HCPCS drug code · CMS crosswalk
Herzuma HCPCS Code
In short
Herzuma is billed under HCPCS Q5113 — Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 2 Herzuma NDCs under this code.
Reference
- Q5113
- Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mgBilling unit: 10 mg
- Labelers
- Cephalon, LLC
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: 8% of reference add-on applied. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Herzuma units and claim line
Enter the dose given to get the Q5113 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Herzuma NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 63459-0303-43 | Q5113 | Cephalon, LLC | 1 | 15 |
| 63459-0305-47 | Q5113 | Cephalon, LLC | 1 | 42 |
Herzuma: common questions
- What is the HCPCS code for Herzuma?
- Herzuma is billed under HCPCS Q5113 — Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 2 Herzuma NDCs under this code.
- How many Q5113 billing units are in a package of Herzuma?
- CMS lists 15 to 42 billing units per package, depending on the NDC, where one unit is 10 mg. Units to report are based on the dose given, not the package.
- Is Q5113 a CPT code?
- No. Q5113 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.
Other codes for the same drug
- J9355Injection, trastuzumab, excludes biosimilar, 10 mg
- J9356Injection, trastuzumab, 10 mg and hyaluronidase-oysk
- Q5112Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg
- Q5114Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg
- Q5116Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg
- Q5117Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg
- Q5146Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg