Q5101 — Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram
Q5101 is a HCPCS Level II code for injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram. It belongs to the Temporary Codes section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of Q5101 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1500 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- outpatient
- 1500 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · Published Contractor Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for Q5101
- Long descriptor
- Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram
- Short descriptor
- Injection, zarxio
- Added
- July 1, 2015
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to Q5101
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If Q5101 is not quite right, the correct code is very often within a few positions of it.
- Q5006Hospice care provided in inpatient hospice facility
- Q5007Hospice care provided in long term care facility
- Q5008Hospice care provided in inpatient psychiatric facility
- Q5009Hospice or home health care provided in place not otherwise specified (nos)
- Q5010Hospice home care provided in a hospice facility
- Q5098Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg
- Q5099Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg
- Q5100Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg
- Q5102Injection, infliximab, biosimilar, 10 mgterminated
- Q5103Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
- Q5104Injection, infliximab-abda, biosimilar, (renflexis), 10 mg
- Q5105Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
- Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
- Q5107Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg
- Q5108Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg
- Q5109Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mgterminated
Questions about Q5101
What is HCPCS code Q5101?
Q5101 is a HCPCS Level II code for injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram. It sits in the Temporary Codes section.
Does Medicare cover Q5101?
The CMS HCPCS file marks Q5101 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is Q5101 paid under the physician fee schedule?
Q5101 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).