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Updated July 1st, 2026

NYVEPRIA Q Code: Q5122

Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg

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Q4 2026 Medicare Payment Limit for Q5122, effective October 1, 2026: $141.289 per HCPCS billing unit, up 3.2% from $136.911. From CMS's final file.

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Medicare Payment Limit ?
$136.911
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$136.911
/ HCPCS billing unit · APC 9406
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg
HCPCS Added Date January 1, 2021
Manufacturer Pfizer
Route of Administration Subcutaneous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Solution

About NYVEPRIA

Nyvepria is a medication aligned to the HCPCS Q Code: Q5122 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology Colony Stimulating Factor, it is administered via the subcutaneous route and manufactured by Pfizer.

According to CMS Drug Use Information: Pegfilgrastim is a man-made version of a certain natural substance made by your body. It is used to help your body make more white blood cells. White blood cells are important to help you fight off infections. Pegfilgrastim is given to people whose ability to make white blood cells is reduced due to chemotherapy. Some brands may also be used to increase white blood cells after exposure to large amounts of radiation. This monograph is about the following pegfilgrastim products: pegfilgrastim, pegfilgrastim-apgf, pegfilgrastim-bmez, pegfilgrastim-cbqv, pegfilgrastim-fpgk, pegfilgrastim-jmdb, and pegfilgrastim-pbbk.

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
00069-0324-01 Nyvepria Pfizer Laboratories Div Pfizer Inc 12 6 MG / 0.6 ML
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NYVEPRIA Pricing & Reimbursement

Q5122 Private Payer Reimbursement
$137.06 / 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

Pegfilgrastim Biosimilar Information:

NYVEPRIA Approval Date: June 10, 2020

Product Name HCPCS Code Active Ingredient BLA Type
Neulasta J2506 Pegfilgrastim 351(a) Originator Product
Fulphila Q5108 Pegfilgrastim 351(k) Biosimilar
Udenyca Q5111 Pegfilgrastim 351(k) Biosimilar
Ziextenzo Q5120 Pegfilgrastim 351(k) Biosimilar
Nyvepria Q5122 Pegfilgrastim 351(k) Biosimilar
Fylnetra Q5130 Pegfilgrastim 351(k) Biosimilar
Stimufend Q5127 Pegfilgrastim 351(k) Biosimilar
Armlupeg Q5169 Pegfilgrastim 351(k) Biosimilar
Ennumo N/A Pegfilgrastim 351(k) Biosimilar

NYVEPRIA Claims Performance

Claims from Jan 2026 – Aug 2026
Claim Denial Rate 16.75%
Avg. Days to File 9.3days
Avg. Days to Pay 21.5days

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

Explore Q5122 claims analytics on FocalPoint →
OnPoint Oncology

NYVEPRIA 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
JW / JZ modifiers apply

CMS has identified Nyvepria (Q5122) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

NYVEPRIA Medically Unlikely Edits (MUE)

The most billing units of Q5122 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.5 mg.

Practitioner Office & Hospital Outpatient
12 units / day
= 6 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.

NYVEPRIA 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.

Non-myeloid malignancies receiving myelosuppressive anti-cancer drugs
Drug Class
Granulocyte Colony-Stimulating Factor [CS]Increased Myeloid Cell Production [PE]Leukocyte Growth Factor [EPC]

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Frequently Asked Questions

Is there an available Nyvepria billing and coding guide?
Billing and coding information for NYVEPRIA can be found through Pfizer. Visit Here →
Are there any available Nyvepria patient assistance programs?
NYVEPRIA patient assistance information can be found through Pfizer. Visit Here →
Where can I find Nyvepria prescribing information?
NYVEPRIA prescribing information can be found at the link below: Visit Here →
Where can I find Nyvepria side effect information?
Information regarding NYVEPRIA's side effects can be found at MedlinePlus Visit Here →
Does billing NYVEPRIA require JZ/JW wastage modifiers?
CMS has identified NYVEPRIA(Q5122) 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 NYVEPRIA.

Q5108FULPHILAInjection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mgBiocon Biologics IncAdded October 1, 2018Q5111UDENYCAInjection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mgAccordAdded January 1, 2019Q5127StimufendInjection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mgFresenius KabiAdded April 1, 2023Q5130FYLNETRAInjection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mgAmneal BiosciencesAdded April 1, 2023J2506NEULASTAInjection, pegfilgrastim, excludes biosimilar, 0.5 mgAmgenAdded January 1, 2022Q5120ZIEXTENZOInjection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mgSandozAdded July 1, 2020J1442NEUPOGENInjection, filgrastim (g-csf), excludes biosimilars, 1 microgramAmgenAdded January 1, 2014J1447GRANIXInjection, tbo-filgrastim, 1 microgramTevaAdded January 1, 2016J1449ROLVEDONInjection, eflapegrastim-xnst, 0.1 mgAssertio PharmaceuticalsAdded April 1, 2023Q5101ZARXIOInjection, filgrastim-sndz, biosimilar, (zarxio), 1 microgramSandozAdded July 1, 2015