HCPCS code Q5130 — Inj, fylnetra, 0.5 mg. Status: Active. Effective Apr 1, 2023. Source: CMS HCPCS Level II.

Q5130

Active

Inj, fylnetra, 0.5 mg

Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg

Category: Temporary
Section: Q-codes: Temporary Codes
Effective: Apr 1, 2023
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 9118

MUE — Medically Unlikely Edits

Maximum units of Q5130 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
Outpatient Hospital 12
Practitioner Services 12

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

National Drug Codes (NDCs) mapped to this HCPCS code.

NDC Drug Name
70121-1627-01 Fylnetra

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2023-Q2
    Inj, fylnetra, 0.5 mg