Q5118 HCPCS code: Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg
Q5118 is the HCPCS Level II code for injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg. In 2024 Medicare paid an average of $16.35 per service for Q5118 across 1,219,678 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 230 per day on outpatient hospital claims. Medicare volume fell 51% from 2022 to 2024 (2,488,492 to 1,219,678 services). In 2024, about 2,114 clinicians billed Medicare for Q5118 for 3,305 beneficiaries; California, Texas, Florida accounted for 44% 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 Q5118 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,114 |
| Medicare beneficiaries | 3,305 |
| States with claims | 30 |
| Share of services in top 3 states (California, Texas, Florida) | 44% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q5118, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,488,492 | 5,623 | $42.79 | $34.16 |
| 2023 | 2,329,893 | 5,670 | $29.16 | $23.22 |
| 2024 | 1,219,678 | 3,305 | $20.54 | $16.35 |
States with the most Q5118 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 201,204 | $16.47 |
| Texas | 199,734 | $16.44 |
| Florida | 122,197 | $16.36 |
| Illinois | 82,984 | $16.73 |
| Virginia | 80,372 | $16.64 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 230 | CMS Policy |
| practitioner claims | 230 | CMS Policy |
Medicare policy articles for this code
- A52370: Billing and Coding: Bevacizumab and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B))
Covered diagnoses (458 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C17.0 | Malignant neoplasm of duodenum | 1 |
| C17.1 | Malignant neoplasm of jejunum | 1 |
| C17.2 | Malignant neoplasm of ileum | 1 |
| C17.3 | Meckel's diverticulum, malignant | 1 |
| C17.8 | Malignant neoplasm of overlapping sites of small intestine | 1 |
| C17.9 | Malignant neoplasm of small intestine, unspecified | 1 |
| C18.0 | Malignant neoplasm of cecum | 1 |
| C18.1 | Malignant neoplasm of appendix | 1 |
| C18.2 | Malignant neoplasm of ascending colon | 1 |
| C18.3 | Malignant neoplasm of hepatic flexure | 1 |
Showing 10 of 458. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for Q5118
- 2019-10-01: Q5118 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 Q5118?
Q5118 is the HCPCS Level II code for injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg. Short descriptor: "Inj., zirabev, 10 mg".
How much does Medicare pay for Q5118?
In 2024, the average Medicare payment was $16.35 per service (average allowed $20.54).
Does Medicare cover Q5118?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for Q5118?
Medicare policy articles that cite Q5118 list 458 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C17.0 (Malignant neoplasm of duodenum), C17.1 (Malignant neoplasm of jejunum), C17.2 (Malignant neoplasm of ileum). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of Q5118 can be billed per day?
230 on outpatient hospital claims; 230 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
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Next steps
- Run a reimbursement report for a device billed under Q5118
- Watch Q5118 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q5118
Sources: CMS HCPCS Level II release October 2026; 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.