Q4081
Q4081 – Injection, epoetin alfa, 100 units (for esrd on dialysis) · NDC Crosswalk & Billing Units
HCPCS Level II Q-code · Medicare Part B drug billing
Q-code
● 16 NDCs crosswalked per 100 UNITS $0.688/unit ASP+6%
📋 Q4081 summary
Q4081 is a HCPCS Level II Q-code used to bill epoetin alfa, 100 units (for esrd on dialysis), billed per 100 UNITS. 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 Q4081: Epogen(Q4081)*, Epogen, Procrit
Code Q4081
Billing unit 100 UNITS Payment limit $0.688/unit NDC-Crosswalk 16
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 codeQ4081
DescriptorInjection, epoetin alfa, 100 units (for esrd on dialysis)
Billing unit100 UNITS
Payment limit / unit$0.688
Est. ASP / unit$0.649 est.
Mapped NDCs16
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
$0.688
Est. ASP / unit
$0.649 est.
Est. after 2% sequester
$0.674
HCPCS dosage
100 UNITS
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 descriptionInjection, epoetin alfa, 100 units (for esrd on dialysis)
CoverageD — Special coverage instructions apply
Pricing indicator57
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeN — No maintenance this year
Effective date2007-01-01
Date added2007-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of Q4081 = 100 units. 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 Q4081 LEAST EXPENSIVE FIRST
16 NDCs map to Q4081. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.688/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 55513-0126-10 | EPOGEN epoetin alfa 2000 [iU]/mL SOLUTION | Amgen, | 10 VIAL in 1 PACKAGE (55513-126-10) / 1 m... | 2000 [iU]/mL | 200 | $137.60 | $32.274 | ● Active | CMS ASP |
| 59676-0302-01 | PROCRIT Erythropoietin 2000 [iU]/mL INJECTION, SOLUTION | Janssen | 6 VIAL, SINGLE-DOSE in 1 CARTON (59676-302... | 2000 [iU]/mL | 120 | $82.56 | $52.123 | ● Active | CMS ASP |
| 55513-0148-10 | EPOGEN epoetin alfa 4000 [iU]/mL SOLUTION | Amgen, | 10 VIAL in 1 PACKAGE (55513-148-10) / 1 m... | 4000 [iU]/mL | 400 | $275.20 | $64.364 | ● Active | CMS ASP |
| 59676-0303-01 | PROCRIT Erythropoietin 3000 [iU]/mL INJECTION, SOLUTION | Janssen | 6 VIAL, SINGLE-DOSE in 1 CARTON (59676-303... | 3000 [iU]/mL | 180 | $123.84 | $78.055 | ● Active | CMS ASP |
| 59676-0304-01 | PROCRIT Erythropoietin 4000 [iU]/mL INJECTION, SOLUTION | Janssen | 6 VIAL, SINGLE-DOSE in 1 CARTON (59676-304... | 4000 [iU]/mL | 240 | $165.12 | $104.282 | ● Active | CMS ASP |
| 55513-0144-10 | EPOGEN epoetin alfa 10000 [iU]/mL SOLUTION | Amgen, | 10 VIAL in 1 PACKAGE (55513-144-10) / 1 m... | 10000 [iU]/mL | 1,000 | $688.00 | $161.800 | ● Active | CMS ASP |
| 59676-0310-01 | PROCRIT Erythropoietin 10000 [iU]/mL INJECTION, SOLUTION | Janssen | 6 VIAL, SINGLE-DOSE in 1 CARTON (59676-310... | 10000 [iU]/mL | 600 | $412.80 | $259.950 | ● Active | CMS ASP |
| 55513-0478-10 | EPOGEN epoetin alfa 20000 [iU]/mL SOLUTION | Amgen, | 10 VIAL in 1 PACKAGE (55513-478-10) / 1 m... | 20000 [iU]/mL | 2,000 | $1,376.00 | $320.147 | ● Active | CMS ASP |
| 59676-0320-04 | PROCRIT Erythropoietin 20000 [iU]/mL INJECTION, SOLUTION | Janssen | 4 VIAL, MULTI-DOSE in 1 CARTON (59676-320-... | 20000 [iU]/mL | 800 | $550.40 | $521.519 | ● Active | CMS ASP |
| 59676-0340-01 | PROCRIT Erythropoietin 40000 [iU]/mL INJECTION, SOLUTION | Janssen | 4 VIAL, SINGLE-DOSE in 1 CARTON (59676-340... | 40000 [iU]/mL | 1,600 | $1,100.80 | $1,036.210 | ● Active | CMS ASP |
