Q5110
Q5110 – Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram · NDC Crosswalk & Billing Units
HCPCS Level II Q-code · Medicare Part B drug billing
Q-code
● 6 NDCs crosswalked per 1 MCG $0.322/unit ASP+6%
📋 Q5110 summary
Q5110 is a HCPCS Level II Q-code used to bill filgrastim-aafi, biosimilar, (nivestym), 1 microgram, billed per 1 MCG. 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 Q5110: Nivestym
Code Q5110
Billing unit 1 MCG Payment limit $0.322/unit NDC-Crosswalk 6
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 codeQ5110
DescriptorInjection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram
Billing unit1 MCG
Payment limit / unit$0.322
Est. ASP / unit$0.304 est.
Mapped NDCs6
Data periodQ3 2026
Last updated2026-08-20
💊 About Filgrastim Injection DRUG GUIDE
Filgrastim injection (available as Neupogen, Nivestym, and Releuko) is used to lower the risk of serious infection in people whose white blood cell counts drop dangerously low.
This can happen during chemotherapy for cancer, during treatment for acute myeloid leukemia (AML), or after bone marrow transplantation.
It is also used to help move stem cells from the bone marrow into the bloodstream so they can be collected for transplantation.In addition, filgrastim is used long-term to reduce infections in people with severe chronic neutropenia — including congenital neutropenia, cyclic neutropenia, and idiopathic neutropenia.
Neupogen is also indicated to increase survival in patients acutely exposed to radiation doses that suppress the bone marrow (Hematopoietic Syndrome of Acute Radiation Syndrome).
Clinical overview from our editorial drug guide for Filgrastim Injection. For billing reference, see the sections above.
🧾 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
$0.322
Est. ASP / unit
$0.304 est.
Est. after 2% sequester
$0.316
HCPCS dosage
1 MCG
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, filgrastim-aafi, biosimilar, (nivestym), 1 microgram
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2018-10-01
Date added2018-10-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of Q5110 = 1 mcg. 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 Q5110 WITH EST. MEDICARE PAY
6 NDCs map to Q5110. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.322/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00069-0291-01 | Nivestym filgrastim-aafi 300 ug/.5mL INJECTION, SOLUTION | Pfizer | 1 SYRINGE in 1 CARTON (0069-0291-01) / .5... | 300 ug/.5mL | 300 | $96.60 | — | ● Active | CMS + PDAC |
| 00069-0291-10 | Nivestym filgrastim-aafi 300 ug/.5mL INJECTION, SOLUTION | Pfizer | 10 CARTON in 1 CARTON (0069-0291-10) / 1... | 300 ug/.5mL | 3,000 | $966.00 | — | ● Active | CMS + PDAC |
| 00069-0292-01 | Nivestym filgrastim-aafi 480 ug/.8mL INJECTION, SOLUTION | Pfizer | 1 SYRINGE in 1 CARTON (0069-0292-01) / .8... | 480 ug/.8mL | 480 | $154.56 | — | ● Active | CMS + PDAC |
| 00069-0292-10 | Nivestym filgrastim-aafi 480 ug/.8mL INJECTION, SOLUTION | Pfizer | 10 CARTON in 1 CARTON (0069-0292-10) / 1... | 480 ug/.8mL | 4,800 | $1,545.60 | — | ● Active | CMS + PDAC |
| 00069-0293-10 | Nivestym filgrastim-aafi 300 ug/mL INJECTION, SOLUTION | Pfizer | 10 VIAL, SINGLE-DOSE in 1 CARTON (0069-029... | 300 ug/mL | 3,000 | $966.00 | — | ● Active | CMS ASP |
| 00069-0294-10 | Nivestym filgrastim-aafi 480 ug/1.6mL INJECTION, SOLUTION | Pfizer | 10 VIAL, SINGLE-DOSE in 1 CARTON (0069-029... | 480 ug/1.6mL | 4,800 | $1,545.60 | — | ● 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
$835.2K
Claims
6,956
Beneficiaries
1,807
Spend / beneficiary
$462.18
Spend / claim
$120.06
Trend by period
Where Q5110 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #398 of 824
#393
VIVITROL J2315
$866.4K
#394
SPEVIGO J1747
$863.1K
#395
TEMOZOLOMIDE J8700
$858.1K
#396
INTEGRA BMWD** Q4104
$855.9K
#397
REZZAYO J0349
$844.7K
#398
NIVESTYM Q5110
$835.2K
#399
FEIBA J7198
$830K
#400
CYCLOSPORINE MODIFIE... J7515
$811.9K
#401
COMPLETE SL PER SQ C... Q4270
$803.1K
#402
CYCLOPHOSPHAMIDE(J90... J9073
$799.5K
#403
XIPERE J3299
$787.6K
Total claims — #190 of 824
#185
GLUCAGON EMERGENCY K... J1611
7,378
#186
ALYMSYS Q5126
7,293
#187
MILRINONE IN 5% DEXT... J2260
7,266
#188
DOCETAXEL J9171
7,049
#189
GAZYVA J9301
7,018
#190
NIVESTYM Q5110
6,956
#191
OGIVRI Q5114
6,950
#192
VYVGART HYTRULO J9334
6,883
#193
OZURDEX J7312
6,823
#194
ROLVEDON J1449
6,822
#195
BOMYNTRA* Q5158
6,821
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 (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $835.2K | 1,807 | 6,956 | $462.18 | $120.06 |
| 2025 (Q1-Q4) | $4.67M | 6,139 | 36,481 | $761.28 | $128.11 |
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
$3.43M
Medicare paid
$2.6M
Submitted services
12,288,171
Denial rate
3.8%
Allowed / service
$0.29
Submitted charges
$20.2M
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.
🗺️ Where Q5110 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 5,691,064 services across 22 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
📊 What bills under Q5110
J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.
NDC products by ingredient
NDC products by labeler
🗃️ 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 + DMEPDAC (PDAC)
6 NDCs 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.
❓ Q5110 billing FAQ
What is HCPCS code Q5110?
Q5110 is a HCPCS Level II Q-code used to bill Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for Q5110?
One unit of Q5110 represents 1 MCG. Report the number of units equal to the dose administered divided by 1 MCG.
How many units of Q5110 should I bill?
Divide the dose administered by the code's unit size (1 MCG) 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 Q5110?
The Medicare Part B payment limit is $0.322 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.316 per unit. Payment limits are revised quarterly.
Which NDCs bill under Q5110?
6 NDCs currently map to Q5110 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 Q5110 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.