Q5114 HCPCS code: Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg
Q5114 is the HCPCS Level II code for injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg. In 2024 Medicare paid an average of $42.70 per service for Q5114 across 824,760 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 120 per day on outpatient hospital claims. Medicare volume rose 830% from 2022 to 2024 (88,701 to 824,760 services). In 2024, about 2,088 clinicians billed Medicare for Q5114 for 2,749 beneficiaries; Florida, California, Texas accounted for 33% of services.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2019-07-01 |
| Last action effective | 2019-07-01 |
Who bills Q5114 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,088 |
| Medicare beneficiaries | 2,749 |
| States with claims | 35 |
| Share of services in top 3 states (Florida, California, Texas) | 33% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q5114, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 88,701 | 363 | $50.08 | $39.97 |
| 2023 | 196,435 | 840 | $40.85 | $32.54 |
| 2024 | 824,760 | 2,749 | $53.62 | $42.70 |
States with the most Q5114 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 141,890 | $42.68 |
| California | 78,213 | $42.93 |
| Texas | 46,554 | $42.41 |
| Alabama | 41,684 | $42.47 |
| Arkansas | 35,567 | $42.33 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 120 | Prescribing Information |
| practitioner claims | 120 | Prescribing Information |
What changed for Q5114
- 2019-07-01: Q5114 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code Q5114?
Q5114 is the HCPCS Level II code for injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg. Short descriptor: "Inj ogivri 10 mg".
How much does Medicare pay for Q5114?
In 2024, the average Medicare payment was $42.70 per service (average allowed $53.62).
Does Medicare cover Q5114?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of Q5114 can be billed per day?
120 on outpatient hospital claims; 120 on practitioner claims (NCCI medically unlikely edits).
Related Q51 codes
- Q5100 — Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg
- Q5101 — Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram
- Q5102 — Injection, infliximab, biosimilar, 10 mg
- Q5103 — Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
- Q5104 — Injection, infliximab-abda, biosimilar, (renflexis), 10 mg
- Q5105 — Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
- Q5106 — Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
- Q5107 — Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg
- Q5108 — Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg
- Q5109 — Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg
- Q5110 — Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram
- Q5111 — Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under Q5114
- Watch Q5114 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q5114
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.