HCPCS Q5106

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

Drugs Drug code Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

745
83rd percentile among 6,116 codes billed · 2020
$25M
94th percentile among 6,116 codes billed · 2020
3.8M
98th percentile among 6,116 codes billed · 2020
3,660
98th percentile among 6,116 codes billed · 2020
14,640
98th percentile among 6,116 codes billed · 2020

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
Florida127$4,511,694670,2524,18012,888
California66$3,803,670567,2626,62925,723
New Jersey52$2,495,380372,6474,87619,116
New York44$1,521,637224,5993,45015,807
Arkansas26$1,518,826227,5806,09118,331
Texas56$1,423,598210,0363,2209,282
Maryland28$1,114,512169,5895,15517,130
Illinois30$1,028,762153,4024,25111,581
North Carolina37$812,804121,9051,02813,300
Michigan27$670,656100,4293,1007,498
Virginia29$583,07987,2601,3289,032
Pennsylvania23$563,82584,4002,4209,602
Ohio11$479,84271,3605,00014,800
Alabama19$479,29273,5773,7576,959
Connecticut12$428,30465,0304,81013,444

Not listed: 1 billers with an armed-forces or unknown state code (XX); they are in the national totals.

Not listed: 20 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ57$2,633,464391,6395,380
Miami-Fort Lauderdale-West Palm Beach, FL33$1,496,711223,2015,380
Los Angeles-Long Beach-Anaheim, CA29$1,404,469209,0926,480
Washington-Arlington-Alexandria, DC-VA-MD-WV28$1,195,469181,9485,470
Little Rock-North Little Rock-Conway, AR15$1,120,288167,82610,680
Chicago-Naperville-Elgin, IL-IN23$991,147148,0634,440
Jacksonville, FL23$811,544121,1014,880
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD34$780,385116,0121,805
Detroit-Warren-Dearborn, MI22$619,08192,5893,265
Dallas-Fort Worth-Arlington, TX21$432,59063,7722,620
Fayetteville-Springdale-Rogers, AR11$398,53859,7545,053
Palm Bay-Melbourne-Titusville, FL12$395,62659,0214,870
Tulsa, OK11$240,98836,3803,440
Greenville-Anderson-Greer, SC11$163,18624,246450
Wilmington, NC11$72,23211,0111,009

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 15 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing Q5106 nationally

Hematology-Oncology accounts for 74% of payment for Q5106 nationally in 2020, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology46963%$18,526,62874%2,766,4275,899
Medical Oncology10814%$4,185,02117%625,3385,790
Hematology192.6%$1,038,3564.1%154,3858,126
Nephrology9613%$715,1662.8%107,8621,124
Internal Medicine192.6%$393,7621.6%58,6953,089
Nurse Practitioner212.8%$196,3650.78%29,9321,425

Not listed: 8 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 2020.

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