HCPCS Level II drug code
Q5106 — Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
In short
Q5106 is the HCPCS Level II code for injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units. CMS assigns NDCs for Retacrit to it. One billing unit is 1000 units. The Medicare Part B payment limit is $8.171 per unit (October 1, 2026 through December 31, 2026).
Code
CMS HCPCS file- Descriptor
- Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
- Short descriptor
- Inj retacrit non-esrd use
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Jan 1, 2020
The billing unit is read from the descriptor. Confirm it against the CMS file before billing.
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. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Units and claim line
Units = dose given ÷ 1000 units. For example, 100000 units is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
NDCs billed under Q5106
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 12 NDCs to Q5106 for Retacrit. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Retacrit | 00069-1305-10 | Pfizer Inc | 10 × 1 | 20 |
| Retacrit | 00069-1306-10 | Pfizer Inc | 10 × 1 | 30 |
| Retacrit | 00069-1307-10 | Pfizer Inc | 10 × 1 | 40 |
| Retacrit | 00069-1308-10 | Pfizer Inc | 10 × 1 | 100 |
| Retacrit | 00069-1309-04 | Pfizer Inc | 4 × 1 | 160 |
| Retacrit | 00069-1311-10 | Pfizer Inc | 10 × 1 | 200 |
| Retacrit | 00069-1318-10 | Pfizer Inc | 10 × 2 | 100 |
| Retacrit | 59353-0002-10 | Vifor (International) Inc. | 10 × 1 | 20 |
| Retacrit | 59353-0003-10 | Vifor (International) Inc. | 10 × 1 | 30 |
| Retacrit | 59353-0004-10 | Vifor (International) Inc. | 10 × 1 | 40 |
| Retacrit | 59353-0120-10 | Vifor (International) Inc. | 10 × 1 | 200 |
| Retacrit | 59353-0220-10 | Vifor (International) Inc. | 10 × 2 | 100 |
Q5106: common questions
- Is Q5106 a CPT code?
- No. Q5106 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
- What NDCs are billed under Q5106?
- CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 12 NDCs under Q5106, for Retacrit. The table on this page shows each one with its billing units per package.
- What is the Medicare payment limit for Q5106?
- $8.171 per 1000 units, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
- What is one billing unit of Q5106?
- One unit of Q5106 is 1000 units, as stated in the code's descriptor. Units to report = dose given ÷ 1000 units. J-code billing units.