HCPCS code Q5114: Ogivri injection, per 10 mg2026 Medicare rate & RVUs in Missouri
Reports the trastuzumab-dkst biosimilar Ogivri in 10 mg units for treatment regimens involving certain HER2-positive breast, gastric, or gastroesophageal junction cancers.
CMS doesn’t publish an office rate for Q5114 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 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 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 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.
How the rate is built · Q5114
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 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.
Place of service · Q5114
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
—
Q5114 isn’t priced in this setting.
Q5114 compared with similar codes
Compare codes · National
5 codes, side by side
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.
Q5114 billing questions
How many units should be reported?
Each unit represents 10 mg of trastuzumab-dkst. For example, 150 mg corresponds to 15 units.
When is Q5114 the right trastuzumab biosimilar code?
Use Q5114 when the product administered is Ogivri (trastuzumab-dkst). Other trastuzumab biosimilars have distinct HCPCS codes.
Does status E mean Medicare never pays for Ogivri?
No. Status E means the code is excluded from the physician fee schedule; when covered, Medicare pays under another method.
How is Medicare coverage determined?
Coverage is left to the Medicare contractor’s judgment. When covered as a Part B drug, payment generally uses CMS’s quarterly ASP drug pricing files.
Does Q5114 describe the infusion administration too?
No. Q5114 identifies the drug quantity, not the infusion administration.
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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