HCPCS code J9030: Intravesical BCG, per 1 mg2026 Medicare rate & RVUs in Missouri
Reports live BCG placed in the bladder as immunotherapy for bladder cancer, with each HCPCS unit representing 1 mg of the drug.
CMS doesn’t publish an office rate for J9030 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.
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On this page 9 sections
What J9030 covers
J9030 represents live bacillus Calmette-Guérin (BCG) prepared for placement directly into the bladder. Urologists commonly use intravesical BCG as immunotherapy for carcinoma in situ and other high-risk non-muscle-invasive bladder cancers, often after endoscopic tumor removal. The medication is delivered through a urinary catheter during an outpatient bladder instillation. J9030 identifies the drug; CPT 51720 describes the bladder-instilling service.
CMS assigns this code status E, excluding it from the physician fee schedule; when Medicare covers the drug, payment is through another method. HCPCS pricing classifies it as a Part B drug generally priced from CMS quarterly ASP drug files. Medicare coverage follows special coverage instructions. Each unit represents 1 mg of live intravesical BCG, so report units based on the milligrams administered. Keep the drug units distinct from the instillation service when both are reported.
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 J9030 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.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the J9030 rate is calculated
Each of J9030’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 · J9030
RVUs × geographic indexes × conversion factor
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 J9030
J9030 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 · J9030
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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J9030 isn’t priced in this setting.
J9030 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 51720Bladder instillationAntineoplastic agent
- 51720 reports the bladder instillation procedure; J9030 reports the BCG drug in 1 mg units.
- 90586Intravesical BCGBladder cancer treatment
- CPT 90586 also reports BCG in 1 mg units; J9030 is the HCPCS Level II code for live intravesical BCG.
- J9029AdstiladrinPer therapeutic dose
- J9029 identifies Adstiladrin, a different intravesical bladder-cancer treatment, not live BCG.
J9030 billing questions
What does one unit of J9030 represent?
One unit represents 1 mg of live intravesical BCG. Calculate units from the milligrams administered.
Which code describes the bladder instillation service?
CPT 51720 describes bladder instillation of an anticarcinogenic agent. J9030 reports the BCG drug, not the catheter instillation service.
How does Medicare treat J9030?
CMS assigns status E, excluding J9030 from the physician fee schedule. When covered, it is treated as a Part B drug and generally priced through CMS quarterly ASP drug files; Medicare coverage follows special coverage instructions.
How should the drug units be supported?
Document the amount of BCG administered in milligrams and report the corresponding number of 1 mg units.
Is J9030 the same as CPT 90586?
Both identify intravesical BCG, and each uses a 1 mg unit. J9030 is an HCPCS Level II code; 90586 is a CPT code.
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.
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