HCPCS code J0588: IncobotulinumtoxinA, per 1 unit2026 Medicare rate & RVUs in California

Reports incobotulinumtoxinA administered by injection for conditions such as dystonia, spasticity, blepharospasm, or excessive salivation.

CMS RVU26DEffective Oct 1, 202629 payment localities

CMS doesn’t publish an office rate for J0588 in California.

—Office (non-facility)
—Hospital or facility

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 9 sections
  1. Rate in California
  2. What J0588 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What J0588 covers

IncobotulinumtoxinA, marketed as Xeomin, is a botulinum toxin used to reduce excessive muscle activity or salivary secretion. Neurologists, physiatrists, ophthalmologists, and other clinicians may administer it by injection for conditions such as cervical dystonia, spasticity, blepharospasm, or chronic sialorrhea. The treatment site and injection approach depend on the condition being treated.

J0588 identifies the drug, not the injection service. One HCPCS unit represents one unit of incobotulinumtoxinA; report the quantity administered in those units, not in milliliters or vials. Its physician fee schedule status is E, so CMS excludes it from the physician fee schedule. When Medicare covers the drug, payment is under another method; HCPCS classifies it as a Part B drug, generally priced using CMS quarterly Average Sales Price drug pricing files. The Medicare contractor determines coverage.

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 J0588 pays more and less in California

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

29 of 29 payment localities

J0588 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CAUnavailableUnavailable
Chico, CAUnavailableUnavailable
El Centro, CAUnavailableUnavailable
Fresno, CAUnavailableUnavailable
Hanford, CAUnavailableUnavailable
Los Angeles, CAUnavailableUnavailable
Madera, CAUnavailableUnavailable
Marin County, CAUnavailableUnavailable
Merced, CAUnavailableUnavailable
Modesto, CAUnavailableUnavailable

How the J0588 rate is calculated

Each of J0588’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 · J0588

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 J0588

J0588 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 · J0588

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

J0588 isn’t priced in this setting.

J0588 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • J0588

    IncobotulinumtoxinA, per 1 unit0 wRVU

    Not priced

  • J0585

    OnabotulinumtoxinA, per 1 unit0 wRVU

    Not priced

  • J0586

    AbobotulinumtoxinA, per 5 units0 wRVU

    Not priced

  • J0587

    RimabotulinumtoxinB, per 100 units0 wRVU

    Not priced

  • J0589

    DaxibotulinumtoxinA, per 1 unit0 wRVU

    Not priced

How to choose

J0585OnabotulinumtoxinAPer 1 unit
J0585 reports onabotulinumtoxinA, while J0588 reports incobotulinumtoxinA. Select the code for the product administered; do not treat their units as interchangeable.
J0586AbobotulinumtoxinAPer 5 units
J0586 is for abobotulinumtoxinA, not incobotulinumtoxinA. The product administered determines which drug code applies.
J0587RimabotulinumtoxinBPer 100 units
J0587 identifies rimabotulinumtoxinB. J0588 identifies incobotulinumtoxinA, a different drug product.
J0589DaxibotulinumtoxinAPer 1 unit
J0589 identifies daxibotulinumtoxinA-lanm, whereas J0588 identifies incobotulinumtoxinA. Report the code matching the administered product.

J0588 billing questions

How many units does J0588 represent?

One billing unit represents one unit of incobotulinumtoxinA. Report the administered drug quantity in units, rather than converting the amount to milliliters or vials.

Can J0588 units be exchanged for J0585 units?

No. J0588 is incobotulinumtoxinA and J0585 is onabotulinumtoxinA; their potency units are product-specific and are not interchangeable.

Does J0588 include the injection service?

No. J0588 identifies the drug quantity, not a distinct injection service.

How does Medicare treat J0588?

CMS assigns status E, excluding the drug from the physician fee schedule. When Medicare covers it, payment is under another method; the HCPCS file classifies it as a Part B drug generally priced from quarterly ASP files.

Does Medicare cover J0588 for every indication?

Coverage is left to the Medicare contractor's judgment.

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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