RIABNI Q Code: Q5123
Injection, rituximab-arrx, biosimilar, (riabni), 10 mg
Q4 2026 Medicare Payment Limit for Q5123, effective October 1, 2026: $21.083 per HCPCS billing unit, up 13.8% from $18.533. From CMS's final file.
Drug & Product Overview
About RIABNI
Riabni is a medication aligned to the HCPCS Q Code: Q5123 for billing, pricing, and reimbursement purposes in the United States. This Oncology medication is administered via the intravenous route and manufactured by Amgen.
According to CMS Drug Use Information: Rituximab is used to treat certain types of cancer (such as non-Hodgkin's lymphoma, chronic lymphocytic leukemia). It works by slowing or stopping the growth of cancer cells. Some brands of rituximab are also used to treat rheumatoid arthritis and can decrease joint pain and swelling. This drug is also used to treat certain types of blood vessel disease (such as granulomatosis with polyangiitis, microscopic polyangiitis) and can decrease the swelling of the blood vessels. Rituximab is also used to treat a certain skin condition (pemphigus vulgaris). It helps to reduce the number of skin lesions. This monograph is about the following rituximab products: rituximab, rituximab-abbs, rituximab-arrx, and rituximab-pvvr.
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 |
|---|---|---|---|---|
| 55513-0224-01 | Riabni | Amgen, Inc | 10 | 100 MG / 10 ML |
| 55513-0326-01 | Riabni | Amgen, Inc | 50 | 500 MG / 50 ML |
RIABNI Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Login to use the calculator →Rituximab Biosimilar Information:
RIABNI Approval Date: December 17, 2020
RIABNI Claims Performance
Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.
Explore Q5123 claims analytics on FocalPoint →
RIABNI 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 |
|---|---|
| 96413 | Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug |
| 96415 | Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure) |
CMS has identified Riabni (Q5123) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →
RIABNI Medically Unlikely Edits (MUE)
The most billing units of Q5123 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.
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 →
RIABNI 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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