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

CMS doesn’t publish an office rate for Q5122 in California.

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

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 in California

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

29 of 29 payment localities

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.

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.

Q5122 compared with similar codes

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.

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