HCPCS Q5106

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

Drugs Drug code Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

695
83rd percentile among 6,405 codes billed · 2023
$13M
90th percentile among 6,405 codes billed · 2023
2.2M
97th percentile among 6,405 codes billed · 2023
2,170
97th percentile among 6,405 codes billed · 2023
9,226
97th percentile among 6,405 codes billed · 2023
-43.8%
Medicare payment on the code vs 2022; billers -26.8%. 2023 changed hospital and observation visit codes · 2023

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
Florida106$2,827,342465,2253,03010,720
California71$1,680,401274,8563,2288,701
New Jersey49$1,469,138238,8613,82014,264
Texas63$951,286157,9691,8205,670
Illinois35$716,579116,6942,70010,238
New York28$647,799107,6003,3208,303
Maryland21$630,854105,6414,04010,120
Pennsylvania33$434,37371,8191,2805,060
Michigan23$431,97871,7421,30010,568
North Carolina45$318,99253,1709602,464
Massachusetts21$285,96046,8141,2806,060
Virginia11$276,50445,4362,16012,840
Alabama11$259,19942,6352,6497,708
Arkansas13$249,91940,4172,4106,908
Delaware28$203,25333,1301,1251,963

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

Not listed: 25 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ44$1,009,079164,6613,410
Miami-Fort Lauderdale-West Palm Beach, FL17$691,013112,9603,840
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD37$687,035113,1211,300
Washington-Arlington-Alexandria, DC-VA-MD-WV20$626,556105,4083,479
Los Angeles-Long Beach-Anaheim, CA21$547,78390,5314,400
Jacksonville, FL22$536,83987,7003,420
Chicago-Naperville-Elgin, IL-IN21$466,31076,0882,840
Palm Bay-Melbourne-Titusville, FL15$439,13072,1894,280
Detroit-Warren-Dearborn, MI20$417,63769,3702,110
San Francisco-Oakland-Fremont, CA15$367,10160,4213,340
Dallas-Fort Worth-Arlington, TX15$249,89742,0352,230
San Antonio-New Braunfels, TX13$182,85730,4711,620
Wichita, KS18$165,80826,3021,270
Fayetteville-Springdale-Rogers, AR11$157,25725,2922,349
Portland-Vancouver-Hillsboro, OR-WA14$63,94310,715609

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 16 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing Q5106 nationally

Hematology-Oncology accounts for 66% of payment for Q5106 nationally in 2023, across 5 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology37254%$8,931,08466%1,466,3613,942
Medical Oncology8012%$1,934,53214%317,1143,964
Nephrology16924%$1,480,40911%246,4131,458
Internal Medicine213.0%$286,7842.1%46,9292,235
Nurse Practitioner324.6%$283,6552.1%47,1741,474

Not listed: 4 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 2023.

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