Q5151
Q5151 – Inj, eculizumab-aagh, 2 mg · NDC Crosswalk & Billing Units
HCPCS Level II Q-code · Medicare Part B drug billing
Q-code
● 1 NDC crosswalked per 2 MG $31.767/unit ASP+6%
📋 Q5151 summary
Q5151 is a HCPCS Level II Q-code used to bill eculizumab-aagh, 2 mg, billed per 2 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 Q5151: Epysqli
Code Q5151
Billing unit 2 MG Payment limit $31.767/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 codeQ5151
DescriptorInj, eculizumab-aagh, 2 mg
Billing unit2 MG
Payment limit / unit$31.767
Est. ASP / unit$29.969 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-08-20
💊 About Eculizumab Injection DRUG GUIDE
Eculizumab injection (brands: Soliris, EPYSQLI) is used to treat four serious conditions.
It treats paroxysmal nocturnal hemoglobinuria (PNH), a rare blood disorder where red blood cells are destroyed, and atypical hemolytic uremic syndrome (aHUS), a disease that causes dangerous blood clots in small vessels.
It is not approved for hemolytic uremic syndrome caused by Shiga toxin-producing E.
coli (STEC-HUS).Eculizumab injection is also used for generalized myasthenia gravis (gMG) in adults and children 6 years and older who test positive for anti-acetylcholine receptor (AChR) antibodies, and for neuromyelitis optica spectrum disorder (NMOSD) in adults who test positive for anti-aquaporin-4 (AQP4) antibodies.
Clinical overview from our editorial drug guide for Eculizumab 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
$31.767
Est. ASP / unit
$29.969 est.
Est. after 2% sequester
$31.132
HCPCS dosage
2 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.
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of Q5151 = 2 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 Q5151 WITH EST. MEDICARE PAY
1 NDC map to Q5151. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($31.767/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 51759-0208-13 | EPYSQLI Eculizumab-aagh 300 mg/30mL INJECTION, SOLUTION | Teva | 1 VIAL, SINGLE-DOSE in 1 CARTON (51759-208... | 300 mg/30mL | 150 | $4,765.05 | — | ● 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
$2.38M
Claims
124
Beneficiaries
38
Spend / beneficiary
$62,719.87
Spend / claim
$19,220.61
Trend by period
Where Q5151 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #310 of 824
#305
SUSVIMO J2779
$2.53M
#306
GELSYN-3 J7328
$2.43M
#307
BORUZU J9054
$2.41M
#308
FYARRO J9331
$2.4M
#309
PANHEMATIN J1640
$2.4M
#310
EPYSQLI Q5151
$2.38M
#311
BELEODAQ J9032
$2.35M
#312
LOQTORZI J3263
$2.35M
#313
ALBUKED-5* P9045
$2.29M
#314
FLUBLOK * 90673
$2.27M
#315
ACAPATCH, PER SQ CM*... Q4325
$2.23M
Total claims — #607 of 824
#602
ARTACENT WOUND, PER... Q4169
131
#603
LEVOTHYROXINE SODIUM... J0651
128
#604
TEVIMBRA J9329
128
#605
ONDANSETRON HCL(Q016... Q0162
127
#606
AMNIO QUAD-CORE, PER... Q4294
126
#607
EPYSQLI Q5151
124
#608
CEFTAROLINE FOSAMIL* J0712
122
#609
ELOCTATE J7205
122
#610
AZITHROMYCIN* J0456
121
#611
MATRION 1 SQ CM** Q4201
121
#612
PAMIDRONATE DISODIUM J2430
118
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) | $2.38M | 38 | 124 | $62,719.87 | $19,220.61 |
| 2025 (Q1-Q4) | $1.98M | 21 | 111 | $94,224.94 | $17,826.34 |
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
$47.8K
Medicare paid
$37.5K
Submitted services
2,400
Submitted charges
$223.6K
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
Not available in current dataset
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.
❓ Q5151 billing FAQ
What is HCPCS code Q5151?
Q5151 is a HCPCS Level II Q-code used to bill Inj, eculizumab-aagh, 2 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for Q5151?
One unit of Q5151 represents 2 MG. Report the number of units equal to the dose administered divided by 2 MG.
How many units of Q5151 should I bill?
Divide the dose administered by the code's unit size (2 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 Q5151?
The Medicare Part B payment limit is $31.767 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $31.132 per unit. Payment limits are revised quarterly.
Which NDCs bill under Q5151?
1 NDC currently map to Q5151 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 Q5151 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.