Home Drug Codes Q Codes Q5106 · RETACRIT
Updated July 1st, 2026

RETACRIT Q Code: Q5106

Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units

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Q4 2026 Medicare Payment Limit for Q5106, effective October 1, 2026: $8.171 per HCPCS billing unit, up 2.5% from $7.968. From CMS's final file.

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Medicare Payment Limit ?
$7.968
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$7.968
/ HCPCS billing unit · APC 9097
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
15
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Drug & Product Overview

HCPCS Descriptor Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
HCPCS Added Date July 1, 2018
Manufacturer Vifor International
Route of Administration Intravenous, Subcutaneous
Generic Status Single-Source; Branded
Dosage Type Single-Dose, Multi-Dose
Dosage Form Injection, Solution

About RETACRIT

Retacrit is a medication aligned to the HCPCS Q Code: Q5106 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology Colony Stimulating Factor drug 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 15 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 20 Retacrit Intravenous I njection 2000 UN… Login for More
00069-1306-10 Retacrit Pfizer Laboratories Div Pfizer Inc 30 Retacrit Intravenous I njection 3000 UN… Login for More
00069-1307-10 Retacrit Pfizer Laboratories Div Pfizer Inc 40 Retacrit Intravenous I njection 4000 UN… Login for More
00069-1308-10 Retacrit Pfizer Laboratories Div Pfizer Inc 100 Retacrit Intravenous I njection 10000 U… Login for More
59353-0002-10 Retacrit Vifor (International) Inc. 20 Retacrit Intravenous I njection 2000 UN… Login for More
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RETACRIT
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RETACRIT Pricing & Reimbursement

Q5106 Private Payer Reimbursement
$7.71 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

Epoetin Alfa Biosimilar Information:

RETACRIT Approval Date: May 15, 2018

Product Name HCPCS Code Active Ingredient BLA Type
Procrit J0885 Epoetin Alfa 351(a) Originator Product
Retacrit Q5105 Epoetin Alfa 351(k) Biosimilar
Retacrit Q5106 Epoetin Alfa 351(k) Biosimilar

RETACRIT Claims Performance

Claims from Jan 2026 – Aug 2026
Claim Denial Rate 17.29%
Avg. Days to File 10.8days
Avg. Days to Pay 25.2days

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

Explore Q5106 claims analytics on FocalPoint →
OnPoint Oncology

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
Not on the CMS JW / JZ list

CMS does not include Retacrit (Q5106) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q5106. Wastage billing guide →

RETACRIT Medically Unlikely Edits (MUE)

The most billing units of Q5106 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1000 units.

Practitioner Office & Hospital Outpatient
60 units / day
= 60,000 units 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 →

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

RETACRIT 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.

Anemia Due to Chemotherapy in Patients with Cancer Anemia Due to Chronic Kidney Disease Anemia Due to Zidovudine in Patients with HIV Infection Anemia due to Chemotherapy in Patients with Cancer Anemia due to Chronic Kidney Disease Anemia due to Zidovudine in Patients with HIV Infection Reduction of Allogeneic Red Blood Cell Transfusions in Patients Undergoing Elective, Noncardiac, Nonvascular Surgery
Drug Class
Erythropoiesis-stimulating Agent [EPC]Erythropoietin [CS]Increased Erythroid Cell Production [PE]

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Frequently Asked Questions

Is there an available Retacrit billing and coding guide?
Billing and coding information for RETACRIT can be found through Vifor International. Visit Here →
Are there any available Retacrit patient assistance programs?
Our team has not identified a manufacturer-published source of patient assistance information for RETACRIT.
Where can I find Retacrit prescribing information?
RETACRIT prescribing information can be found at the link below. Please reach out to us if you believe this information to be innacurate or out of date. Visit Here →
Where can I find Retacrit side effect information?
Our team has not yet identified a source of side effects information for RETACRIT. Please check back in a few weeks.
Does billing RETACRIT require JZ/JW wastage modifiers?
CMS does not include RETACRIT (Q5106) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q5106. For more information, visit the link below.

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