastuzumab-dttb, so the reported units reflect the administered dose divided by 10 mg.
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 Q5112 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the Q5112 rate is calculated
Each of Q5112’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 · Q5112
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 Q5112
Q5112 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 · Q5112
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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Q5112 isn’t priced in this setting.
Q5112 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- Q5113Herzuma injectionPer 10 mg
- Q5113 identifies Herzuma (trastuzumab-pkrb); Q5112 identifies Ontruzant (trastuzumab-dttb). Select the code for the product actually administered.
- Q5114Ogivri injectionPer 10 mg
- Q5114 identifies Ogivri (trastuzumab-dkst), not Ontruzant. Both represent trastuzumab biosimilars, but the administered product determines the code.
- Q5116TrazimeraPer 10 mg
- Q5116 identifies Trazimera (trastuzumab-qyyp). Use Q5112 only for trastuzumab-dttb, marketed as Ontruzant.
- Q5117Kanjinti injectionPer 10 mg
- Q5117 identifies Kanjinti (trastuzumab-anns), while Q5112 identifies Ontruzant. Distinguish them by the biosimilar product administered.
Q5112 billing questions
What does one Q5112 unit represent?
One unit represents 10 mg of trastuzumab-dttb. Report units based on the administered dose in 10 mg increments.
How is Q5112 different from other trastuzumab biosimilar codes?
Q5112 identifies Ontruzant (trastuzumab-dttb). Use the code matching the specific trastuzumab biosimilar administered, such as Herzuma under Q5113 or Ogivri under Q5114.
Does Q5112 include the infusion administration?
Q5112 identifies the drug product, not the infusion service. Report the administration separately when applicable.
How does Medicare treat Q5112?
CMS excludes Q5112 from the physician fee schedule with status E. When covered, it generally uses the Part B drug payment method based on quarterly ASP pricing files; the Medicare contractor determines coverage.
What documentation supports Q5112 units?
Document the product administered and the dose given so the billed 10 mg units can be supported.
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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