Q5126
Q5126 – Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg · NDC Crosswalk & Billing Units
HCPCS Level II Q-code · Medicare Part B drug billing
Q-code
● 4 NDCs crosswalked per 10 MG $79.944/unit ASP+6%
📋 Q5126 summary
Q5126 is a HCPCS Level II Q-code used to bill bevacizumab-maly, biosimilar, (alymsys), 10 mg, billed per 10 MG. 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 Q5126: Alymsys
Code Q5126
Billing unit 10 MG Payment limit $79.944/unit NDC-Crosswalk 4
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 codeQ5126
DescriptorInjection, bevacizumab-maly, biosimilar, (alymsys), 10 mg
Billing unit10 MG
Payment limit / unit$79.944
Est. ASP / unit$75.419 est.
Mapped NDCs4
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
$79.944
Est. ASP / unit
$75.419 est.
Est. after 2% sequester
$78.345
HCPCS dosage
10 MG
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, bevacizumab-maly, biosimilar, (alymsys), 10 mg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2023-01-01
Date added2023-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of Q5126 = 10 mg. 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 Q5126 WITH EST. MEDICARE PAY
4 NDCs map to Q5126. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($79.944/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 70121-1754-01 | ALYMSYS bevacizumab-maly 100 mg/4mL INJECTION, SOLUTION | Amneal | 1 VIAL in 1 CARTON (70121-1754-1) / 4 mL... | 100 mg/4mL | 10 | $799.44 | — | ● Active | CMS ASP |
| 70121-1755-01 | ALYMSYS bevacizumab-maly 400 mg/16mL INJECTION, SOLUTION | Amneal | 1 VIAL in 1 CARTON (70121-1755-1) / 16 mL... | 400 mg/16mL | 40 | $3,197.76 | — | ● Active | CMS ASP |
| 85006-1754-01 | ALYMSYS bevacizumab-maly 100 mg/4mL INJECTION, SOLUTION | Valorum | 1 VIAL in 1 CARTON (85006-1754-1) / 4 mL... | 100 mg/4mL | 10 | $799.44 | — | ● Active | CMS + PDAC |
| 85006-1755-01 | ALYMSYS bevacizumab-maly 400 mg/16mL INJECTION, SOLUTION | Valorum | 1 VIAL in 1 CARTON (85006-1755-1) / 16 mL... | 400 mg/16mL | 40 | $3,197.76 | — | ● Active | CMS + PDAC |
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
$16.72M
Claims
7,293
Beneficiaries
2,587
Spend / beneficiary
$6,463.71
Spend / claim
$2,292.83
Trend by period
Where Q5126 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #134 of 824
#129
NEXVIAZYME J0219
$18.44M
#130
AMCHOPLAST, PER SQ C... Q4316
$18.44M
#131
EMPLICITI J9176
$17.91M
#132
DALBAVANCIN HCL* J0875
$17.7M
#133
ELREXFIO J1323
$16.82M
#134
ALYMSYS Q5126
$16.72M
#135
IDELVION J7202
$16.67M
#136
NIKTIMVO J9038
$16.36M
#137
RYSTIGGO J9333
$16.15M
#138
ZIRABEV Q5118
$15.94M
#139
PROVENGE Q2043
$15.72M
Total claims — #186 of 824
#181
ERBITUX J9055
7,526
#182
DIPRIVAN* J2704
7,494
#183
BENLYSTA J0490
7,491
#184
TDVAX* 90714
7,419
#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
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) | $16.72M | 2,587 | 7,293 | $6,463.71 | $2,292.83 |
| 2025 (Q1-Q4) | $100.74M | 5,144 | 31,641 | $19,583.04 | $3,183.69 |
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
$50.59M
Medicare paid
$39.17M
Submitted services
1,139,301
Denial rate
3.7%
Allowed / service
$46.09
Submitted charges
$176.04M
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 Q5126 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 307,370 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 Q5126
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)
4 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.
❓ Q5126 billing FAQ
What is HCPCS code Q5126?
Q5126 is a HCPCS Level II Q-code used to bill Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for Q5126?
One unit of Q5126 represents 10 MG. Report the number of units equal to the dose administered divided by 10 MG.
How many units of Q5126 should I bill?
Divide the dose administered by the code's unit size (10 MG) 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 Q5126?
The Medicare Part B payment limit is $79.944 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $78.345 per unit. Payment limits are revised quarterly.
Which NDCs bill under Q5126?
4 NDCs currently map to Q5126 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 Q5126 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.