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HCPCS code Q5122: Nyvepria injection, per 0.5 mg2026 Medicare rate & RVUs

Nyvepria is pegfilgrastim-apgf, a long-acting biosimilar used as supportive care to reduce febrile neutropenia risk during myelosuppressive chemotherapy.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · Q5122

Nyvepria injection, 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 Q5122 →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 Q5122 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 Q5122 covers

Nyvepria is pegfilgrastim-apgf, a long-acting granulocyte colony-stimulating factor biosimilar. Oncology practices and outpatient hospital departments use it as supportive care for patients receiving myelosuppressive cancer chemotherapy, to reduce the risk of febrile neutropenia. It is typically administered by subcutaneous injection after chemotherapy. Q5122 identifies the drug; the injection administration is a separate service when separately reportable.

CMS assigns Q5122 physician fee schedule status E, meaning it is excluded from the physician fee schedule. When Medicare covers the drug, payment is under another method. HCPCS classifies it as a Part B drug, generally priced through CMS’s quarterly Average Sales Price drug files, and leaves coverage to the Medicare contractor’s judgment. Each billing unit represents 0.5 mg; a 6-mg dose corresponds to 12 units.

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 Q5122 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

Q5122 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

Q5122 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
Q5122 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 Q5122 rate is calculated

Each of Q5122’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 · Q5122

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 Q5122

Q5122 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 · Q5122

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

Q5122 isn’t priced in this setting.

Q5122 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • Q5122

    Nyvepria injection, per 0.5 mg0 wRVU

    Not priced

  • Q5120

    Pegfilgrastim-bmez, per 0.5 mg0 wRVU

    Not priced

  • Q5111

    Udenyca injection, per 0.5 mg0 wRVU

    Not priced

  • Q5110

    Nivestym, per 1 mcg0 wRVU

    Not priced

How to choose

Q5120Pegfilgrastim-bmezPer 0.5 mg
Use Q5122 for pegfilgrastim-apgf (Nyvepria); Q5120 identifies pegfilgrastim-bmez. Both use 0.5-mg units.
Q5111Udenyca injectionPer 0.5 mg
Q5111 identifies Udenyca, a different pegfilgrastim biosimilar. Q5122 is specific to pegfilgrastim-apgf (Nyvepria).
Q5110NivestymPer 1 mcg
Q5110 identifies Nivestym, a filgrastim biosimilar. Q5122 is for pegfilgrastim-apgf, a long-acting pegfilgrastim biosimilar.

Codes related to Q5122

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

Codes related to Q5122
CodeHow it relatesNational office range
Same family
Q5108Fulphila injection, per 0.5 mgFulphila is another pegfilgrastim biosimilar reported in the same drug family.No office rate
Q5111Udenyca injection, per 0.5 mgUdenyca is another pegfilgrastim biosimilar with a 0.5-mg billing unit.No office rate
Q5120Pegfilgrastim-bmez, per 0.5 mgIdentifies pegfilgrastim-bmez, another pegfilgrastim biosimilar reported in 0.5-mg units.No office rate
Q5127Stimufend injection, per 0.5 mgIdentifies Stimufend, another pegfilgrastim biosimilar reported in 0.5-mg units.No office rate
Q5130Pegfilgrastim-pbbk, per 0.5 mgIdentifies Fylnetra, another pegfilgrastim biosimilar reported in 0.5-mg units.No office rate

Q5122 billing questions

How many units represent a 6-mg dose?

Each Q5122 unit represents 0.5 mg, so 6 mg corresponds to 12 units.

How is Q5122 different from Q5120?

Both identify pegfilgrastim biosimilars billed in 0.5-mg units, but Q5122 is pegfilgrastim-apgf (Nyvepria), while Q5120 identifies pegfilgrastim-bmez.

Does Q5122 include the injection administration?

No. Q5122 identifies the drug; report the administration service separately when it is separately reportable.

What documentation supports the units?

Document the product administered and the dose given so the claim units reflect the amount of pegfilgrastim-apgf reported.

How does Medicare treat Q5122?

CMS excludes it from the physician fee schedule with status E. If covered, it is treated as a Part B drug and generally priced through CMS’s quarterly ASP drug pricing files; coverage is left to the Medicare contractor’s judgment.

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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