HCPCS drug code · CMS crosswalk
Renflexis HCPCS Code
In short
Renflexis is billed under HCPCS Q5104 — Injection, infliximab-abda, biosimilar, (renflexis), 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 1 Renflexis NDC under this code.
Reference
- Q5104
- Injection, infliximab-abda, biosimilar, (renflexis), 10 mgBilling unit: 10 mg
- Labelers
- Organon 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
Renflexis units and claim line
Enter the dose given to get the Q5104 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Renflexis 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 |
|---|---|---|---|---|
| 78206-0162-01 | Q5104 | Organon LLC | 1 | 10 |
Renflexis: common questions
- What is the HCPCS code for Renflexis?
- Renflexis is billed under HCPCS Q5104 — Injection, infliximab-abda, biosimilar, (renflexis), 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 1 Renflexis NDC under this code.
- How many Q5104 billing units are in a package of Renflexis?
- CMS lists 10 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 Q5104 a CPT code?
- No. Q5104 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.