HCPCS Level II drug code
Q5123 — Injection, rituximab-arrx, biosimilar, (riabni), 10 mg
In short
Q5123 is the HCPCS Level II code for injection, rituximab-arrx, biosimilar, (riabni), 10 mg. CMS assigns NDCs for Riabni to it. One billing unit is 10 mg. The Medicare Part B payment limit is $21.083 per unit (October 1, 2026 through December 31, 2026).
Code
CMS HCPCS file- Descriptor
- Injection, rituximab-arrx, biosimilar, (riabni), 10 mg
- Short descriptor
- Inj. riabni, 10 mg
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Jul 1, 2021
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. 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
Units and claim line
Units = dose given ÷ 10 mg. For example, 1000 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 Q5123
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 2 NDCs to Q5123 for Riabni. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Riabni | 55513-0224-01 | Amgen Inc | 10 | 10 |
| Riabni | 55513-0326-01 | Amgen Inc | 50 | 50 |
Q5123: common questions
- Is Q5123 a CPT code?
- No. Q5123 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 Q5123?
- CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under Q5123, for Riabni. The table on this page shows each one with its billing units per package.
- What is the Medicare payment limit for Q5123?
- $21.083 per 10 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 Q5123?
- One unit of Q5123 is 10 mg, as stated in the code's descriptor. Units to report = dose given ÷ 10 mg. J-code billing units.