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CPT code 90586: Intravesical BCG, bladder cancer treatment2026 Medicare rate & RVUs

Intravesical BCG is the live BCG product used for bladder cancer immunotherapy, reported when the product is instilled into the bladder.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 90586

Intravesical BCG, bladder cancer treatment

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 90586 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 90586 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 90586 covers

This code identifies live BCG used as intravesical immunotherapy for bladder cancer, including non-muscle-invasive disease such as carcinoma in situ. A urologist or other qualified clinician administers the product through a urinary catheter, commonly during an outpatient treatment course after resection of bladder tumors. The BCG product is distinct from the service of instilling it into the bladder.

CMS assigns this code physician fee schedule status E, which excludes it from the physician fee schedule. When Medicare covers the item or service, payment is made under another payment method. Report one unit for each instillation; the unit is not based on the amount of BCG in the dose. Code 51720 represents the bladder instillation service when applicable. This code is for intravesical BCG, not percutaneous BCG vaccination against tuberculosis.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 90586 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

90586 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

90586 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
90586 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 90586 rate is calculated

Each of 90586’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 90586

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 90586

90586 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 90586

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

90586 isn’t priced in this setting.

90586 compared with similar codes

Compare codes · National

90586 vs 51720 vs 90585: Medicare rates

Office or facility?

  • 90586

    Intravesical BCG, bladder cancer treatment0 wRVU

    Not priced

  • 51720

    Bladder instillation, antineoplastic agent0.85 wRVU

    $91.85

  • 90585

    BCG vaccine, percutaneous route0 wRVU

    Not priced

How to choose

51720Bladder instillationAntineoplastic agent
90586 identifies the intravesical BCG product; 51720 represents the bladder instillation service. They describe different parts of the treatment.
90585BCG vaccinePercutaneous route
90585 is for percutaneous BCG vaccination. Use 90586 for BCG used intravesically as bladder cancer immunotherapy.

Codes related to 90586

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 90586
CodeHow it relatesNational office range
Often billed with
51720Bladder instillation, antineoplastic agentRepresents the bladder instillation service associated with intravesical BCG treatment.$81.64–$119.70
Same family
90585BCG vaccine, percutaneous routeBCG vaccine code for percutaneous use, rather than intravesical bladder cancer treatment.No office rate

90586 billing questions

When should I report 90586 instead of 90585?

Report 90586 for BCG used intravesically as bladder cancer immunotherapy. Code 90585 identifies BCG given percutaneously.

Does 90586 include the bladder instillation?

90586 identifies the BCG product. Code 51720 represents the bladder instillation service when that service is performed and separately reported.

How many units should I report?

Report one unit for each BCG instillation. The unit is not based on the amount of BCG in the dose.

What documentation supports reporting 90586?

Document the BCG product administered, its intravesical route, and the bladder cancer treatment encounter. The record should distinguish the product from the instillation service.

How does Medicare treat 90586?

CMS assigns status E, excluding the code from the physician fee schedule. When Medicare covers the item or service, payment is made under another payment method.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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