HCPCS code Q5117: Kanjinti injection, per 10 mg2026 Medicare rate & RVUs in New York
Reports Kanjinti, a trastuzumab biosimilar given by infusion for certain HER2-positive cancers, in 10-mg units based on the amount furnished.
CMS doesn’t publish an office rate for Q5117 in New York.
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 Q5117 covers
Q5117 identifies trastuzumab-anns, marketed as Kanjinti, a biosimilar medicine that targets HER2. It is given by intravenous infusion in oncology care, including treatment plans for HER2-positive breast cancer and HER2-positive metastatic gastric or gastroesophageal junction cancer. Hospital outpatient departments and physician-based infusion practices may report the drug when they furnish it. The medical record should identify the product and the dose administered.
Medicare assigns this code status E, excluding it from the physician fee schedule; when Medicare covers the drug, payment is made under another method. HCPCS classifies it as a Part B drug, generally priced using CMS’s quarterly Average Sales Price drug files. Coverage is left to the Medicare contractor’s judgment. Each billing unit represents 10 mg of trastuzumab-anns, so report units in 10-mg increments based on the dose furnished.
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 Q5117 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | Unavailable |
| NYC suburbs and Long Island, NY | Unavailable | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | Unavailable |
| Queens, NY | Unavailable | Unavailable |
| Rest of New York | Unavailable | Unavailable |
How the Q5117 rate is calculated
Each of Q5117’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 · Q5117
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 Q5117
Q5117 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 · Q5117
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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Q5117 isn’t priced in this setting.
Q5117 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- Q5112Ontruzant injectionPer 10 mg
- Q5112 identifies Ontruzant (trastuzumab-dttb); Q5117 identifies Kanjinti (trastuzumab-anns). Both are trastuzumab biosimilars with 10-mg units, so product identity distinguishes them.
- Q5113Herzuma injectionPer 10 mg
- Q5113 identifies Herzuma (trastuzumab-pkrb), not Kanjinti. Select the code for the specific trastuzumab biosimilar administered.
- Q5114Ogivri injectionPer 10 mg
- Q5114 identifies Ogivri (trastuzumab-dkst); Q5117 identifies Kanjinti. Both use 10-mg units, but the reported product must match.
- Q5116TrazimeraPer 10 mg
- Q5116 identifies Trazimera (trastuzumab-qyyp), while Q5117 identifies Kanjinti (trastuzumab-anns). Use the code corresponding to the product furnished.
Q5117 billing questions
How is Q5117 different from Q5116?
Q5117 identifies Kanjinti (trastuzumab-anns); Q5116 identifies Trazimera (trastuzumab-qyyp). Choose the code matching the specific product furnished.
What amount does one unit represent?
One unit represents 10 mg of trastuzumab-anns. Report units based on the amount of Kanjinti furnished.
Does Medicare pay for Q5117 under the physician fee schedule?
No. CMS assigns status E, excluding the code from the physician fee schedule; when covered, Medicare pays under another payment method. HCPCS identifies it as a Part B drug generally priced from quarterly CMS ASP files.
Does Medicare cover Kanjinti for every use?
Coverage is left to the Medicare contractor’s judgment.
What product and dose details should the record support?
Document that Kanjinti was furnished and record the dose administered. The reported units correspond to 10-mg amounts.
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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