HCPCS Q5106

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

Drugs Drug code Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

977
85th percentile among 6,253 codes billed · 2021
$33M
94th percentile among 6,253 codes billed · 2021
4.8M
98th percentile among 6,253 codes billed · 2021
3,440
98th percentile among 6,253 codes billed · 2021
14,080
98th percentile among 6,253 codes billed · 2021
–
Not compared: 2021 changed office visit values · 2021

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
Florida209$7,635,4261,093,8034,05013,424
California77$3,571,997513,9324,60019,373
New Jersey57$3,140,112450,5156,14022,449
Texas79$2,178,863315,9472,88012,947
Arkansas32$1,944,287280,3906,33721,853
Illinois50$1,900,957271,5133,42013,724
New York46$1,632,759235,9223,08014,970
Maryland30$1,577,613230,3726,05922,765
Pennsylvania24$1,180,469171,4976,87914,893
North Carolina63$983,135143,2721,0507,276
Michigan35$963,336139,6823,6007,393
South Carolina21$576,48583,2213,07014,160
Virginia21$502,56472,6712,9447,140
Nebraska19$500,02971,9943,9605,891
Ohio12$475,27568,6004,09511,828

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

Not listed: 17 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ67$3,282,669472,2895,847
Miami-Fort Lauderdale-West Palm Beach, FL30$1,717,074246,5236,941
Chicago-Naperville-Elgin, IL-IN33$1,583,779226,1645,870
Washington-Arlington-Alexandria, DC-VA-MD-WV28$1,539,408225,2215,541
Little Rock-North Little Rock-Conway, AR20$1,510,230217,9139,008
Los Angeles-Long Beach-Anaheim, CA26$1,246,238179,3755,665
Tampa-St. Petersburg-Clearwater, FL30$1,051,296149,6664,200
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD34$967,582140,3012,485
Jacksonville, FL23$791,102113,6304,760
Detroit-Warren-Dearborn, MI24$707,670103,1073,766
Orlando-Kissimmee-Sanford, FL24$681,03597,2072,979
Dallas-Fort Worth-Arlington, TX29$631,50190,8252,570
Palm Bay-Melbourne-Titusville, FL16$508,33573,7004,031
San Francisco-Oakland-Fremont, CA14$483,42670,0793,267
Cape Coral-Fort Myers, FL13$448,09864,2123,470

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 23 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing Q5106 nationally

Hematology-Oncology accounts for 74% of payment for Q5106 nationally in 2021, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology58860%$24,903,79474%3,587,4986,101
Medical Oncology14315%$5,077,17315%732,3065,121
Nephrology15416%$1,669,6005.0%243,4881,581
Hematology131.3%$801,2912.4%115,5208,886
Internal Medicine282.9%$553,6851.7%79,9262,855
Nurse Practitioner282.9%$297,5270.89%42,8881,532

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 2021.

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