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Updated July 1st, 2026

Trazimera Q Code: Q5116

Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg

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Q4 2026 Medicare Payment Limit for Q5116, effective October 1, 2026: $11.271 per HCPCS billing unit, down 13.5% from $13.033. From CMS's final file.

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Medicare Payment Limit ?
$13.033
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$13.033
/ HCPCS billing unit · APC 9350
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
2
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Drug & Product Overview

HCPCS Descriptor Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg
HCPCS Added Date October 1, 2019
Manufacturer Pfizer
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose, Multi-Dose
Dosage Form Injection, Powder, Lyophilized, For Solution | Kit

About Trazimera

Trazimera is a medication aligned to the HCPCS Q Code: Q5116 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology, it is administered via the intravenous route and manufactured by Pfizer.

According to CMS Drug Use Information: Trastuzumab is used to treat certain types of breast, stomach, or esophagus cancer. Trastuzumab belongs to a class of medications known as monoclonal antibodies. It works by slowing or stopping the growth of cancer cells. This monograph is about the following trastuzumab products: trastuzumab, trastuzumab-anns, trastuzumab-dkst, trastuzumab-dttb, trastuzumab-pkrb, trastuzumab-qyyp, trastuzumab-strf.

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
00069-0305-01 Trazimera Pfizer Laboratories Div Pfizer Inc 42 Kit
00069-0308-01 Trazimera Pfizer Laboratories Div Pfizer Inc 15 150 MG / 7.15 ML
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Trazimera Pricing & Reimbursement

Q5116 Private Payer Reimbursement
$13.34 / 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

Trastuzumab Biosimilar Information:

Trazimera Approval Date: March 11, 2019

Product Name HCPCS Code Active Ingredient BLA Type
Herceptin J9355 Trastuzumab 351(a) Originator Product
Ogivri Q5114 Trastuzumab 351(k) Biosimilar
Herzuma Q5113 Trastuzumab 351(k) Biosimilar
Ontruzant Q5112 Trastuzumab 351(k) Biosimilar
Trazimera Q5116 Trastuzumab 351(k) Biosimilar
Kanjinti Q5117 Trastuzumab 351(k) Biosimilar
Hercessi Q5146 Trastuzumab 351(k) Biosimilar

Trazimera Claims Performance

Claims from Jan 2026 – Aug 2026
Claim Denial Rate 11.86%
Avg. Days to File 9.1days
Avg. Days to Pay 25.1days

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

Explore Q5116 claims analytics on FocalPoint →
OnPoint Oncology

Trazimera 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)
Not on the CMS JW / JZ list

CMS does not include Trazimera (Q5116) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q5116. Wastage billing guide →

Trazimera Medically Unlikely Edits (MUE)

The most billing units of Q5116 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.

Practitioner Office & Hospital Outpatient
120 units / day
= 1,200 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.

Trazimera 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.

Breast Cancer Metastatic Breast Cancer Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma
Drug Class
HER2/Neu/cerbB2 Antagonists [MoA]HER2/neu Receptor Antagonist [EPC]

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Frequently Asked Questions

Is there an available Trazimera billing and coding guide?
Billing and coding information for Trazimera can be found through Pfizer. Visit Here →
Are there any available Trazimera patient assistance programs?
Trazimera patient assistance information can be found through Pfizer. Visit Here →
Where can I find Trazimera prescribing information?
Trazimera prescribing information can be found at the link below: Visit Here →
Where can I find Trazimera side effect information?
Information regarding Trazimera's side effects can be found at MedlinePlus Visit Here →
Does billing Trazimera require JZ/JW wastage modifiers?
CMS does not include Trazimera (Q5116) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q5116. For more information, visit the link below.

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Related Drug Codes

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

Q5113HERZUMAInjection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mgTevaAdded July 1, 2019Q5112ONTRUZANTInjection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mgOrganonAdded July 1, 2019Q5114OGIVRIInjection, trastuzumab-dkst, biosimilar, (ogivri), 10 mgBiocon Biologics IncAdded July 1, 2019Q5117KANJINTIInjection, trastuzumab-anns, biosimilar, (kanjinti), 10 mgAmgenAdded October 1, 2019J9355HERCEPTINInjection, trastuzumab, excludes biosimilar, 10 mgGenentechAdded January 1, 2000Q5146HERCESSIInjection, trastuzumab-strf (hercessi), biosimilar, 10 mgAccordAdded January 1, 2025J9000ADRIAMYCINInjection, doxorubicin hydrochloride, 10 mgMultiple ManufacturersAdded January 1, 1984J9267PaclitaxelInjection, paclitaxel, 1 mgMultiple ManufacturersAdded January 1, 2015J9356HERCEPTIN HYLECTAInjection, trastuzumab, 10 mg and hyaluronidase-oyskGenentechAdded July 1, 2019J9306PERJETAInjection, pertuzumab, 1 mgGenentechAdded January 1, 2014