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Updated July 1st, 2026

INFLECTRA Q Code: Q5103

Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg

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Q4 2026 Medicare Payment Limit for Q5103, effective October 1, 2026: $28.456 per HCPCS billing unit, up 2.7% from $27.71. From CMS's final file.

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Medicare Payment Limit ?
$27.71
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$27.71
/ HCPCS billing unit · APC 1847
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
HCPCS Added Date April 1, 2018
Manufacturer Pfizer
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Powder, Lyophilized, For Solution

About INFLECTRA

Inflectra is a medication aligned to the HCPCS Q Code: Q5103 for billing, pricing, and reimbursement purposes in the United States. It is an Immunology: Anti-TNF drug administered via the intravenous route and manufactured by Pfizer.

According to CMS Drug Use Information: This medication is used to treat certain types of arthritis (rheumatoid arthritis, arthritis of the spine, psoriatic arthritis), certain bowel diseases (Crohn's disease, ulcerative colitis), and a certain severe skin disease (chronic plaque psoriasis). In these conditions, the body's defense system (immune system) attacks healthy tissues. Infliximab works by blocking the actions of a certain natural substance (tumor necrosis factor alpha) in the body. This helps to decrease swelling (inflammation) and weaken your immune system, which slows or stops the damage from the disease. This monograph is about the following infliximab products: infliximab, infliximab-abda, infliximab-axxq, and infliximab-dyyb.

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. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
00069-0809-01 Inflectra Pfizer Laboratories Div Pfizer Inc 10 100 MG / 10 ML
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INFLECTRA Pricing & Reimbursement

Q5103 Private Payer Reimbursement
$30.13 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →
UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

Infliximab Biosimilar Information:

INFLECTRA Approval Date: April 5, 2016

Product Name HCPCS Code Active Ingredient BLA Type
Remicade J1745 Infliximab 351(a) Originator Product
Inflectra J1748 Infliximab 351(k) Biosimilar
Inflectra Q5103 Infliximab 351(k) Biosimilar
Renflexis Q5104 Infliximab 351(k) Biosimilar
Avsola Q5121 Infliximab 351(k) Biosimilar

INFLECTRA Claims Performance

Claims from Jan 2026 – Aug 2026
Claim Denial Rate 22.39%
Avg. Days to File 7.9days
Avg. Days to Pay 21.4days

Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.

Explore Q5103 claims analytics on FocalPoint →
OnPoint Oncology

INFLECTRA 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
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
JW / JZ modifiers apply

CMS has identified Inflectra (Q5103) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

INFLECTRA Medically Unlikely Edits (MUE)

The most billing units of Q5103 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.

Practitioner Office & Hospital Outpatient
150 units / day
= 1,500 mg per day

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 →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

INFLECTRA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

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.

Ankylosing Spondylitis Crohn's Disease Plaque Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Ulcerative Colitis
Drug Class
Tumor Necrosis Factor Blocker [EPC]Tumor Necrosis Factor Receptor Blocking Activity [MoA]

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Frequently Asked Questions

Is there an available Inflectra billing and coding guide?
Billing and coding information for INFLECTRA can be found through Pfizer. Visit Here →
Are there any available Inflectra patient assistance programs?
INFLECTRA patient assistance information can be found through Pfizer. Visit Here →
Where can I find Inflectra prescribing information?
INFLECTRA prescribing information can be found at the link below: Visit Here →
Where can I find Inflectra side effect information?
Information regarding INFLECTRA's side effects can be found at MedlinePlus Visit Here →
Does billing INFLECTRA require JZ/JW wastage modifiers?
CMS has identified INFLECTRA(Q5103) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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Related Drug Codes

Explore billing, coding, and pricing for drugs related to INFLECTRA.

J1748ZymfentraInjection, infliximab-dyyb (zymfentra), 10 mgCelltrion USAAdded July 1, 2024J1745RemicadeInjection, infliximab, excludes biosimilar, 10 mgJanssenAdded January 1, 2000Q5104RENFLEXISInjection, infliximab-abda, biosimilar, (renflexis), 10 mgOrganonAdded April 1, 2018Q5121AvsolaInjection, infliximab-axxq, biosimilar, (avsola), 10 mgAmgenAdded July 1, 2020J0717CIMZIAInjection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)UCB PharmaAdded January 1, 2014J1438ENBRELInjection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)AmgenAdded January 1, 2000J1602SIMPONI ARIAInjection, golimumab, 1 mg, for intravenous useJanssenAdded January 1, 2014J0139HUMIRAInjection, adalimumab, 1 mgAbbvieAdded January 1, 2025J1628TREMFYAInjection, guselkumab, 1 mgJanssenAdded January 1, 2019J3357STELARAUstekinumab, for subcutaneous injection, 1 mgJanssenAdded January 1, 2011