EPOGEN Q Code: Q4081
Injection, epoetin alfa, 100 units (for esrd on dialysis)
Q4 2026 Medicare Payment Limit for Q4081, effective October 1, 2026: $0.667 per HCPCS billing unit, down 3.1% from $0.688. From CMS's final file.
Drug & Product Overview
About EPOGEN
Epogen is a medication aligned to the HCPCS Q Code: Q4081 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology Colony Stimulating Factor, it is administered via the intravenous or subcutaneous routes and manufactured by Amgen.
According to CMS Drug Use Information: This medication is used to treat anemia (low red blood cell count) in people with long-term serious kidney disease (chronic kidney failure), people receiving zidovudine to treat HIV, and people receiving chemotherapy for some types of cancer (cancer that does not involve the bone marrow or blood cells). It may also be used in anemic patients to reduce the need for blood transfusions before certain planned surgeries that have a high risk of blood loss (usually given with an anticoagulant/"blood thinner" medication such as warfarin to lower the risk of serious blood clots). Epoetin alfa works by signaling the bone marrow to make more red blood cells. This medication is very similar to the natural substance in your body (erythropoietin) that prevents anemia. This monograph is about the following epoetin alfa products: epoetin alfa and epoetin alfa-epbx.
Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.
NDC Code Information
Based on publicly available CMS files. Showing 5 of 19 NDCs — log in for the full crosswalk.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| 55513-0126-10 | Epogen | Amgen, Inc | 200 | Epogen Intravenous Sol ution 2000 UNIT/… Login for More |
| 55513-0144-10 | Epogen | Amgen, Inc | 1000 | Epogen Intravenous Sol ution 10000 UNIT… Login for More |
| 55513-0148-10 | Epogen | Amgen, Inc | 400 | Epogen Intravenous Sol ution 4000 UNIT/… Login for More |
| 55513-0267-10 | Epogen | Amgen, Inc | 300 | Epogen Intravenous Sol ution 3000 UNIT/… Login for More |
| 59676-0302-01 | Procrit | Janssen Products, LP | 120 | Procrit Intravenous In jection 2000 UNI… Login for More |
| •••••-••••-•• Log in to view | EPOGEN | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | EPOGEN | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | EPOGEN | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
EPOGEN Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Login to use the calculator →EPOGEN CPT Administration Codes
The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.
| CPT Code | Description |
|---|---|
| 96372 | Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular |
CMS does not include Epogen (Q4081) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q4081. Wastage billing guide →
EPOGEN Medically Unlikely Edits (MUE)
The most billing units of Q4081 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 100 units. The limit is different in the office and the hospital. Use the one for your setting.
MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →
EPOGEN Clinical Information
Indications and drug classification.
This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.
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Frequently Asked Questions
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