Q5117 HCPCS code: Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg
Q5117 is the HCPCS Level II code for injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg. In 2024 Medicare paid an average of $13.09 per service for Q5117 across 104,606 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 fell 90% from 2022 to 2024 (1,075,416 to 104,606 services). In 2024, about 503 clinicians billed Medicare for Q5117 for 385 beneficiaries; California, Texas, Illinois accounted for 74% 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 | 2019-10-01 |
| Last action effective | 2019-10-01 |
Who bills Q5117 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 503 |
| Medicare beneficiaries | 385 |
| States with claims | 9 |
| Share of services in top 3 states (California, Texas, Illinois) | 74% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q5117, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,075,416 | 3,136 | $39.90 | $31.83 |
| 2023 | 438,432 | 1,580 | $27.10 | $21.52 |
| 2024 | 104,606 | 385 | $16.59 | $13.09 |
States with the most Q5117 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 35,684 | $13.42 |
| Texas | 15,951 | $13.38 |
| Illinois | 8,478 | $13.33 |
| Maryland | 6,939 | $13.72 |
| Ohio | 4,078 | $14.85 |
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 Q5117
- 2019-10-01: Q5117 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 Q5117?
Q5117 is the HCPCS Level II code for injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg. Short descriptor: "Inj., kanjinti, 10 mg".
How much does Medicare pay for Q5117?
In 2024, the average Medicare payment was $13.09 per service (average allowed $16.59).
Does Medicare cover Q5117?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of Q5117 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 Q5117
- Watch Q5117 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q5117
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.