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HCPCS code Q5120: Pegfilgrastim-bmez, per 0.5 mg2026 Medicare rate & RVUs

Reports Ziextenzo, a pegfilgrastim biosimilar given to reduce febrile neutropenia risk during myelosuppressive chemotherapy, in 0.5 mg units.

CMS RVU26DEffective Oct 1, 2026109 payment localities699 Medicare services in 2024

Medicare rate · Q5120

Pegfilgrastim-bmez, per 0.5 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for Q5120 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What Q5120 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What Q5120 covers

Pegfilgrastim-bmez, marketed as Ziextenzo, is a biosimilar of pegfilgrastim, a granulocyte colony-stimulating factor used to reduce infection risk associated with febrile neutropenia in patients receiving myelosuppressive cancer chemotherapy. Oncology practices commonly report it for a subcutaneous dose administered in an outpatient setting. The code identifies this specific biosimilar, not pegfilgrastim products with other product-specific HCPCS codes.

CMS assigns status E, excluding Q5120 from the physician fee schedule. When Medicare covers the drug, payment is through another method; as a Part B drug, it is generally priced using CMS quarterly Average Sales Price drug pricing files. Coverage is left to the Medicare contractor's judgment. Each billing unit represents 0.5 mg, so a 6 mg dose is reported as 12 units. The drug code identifies the medication and dose; the injection administration is a separate service when separately reportable.

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 Q5120 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

Q5120 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

Q5120 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
Q5120 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the Q5120 rate is calculated

Each of Q5120’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 · Q5120

RVUs × geographic indexes × conversion factor

Office or facility?

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 Q5120

Q5120 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 · Q5120

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

Q5120 isn’t priced in this setting.

Q5120 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • Q5120

    Pegfilgrastim-bmez, per 0.5 mg0 wRVU

    Not priced

  • Q5108

    Fulphila injection, per 0.5 mg0 wRVU

    Not priced

  • Q5111

    Udenyca injection, per 0.5 mg0 wRVU

    Not priced

  • Q5127

    Stimufend injection, per 0.5 mg0 wRVU

    Not priced

How to choose

Q5108Fulphila injectionPer 0.5 mg
Q5108 identifies the pegfilgrastim biosimilar Fulphila; Q5120 identifies Ziextenzo. Report the code matching the product administered.
Q5111Udenyca injectionPer 0.5 mg
Q5111 identifies the pegfilgrastim biosimilar Udenyca, while Q5120 identifies Ziextenzo. The product administered determines which code applies.
Q5127Stimufend injectionPer 0.5 mg
Q5127 identifies Stimufend, another pegfilgrastim biosimilar. Use Q5120 only when the administered product is Ziextenzo.

Codes related to Q5120

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

Codes related to Q5120
CodeHow it relatesNational office range
Same family
Q5108Fulphila injection, per 0.5 mgPegfilgrastim biosimilar code for Fulphila; select according to the product administered.No office rate
Q5111Udenyca injection, per 0.5 mgPegfilgrastim biosimilar code for Udenyca; select according to the product administered.No office rate
Q5122Nyvepria injection, per 0.5 mgPegfilgrastim biosimilar code for Nyvepria.No office rate
Q5127Stimufend injection, per 0.5 mgPegfilgrastim biosimilar code for Stimufend.No office rate
Q5130Pegfilgrastim-pbbk, per 0.5 mgPegfilgrastim biosimilar code for Fylnetra.No office rate
Often billed with
96372SC/IM injection, therapeutic, prophylactic, or diagnosticInjection administration code for a therapeutic subcutaneous or intramuscular injection, when separately reportable.$13.88–$19.97

Q5120 billing questions

What does one unit of Q5120 represent?

One unit represents 0.5 mg of pegfilgrastim-bmez. A 6 mg dose equals 12 units.

How is Q5120 different from other pegfilgrastim biosimilar codes?

Q5120 identifies pegfilgrastim-bmez (Ziextenzo). Use the product-specific code that matches the biosimilar administered, rather than selecting a code solely because the products contain pegfilgrastim.

Does Q5120 include the injection administration?

No. Q5120 identifies the drug and its units; the administration is a separate service when separately reportable.

How does Medicare treat Q5120?

CMS assigns status E, excluding it from the physician fee schedule. When covered, Medicare generally prices this Part B drug through CMS quarterly ASP drug pricing files, and coverage is left to the Medicare contractor's judgment.

What should the record support for the units billed?

Document the product administered and the dose given so the reported 0.5 mg units match the administered amount.

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

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