HCPCS code Q5114: Ogivri injection, per 10 mg2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for Q5114 in California.

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

What Q5114 covers

Q5114 identifies trastuzumab-dkst, marketed as Ogivri, a biosimilar to trastuzumab. Oncology clinicians use it as an intravenous infusion for certain HER2-positive breast cancers and metastatic gastric or gastroesophageal junction cancers. It may be given with other cancer treatment or as part of a treatment regimen; the product administered determines which biosimilar code applies.

CMS excludes Q5114 from the physician fee schedule (status E). When Medicare covers the drug, it is a Part B drug generally priced through CMS’s quarterly Average Sales Price drug files; coverage is left to the Medicare contractor’s judgment. Each unit represents 10 mg of trastuzumab-dkst, so 150 mg corresponds to 15 units. The code identifies the drug, not the infusion service.

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 Q5114 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

How the Q5114 rate is calculated

Each of Q5114’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.

Payment rules and modifiers for Q5114

Q5114 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.

Q5114 compared with similar codes

How to choose

Q5112Ontruzant injectionPer 10 mg

Q5112 identifies Ontruzant (trastuzumab-dttb); Q5114 identifies Ogivri (trastuzumab-dkst). Select the code for the specific product administered.

Q5113Herzuma injectionPer 10 mg

Q5113 identifies Herzuma (trastuzumab-pkrb), while Q5114 identifies Ogivri (trastuzumab-dkst). The products have separate HCPCS codes despite being trastuzumab biosimilars.

Q5116TrazimeraPer 10 mg

Q5116 is for Trazimera (trastuzumab-qyyp); Q5114 is for Ogivri (trastuzumab-dkst). Report the code matching the administered product.

Q5117Kanjinti injectionPer 10 mg

Q5117 identifies Kanjinti (trastuzumab-anns), not Ogivri. Both codes represent trastuzumab biosimilars in 10 mg units, but the product determines the code.

Codes related to Q5114

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

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