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HCPCS code J0585: OnabotulinumtoxinA, per 1 unit2026 Medicare rate & RVUs

OnabotulinumtoxinA is a botulinum toxin injection reported by dose unit for selected muscle, gland, or bladder indications when Medicare coverage applies.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J0585

OnabotulinumtoxinA, per 1 unit

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 J0585 →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 J0585 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 J0585 covers

OnabotulinumtoxinA, commonly known by the brand name Botox, is injected to reduce muscle activity or treat certain other conditions. Neurologists, physiatrists, ophthalmologists, urologists, and other clinicians may administer it for conditions such as focal spasticity, cervical dystonia, blepharospasm, chronic migraine, or bladder overactivity. The injection site and technique depend on the treated condition; treatment may involve muscles, skin, or the bladder wall. The drug code identifies the product, not the clinical service used to administer it.

J0585 represents one unit of onabotulinumtoxinA, so report units according to the dose administered. Doses vary by indication and treatment plan. CMS assigns physician fee schedule status E, meaning the drug is excluded from that schedule; when Medicare covers it, payment is made under another payment method. The HCPCS pricing method identifies it as a Part B drug generally priced from CMS quarterly Average Sales Price files when covered. Medicare coverage is subject to special coverage instructions.

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 J0585 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

J0585 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

J0585 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
J0585 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 J0585 rate is calculated

Each of J0585’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 · J0585

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 J0585

J0585 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 · J0585

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

J0585 isn’t priced in this setting.

J0585 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • J0585

    OnabotulinumtoxinA, per 1 unit0 wRVU

    Not priced

  • J0586

    AbobotulinumtoxinA, per 5 units0 wRVU

    Not priced

  • J0587

    RimabotulinumtoxinB, per 100 units0 wRVU

    Not priced

  • J0588

    IncobotulinumtoxinA, per 1 unit0 wRVU

    Not priced

  • J0589

    DaxibotulinumtoxinA, per 1 unit0 wRVU

    Not priced

How to choose

J0586AbobotulinumtoxinAPer 5 units
J0586 identifies abobotulinumtoxinA, not onabotulinumtoxinA. Select the code for the product administered; the products' units are not interchangeable.
J0587RimabotulinumtoxinBPer 100 units
J0587 identifies rimabotulinumtoxinB. Use J0585 for onabotulinumtoxinA; these are different products with distinct units.
J0588IncobotulinumtoxinAPer 1 unit
J0588 identifies incobotulinumtoxinA rather than onabotulinumtoxinA. The drug administered determines which code applies.
J0589DaxibotulinumtoxinAPer 1 unit
J0589 identifies daxibotulinumtoxinA-lanm. It is a separate product, not another unit or formulation code for J0585.

Codes related to J0585

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

Codes related to J0585
CodeHow it relatesNational office range
Used instead
J0586AbobotulinumtoxinA, per 5 unitsUse J0586 when abobotulinumtoxinA, rather than onabotulinumtoxinA, is administered.No office rate
J0587RimabotulinumtoxinB, per 100 unitsUse J0587 when rimabotulinumtoxinB, rather than onabotulinumtoxinA, is administered.No office rate
J0588IncobotulinumtoxinA, per 1 unitUse J0588 when incobotulinumtoxinA, rather than onabotulinumtoxinA, is administered.No office rate
J0589DaxibotulinumtoxinA, per 1 unitUse J0589 when daxibotulinumtoxinA-lanm, rather than onabotulinumtoxinA, is administered.No office rate

J0585 billing questions

How many units does J0585 represent?

Each J0585 unit represents one unit of onabotulinumtoxinA. Report units for the dose administered, not the number of injection sites.

How is J0585 different from J0586 or J0588?

J0585 is onabotulinumtoxinA; J0586 is abobotulinumtoxinA and J0588 is incobotulinumtoxinA. Their product units are not interchangeable.

Does J0585 include the injection procedure?

No. J0585 identifies the drug. A separately reportable procedure code may describe the therapeutic injection service when applicable.

How does Medicare treat J0585?

CMS excludes it from the physician fee schedule under status E. When Medicare covers the drug, it generally uses the Part B drug pricing method, with special coverage instructions applying.

What documentation supports the units billed?

Document the onabotulinumtoxinA dose administered and the treated condition and sites. The recorded dose should support the number of J0585 units reported.

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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