HCPCS code Q5120: Pegfilgrastim-bmez, per 0.5 mg2026 Medicare rate & RVUs in Louisiana
Reports Ziextenzo, a pegfilgrastim biosimilar given to reduce febrile neutropenia risk during myelosuppressive chemotherapy, in 0.5 mg units.
CMS doesn’t publish an office rate for Q5120 in Louisiana.
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 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 in Louisiana
| Payment locality | Office | Facility |
|---|---|---|
| New Orleans, LA | Unavailable | Unavailable |
| Rest of Louisiana | Unavailable | Unavailable |
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
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
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Q5120 isn’t priced in this setting.
Q5120 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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