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Q2054

Q2054 – Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-pos · NDC Crosswalk & Billing Units

HCPCS Level II Q-code · Medicare Part B drug billing
Q-code ● 1 NDC crosswalked per Up to 110 million CAR-positive viable T cells, per therapeutic dose $579,570.614/unit ASP+6%

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 Q2054 summary

Q2054 is a HCPCS Level II Q-code used to bill Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cel..., billed per Up to 110 million CAR-positive viable T cells, per therapeutic dose. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Brand names associated with Q2054: Breyanzi

Code Q2054 Billing unit Up to 110 million CAR-positive viable T cells, per therapeutic dose Payment limit $579,570.614/unit NDC-Crosswalk 1 Quarter Q3 2026 RxCUI Atlas Trace the drug concept →

⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.

🗂️ Key billing facts

HCPCS codeQ2054
DescriptorLisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Billing unitUp to 110 million CAR-positive viable T cells, per therapeutic dose
Payment limit / unit$579,570.614
Est. ASP / unit$546,764.730 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-08-20

🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026

📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$579,570.614
Est. ASP / unit
$546,764.730 est.
Est. after 2% sequester
$567,979.202
HCPCS dosage
Up to 110 million CAR-positive viable T cells, per therapeutic dose
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionLisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeN — No maintenance this year
Effective date2021-10-01
Date added2021-10-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of Q2054 = 110 million. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.

🔁 NDCs that bill under Q2054 WITH EST. MEDICARE PAY

1 NDC map to Q2054. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($579,570.614/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
73153-0900-01 BREYANZI Lisocabtagene maraleucel KIT Juno 1 KIT in 1 CARTON (73153-900-01) * 5 mL... — 1 $579,570.61 — ● Active CMS ASP
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period
Total Part B spend
$34.18M
Claims
89
Beneficiaries
62
Spend / beneficiary
$551,256.67
Spend / claim
$384,021.50
Trend by period
Where Q2054 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #88 of 824
#83 IDOSE TR J7355 $38.31M #84 TYVASO INSTITUTIONAL... J7686 $36.52M #85 CAPVAXIVE 90684 $36.18M #86 NULOJIX J0485 $34.95M #87 TYSABRI J2323 $34.71M #88 BREYANZI Q2054 $34.18M #89 RYBREVANT J9061 $33.53M #90 CYRAMZA J9308 $33.32M #91 KADCYLA J9354 $32.97M #92 BENLYSTA J0490 $32.83M #93 TRUXIMA Q5115 $32.81M
Total claims — #641 of 824
#636 PFIZER COVID (6M-4... 91318 95 #637 REBYOTA J1440 95 #638 DIHYDROERGOTAMINE ME... J1110 94 #639 ELFABRIO J2508 94 #640 OMVOH PEN* J2267 90 #641 BREYANZI Q2054 89 #642 BUTORPHANOL TARTRATE J0595 88 #643 CYTOGAM J0850 88 #644 SEVENFACT J7212 87 #645 GEMCITABINE HCL(J919... J9196 86 #646 BKEMV Q5152 84

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $34.18M 62 89 $551,256.67 $384,021.50
2025 (Q1-Q4) $134.17M 254 353 $528,238.62 $380,092.38
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.

📈 Medicare Part B claims detail CMS PSPS · 2024

Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
—
Medicare paid
$4.22M
Submitted services
—
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.

🗃️ Data sources & freshness

Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
1 NDC mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.

⚠️ Practical billing caveats

  • A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
  • Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
  • Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
  • Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
  • The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
  • Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.

❓ Q2054 billing FAQ

What is HCPCS code Q2054?
Q2054 is a HCPCS Level II Q-code used to bill Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for Q2054?
One unit of Q2054 represents Up to 110 million CAR-positive viable T cells, per therapeutic dose. Report the number of units equal to the dose administered divided by Up to 110 million CAR-positive viable T cells, per therapeutic dose.
How many units of Q2054 should I bill?
Divide the dose administered by the code's unit size (Up to 110 million CAR-positive viable T cells, per therapeutic dose) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for Q2054?
The Medicare Part B payment limit is $579,570.614 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $567,979.202 per unit. Payment limits are revised quarterly.
Which NDCs bill under Q2054?
1 NDC currently map to Q2054 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean Q2054 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.