| 55513-0267-10 | EPOGEN epoetin alfa 3000 [iU]/mL SOLUTION | Amgen, | 10 VIAL in 1 PACKAGE (55513-267-10) / 1 m... | 3000 [iU]/mL | 300 | $206.40 | — | ● Active | CMS ASP |
| 55513-0283-10 | EPOGEN epoetin alfa 10000 [iU]/mL SOLUTION | Amgen, | 10 VIAL in 1 PACKAGE (55513-283-10) / 2 m... | 10000 [iU]/mL | 2,000 | $1,376.00 | — | ● Active | CMS ASP |
| 55513-0283-20 | EPOGEN epoetin alfa 10000 [iU]/mL SOLUTION | Amgen, | 10 VIAL in 1 PACKAGE (55513-283-20) / 2 m... | 10000 [iU]/mL | 2,000 | $1,376.00 | — | ● Active | CMS ASP |
| 55513-0478-20 | EPOGEN epoetin alfa 20000 [iU]/mL SOLUTION | Amgen, | 10 VIAL in 1 PACKAGE (55513-478-20) / 1 m... | 20000 [iU]/mL | 2,000 | $1,376.00 | — | ● Active | CMS ASP |
| 59676-0310-02 | PROCRIT Erythropoietin 10000 [iU]/mL INJECTION, SOLUTION | Janssen | 25 VIAL, SINGLE-DOSE in 1 CARTON (59676-31... | 10000 [iU]/mL | 2,500 | $1,720.00 | — | ● Active | CMS ASP |
| 59676-0312-04 | PROCRIT Erythropoietin 10000 [iU]/mL INJECTION, SOLUTION | Janssen | 4 VIAL, MULTI-DOSE in 1 CARTON (59676-312-... | 10000 [iU]/mL | 800 | $550.40 | — | ● 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 · 2025 (Q1-Q4)
Total Part B spend
$5.6K
Claims
21
Beneficiaries
15
Spend / beneficiary
$370.60
Spend / claim
$264.72
Where Q4081 ranks among Part B drugs · 2025 (Q1-Q4) · neighbors ±5
Total spending — #831 of 918
#826
ABELCET J0287
$6K
#827
PHYTONADIONE* J3430
$5.8K
#828
HAVRIX* 90632
$5.7K
#829
ACETAMINOPHEN(J0136) J0136
$5.7K
#830
AMPICILLIN-SULBACTAM... J0295
$5.6K
#831
EPOGEN(Q4081)* Q4081
$5.6K
#832
MICAFUNGIN(J2247) J2247
$5.5K
#833
NALBUPHINE HCL J2300
$5.4K
#834
BICILLIN C-R J0558
$5.2K
#835
TYZAVAN* J3375
$5.1K
#836
CYTARABINE J9100
$4.8K
Total claims — #891 of 918
#886
ROMIDEPSIN J9318
24
#887
DIGOXIN* J1160
23
#888
NALOXONE HCL(J2312) J2312
23
#889
RIASTAP J7178
22
#890
CHORIPLY, PER SQ CM*... Q4359
22
#891
EPOGEN(Q4081)* Q4081
21
#892
ETHAMOLIN J1430
20
#893
BEIZRAY-ALBUMIN* J9174
20
#894
ACESSO AC, PER SQ CM... Q4312
20
#895
INJ, EPINEPHRINE (BE... J0173
18
#896
DECITABINE J0893
18
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (1)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2025 (Q1-Q4) | $5.6K | 15 | 21 | $370.60 | $264.72 |
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
$1.1K
Medicare paid
$830.83
Submitted services
10,817
Denial rate
87.6%
Allowed / service
$0.79
Submitted charges
$80.6K
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
16 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2025
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.
❓ Q4081 billing FAQ
What is HCPCS code Q4081?
Q4081 is a HCPCS Level II Q-code used to bill Injection, epoetin alfa, 100 units (for esrd on dialysis) under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for Q4081?
One unit of Q4081 represents 100 UNITS. Report the number of units equal to the dose administered divided by 100 UNITS.
How many units of Q4081 should I bill?
Divide the dose administered by the code's unit size (100 UNITS) 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 Q4081?
The Medicare Part B payment limit is $0.688 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.674 per unit. Payment limits are revised quarterly.
Which NDCs bill under Q4081?
16 NDCs currently map to Q4081 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 Q4081 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.