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See a sample rate comparisonHCPCS Q5111 (Udenyca) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Temporary Codes Anti-Inflammatory Medication and Chemotherapy Medication |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for Q5111 |
| Medicare Payment Limit | $106.334  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS Q5111 by major payers:
$160.36
$165.65
$173.22
$157.02
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HCPCS Q5111
5 of 25 sample ratesHigher to lower in this preview
Spencer Kroll
Kroll Medical Group Inc
$184.85Published rateJames Cort
James T. Cort. M.D.
$150.89Published rateDaryl Kim
Premier Health Associates, LLC
$146.38Published rateAnuradha Munshi
Virtua Medical Group PA
$135.55Published rateVanessa Trespalacios
$122.00Published rate
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See a sample payer proposalHCPCS Q5111 vs. Other Anti-Inflammatory Medication and Chemotherapy Medication Codes
The HCPCS Q5111 code is part of the Temporary Codes services used for Anti-Inflammatory Medication and Chemotherapy Medication. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS Q5111 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| Q5110-HCPCS | Low | Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram |
| Q5111-HCPCS | Low | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg |
| Q5112-HCPCS | Low | Injection, trastuzumab-dttb, biosimilar, (Ontruzant), 10 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q5111. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q5111 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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