HCPCS Q5106

Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units (CMS descriptor)

Drugs Drug code Work RVU per service none (2024 fee schedule; adds 0 work RVUs)

539
82nd percentile among 6,471 codes billed · 2024
$8.9M
87th percentile among 6,471 codes billed · 2024
1.6M
97th percentile among 6,471 codes billed · 2024
1,840
96th percentile among 6,471 codes billed · 2024
9,968
97th percentile among 6,471 codes billed · 2024
-33.8%
Medicare payment on the code vs 2023; billers -22.4% · 2024

Trend

Medicare payment on the code

$0$20M2020: $25M paid20202021: $33M paid20212022: $24M paid20222023: $13M paid20232024: $8.9M paid2024$8.9M$0$20M2020: $25M paid20202021: $33M paid20212022: $24M paid20222023: $13M paid20232024: $8.9M paid2024$8.9M$0$20M2020: $25M paid20202021: $33M paid20212022: $24M paid20222023: $13M paid20232024: $8.9M paid2024$8.9M$0$20M2020: $25M paid20202021: $33M paid20212022: $24M paid20222023: $13M paid20232024: $8.9M paid2024$8.9M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

05001,0002020: 745 providers20202021: 977 providers20212022: 949 providers20222023: 695 providers20232024: 539 providers202453905001,0002020: 745 providers20202021: 977 providers20212022: 949 providers20222023: 695 providers20232024: 539 providers202453905001,0002020: 745 providers20202021: 977 providers20212022: 949 providers20222023: 695 providers20232024: 539 providers202453905001,0002020: 745 providers20202021: 977 providers20212022: 949 providers20222023: 695 providers20232024: 539 providers2024539

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
2024539$8,910,055-34%1,562,8601,8409,9680.00
2023695$13,459,259-44% (2023 changed hospital and observation visit codes)2,213,1602,1709,2260.00
2022949$23,954,432-28%3,762,5832,91010,9450.00
2021977$33,495,100– (Not compared: 2021 changed office visit values)4,829,3603,44014,0800.00
2020745$25,194,887first year in data3,763,4753,66014,6400.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida96$2,152,402372,1172,62010,785
California50$1,199,135209,8263,43510,369
New Jersey30$1,031,580180,0943,47014,772
Texas59$652,375114,5751,7004,306
New York28$529,79295,3562,7467,197
Maryland20$520,51394,6132,95212,818
Pennsylvania30$305,09053,2217584,484
North Carolina39$275,19049,4911,0403,134
Massachusetts18$248,21143,5451,3327,245
Illinois15$191,70033,6652,2004,583
Delaware28$162,85928,1409001,968
Oregon18$141,51624,9841,1533,035

Not listed: 28 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ35$733,014130,3722,590
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD33$536,89394,1271,290
Los Angeles-Long Beach-Anaheim, CA14$449,17078,1824,251
Palm Bay-Melbourne-Titusville, FL12$424,13974,1824,891
San Francisco-Oakland-Fremont, CA14$286,68550,4133,350
North Port-Bradenton-Sarasota, FL13$249,34742,7902,950
Chicago-Naperville-Elgin, IL-IN15$218,68938,2961,842
Dallas-Fort Worth-Arlington, TX17$217,51838,5501,720
Wilmington, NC12$61,76211,106983
Allentown-Bethlehem-Easton, PA-NJ17$53,9339,538579
Portland-Vancouver-Hillsboro, OR-WA12$50,6879,108612

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 11 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing Q5106 nationally

Hematology-Oncology accounts for 67% of payment for Q5106 nationally in 2024, across 5 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology25247%$5,930,67367%1,039,2504,124
Nephrology16030%$1,189,08013%210,8541,318
Medical Oncology6212%$1,084,70112%188,4963,040
Nurse Practitioner315.8%$170,0881.9%30,567986
Internal Medicine163.0%$154,3691.7%27,1111,694

Not listed: 5 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2024.

Top billers of Q5106 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations