How much does Medicare pay for HCPCS J9030?

Medicare allowed an average of $2.85 per service and paid $2.21 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $7.82, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code J9030?

Bcg live intravesical instillation, 1 mg. It was billed 1,933,786 times to 15,884 Medicare beneficiaries by 860 providers in 2024.

Which specialty bills J9030 most?

Urology, with 1,404,060 services from 645 clinicians. Next are Nurse Practitioner, Physician Assistant, Hematology-Oncology.

HCPCS J9030

Bcg live intravesical instillation, 1 mg

$2.85Medicare-allowed amount per service, averaged across 1,933,786 services

Providers submitted

$7.82

Asking price, not received

Medicare allowed

$2.85

The fee schedule figure

Medicare paid

$2.21

Balance is patient coinsurance

Providers submitted an average of $7.82 for this code and Medicare allowed $2.85 — 2.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $2.21 (78%); the rest is the patient’s coinsurance and deductible.

Services: 1,933,786
Beneficiaries: 15,884
Providers billing it: 860
Total allowed: $5,511,290

What Medicare pays for HCPCS J9030

Across 1,933,786 services billed by 860 providers to 15,884 beneficiaries, Medicare allowed an average of $2.85 per service. That is 121.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills J9030

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	1,404,060	11,556	$2.85	645
Nurse Practitioner	267,273	1,895	$2.85	89
Physician Assistant	190,684	1,689	$2.85	87
Hematology-Oncology	54,749	500	$2.86	26
Medical Oncology	7,994	140	$2.81	7
Certified Clinical Nurse Specialist	4,610	32	$2.86	1
Infectious Disease	2,100	24	$2.88	2
Internal Medicine	1,778	36	$2.89	2
Obstetrics & Gynecology	538	12	$2.86	1

J9030 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	219,361	$2.85	$2.22	72
California	157,501	$2.86	$2.22	61
Illinois	128,628	$2.85	$2.23	40
Massachusetts	104,001	$2.85	$2.24	33
Pennsylvania	98,991	$2.85	$2.23	43
Arizona	98,005	$2.86	$2.23	41
Maryland	95,912	$2.82	$2.24	48
Texas	88,299	$2.85	$2.20	47
Virginia	85,075	$2.84	$2.19	38
New York	82,203	$2.85	$2.22	34
New Jersey	60,701	$2.87	$2.25	24
Michigan	53,094	$2.87	$2.23	25
Indiana	49,046	$2.85	$2.21	20
Georgia	47,918	$2.85	$2.20	17
Missouri	47,886	$2.86	$2.23	14
Ohio	46,262	$2.83	$2.21	17
North Carolina	42,914	$2.85	$2.19	24
South Carolina	42,798	$2.86	$2.22	27
Washington	33,652	$2.86	$2.19	15
Delaware	28,066	$2.86	$2.24	11
Iowa	27,545	$2.86	$2.18	14
Arkansas	27,175	$2.84	$2.20	10
Minnesota	26,922	$2.86	$2.22	31
Tennessee	25,861	$2.87	$2.21	11
Oklahoma	22,422	$2.84	$2.20	15
Oregon	22,332	$2.83	$2.23	17
Colorado	20,592	$2.86	$2.18	23
Kansas	20,103	$2.83	$2.25	12
New Hampshire	16,538	$2.86	$2.20	8
Nevada	12,550	$2.86	$2.18	7
Connecticut	12,242	$2.80	$2.21	7
Louisiana	11,500	$2.87	$2.25	2
Rhode Island	10,132	$2.86	$2.25	5
Kentucky	8,650	$2.83	$2.28	5
Mississippi	7,592	$2.87	$2.19	4
Wisconsin	7,375	$2.86	$2.22	6
Idaho	6,670	$2.83	$2.20	5
Utah	6,652	$2.86	$2.20	3
Nebraska	6,157	$2.88	$2.26	7
South Dakota	5,200	$2.87	$2.19	6
Alaska	4,884	$2.87	$2.24	4
Alabama	4,350	$2.86	$2.26	2
Montana	3,800	$2.85	$2.12	2
District of Columbia	3,400	$2.89	$2.30	1
Wyoming	2,067	$2.76	$2.19	1
West Virginia	762	$2.87	$2.13	1

Related codes

J9025Injection, azacitidine, 1 mg$0.37
J9041Injection, bortezomib, 0.1 mg$1.80
J9045Injection, carboplatin, 50 mg$3.52
J9035Injection, bevacizumab, 10 mg$69.31
J9047Injection, carfilzomib, 1 mg$47.63
J9022Injection, atezolizumab, 10 mg$83.41
J9073Injection, cyclophosphamide (ingenus), 5 mg$0.89
J9075Injection, cyclophosphamide, not otherwise specified, 5 mg$0.99
J9060Injection, cisplatin, powder or solution, 10 mg$3.28
J9000Injection, doxorubicin hydrochloride, 10 mg$3.29

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.