HCPCS Level II drug code
Q5120 — Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg
In short
Q5120 is the HCPCS Level II code for injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg. CMS assigns NDCs for Ziextenzo to it. One billing unit is 0.5 mg. The Medicare Part B payment limit is $302.247 per unit (October 1, 2026 through December 31, 2026).
Code
CMS HCPCS file- Descriptor
- Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg
- Short descriptor
- Inj pegfilgrastim-bmez 0.5mg
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Apr 1, 2023
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 ÷ 0.5 mg. For example, 50 mg 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 Q5120
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 2 NDCs to Q5120 for Ziextenzo. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Ziextenzo | 61314-0866-01 | Sandoz Inc. | 0.6 | 12 |
| Ziextenzo | 61314-0866-02 | Sandoz Inc. | 0.6 | 12 |
Q5120: common questions
- Is Q5120 a CPT code?
- No. Q5120 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 Q5120?
- CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under Q5120, for Ziextenzo. The table on this page shows each one with its billing units per package.
- What is the Medicare payment limit for Q5120?
- $302.247 per 0.5 mg, 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 Q5120?
- One unit of Q5120 is 0.5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 0.5 mg. J-code billing units.