RETACRIT Q Code: Q5105
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
Q4 2026 Medicare Payment Limit for Q5105, effective October 1, 2026: $0.817 per HCPCS billing unit, up 2.5% from $0.797. From CMS's final file.
Drug & Product Overview
About RETACRIT
Retacrit is a medication aligned to the HCPCS Q Code: Q5105 for billing, pricing, and reimbursement purposes in the United States. This Oncology Colony Stimulating Factor medication is administered via the intravenous or subcutaneous routes and manufactured by Vifor International.
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 |
|---|---|---|---|---|
| 00069-1305-10 | Retacrit | Pfizer Laboratories Div Pfizer Inc | 200 | Retacrit Intravenous I njection 2000 UN… Login for More |
| 00069-1306-10 | Retacrit | Pfizer Laboratories Div Pfizer Inc | 300 | Retacrit Intravenous I njection 3000 UN… Login for More |
| 00069-1307-10 | Retacrit | Pfizer Laboratories Div Pfizer Inc | 400 | Retacrit Intravenous I njection 4000 UN… Login for More |
| 00069-1308-10 | Retacrit | Pfizer Laboratories Div Pfizer Inc | 1000 | Retacrit Intravenous I njection 10000 U… Login for More |
| 59353-0002-10 | Retacrit | Vifor (International) Inc. | 200 | Retacrit Intravenous I njection 2000 UN… Login for More |
| •••••-••••-•• Log in to view | RETACRIT | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | RETACRIT | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | RETACRIT | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
RETACRIT Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Login to use the calculator →Epoetin Alfa Biosimilar Information:
RETACRIT Approval Date: May 15, 2018
RETACRIT Claims Performance
Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.
Explore Q5105 claims analytics on FocalPoint →
RETACRIT 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 Retacrit (Q5105) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q5105. Wastage billing guide →
RETACRIT Medically Unlikely Edits (MUE)
The most billing units of Q5105 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 →
RETACRIT 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
Is there an available Retacrit billing and coding guide?
Are there any available Retacrit patient assistance programs?
Where can I find Retacrit prescribing information?
Where can I find Retacrit side effect information?
Does billing RETACRIT require JZ/JW wastage modifiers?
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