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

CMS doesn’t publish an office rate for J0585 in Missouri.

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

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 in Missouri

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

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.

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.

J0585 compared with similar codes

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.

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