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HCPCS J0586 (Dysport) Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Injection, abobotulinumtoxinA, 5 Units
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

11 - Office

None

Complexity LevelLow
Medicare Payment Limit
$8.752BuyandBill.com
WAC Price
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Related NDC Codes

15054-0500-01 - DYSPORT 500 U

15054-0530-06 - DYSPORT (SINGLE USE) 300 U


National average reimbursement for HCPCS J0586 by major payers:

bcbs

$9.06

uhc

$8.88

aetna

$9.64

cigna

$9.17

Preview provider-level rates for...
For billing codeHCPCS J0586
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J0586

United
J0586$8.611386779031 - ADVOCATE LUTHERAN GENERAL362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATIONILGeneral Acute Care Hospital (282N00000X)
United
J0586$8.521932543428 - BANNER GOLDFIELD MEDICAL CENTER900981239 - (AZ) BANNER GOLDFIELD MEDICAL CENTERAZGeneral Acute Care Hospital (282N00000X)
United
J0586$8.631265437297 - BARNWELL COUNTY HOSPITAL570871995SCGeneral Acute Care Hospital (282N00000X)
United
J0586$9.221093095556 - LAUREN KOCH202088165 - ATLANTIC HEALTH SYSTEM INCNJGeneral Acute Care Hospital (282N00000X)
United
J0586$8.521609822881 - COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC, FROEDTERT MENOMONEE FALLS HOSPITAL843381796WIGeneral Acute Care Hospital (282N00000X)
United
J0586$8.521225327414 - FAYE FARBER562070036 - DUKE UNIVERSITY HEALTH SYSTEM INCNCGeneral Acute Care Hospital (282N00000X)
United
J0586$8.521093246779 - JASLEEN DHALIWAL954552089 - (CA) COLUMBIA EMERGENCY MEDICAL GROUP, INC.CAGeneral Acute Care Hospital (282N00000X)
United
J0586$8.631801825005 - HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH, LASALLE GENERAL HOSPITAL720690217 - (LA) HOSPITAL SERVICE DISTRICT 2 OF LASALLE PARISHLAGeneral Acute Care Hospital (282N00000X)
United
J0586$9.651609860360 - OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL, ASSUMPTION COMMUNITY HOSPITAL721495500 - (LA) OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INCLACritical Access Hospital (282NC0060X)
United
J0586$8.521821465576 - LAKE SURGICAL HOSPITAL SLIDELL, LLC, SOUTHERN SURGICAL HOSPITAL474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITALLAGeneral Acute Care Hospital (282N00000X)
United
J0586$8.521407191984 - BSA HOSPITAL LLC900914340TXGeneral Acute Care Hospital (282N00000X)
United
J0586$8.521285634394 - TRINITAS REGIONAL MEDICAL CENTER, TRINITAS HOSPITAL - DMI223601678 - (NJ) RWJ BARNABAS HEALTH INCNJGeneral Acute Care Hospital (282N00000X)
United
J0586$7.761285175596 - VENKAT SUBRAMANIAM61603195NYGeneral Acute Care Hospital (282N00000X)
United
J0586$11.271508883422 - LAWRENCE MEMORIAL HOSPITAL486033703KSGeneral Acute Care Hospital (282N00000X)
United
J0586$9.031558392563 - LAHEY CLINIC HOSPITAL, INC.42704686 - (MA) LAHEY CLINIC HOSPITAL INCMAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J0586 vs. Other Drugs, Administered by Injection Codes

The HCPCS J0586 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS J0586 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
15054-0500-01-NDCModerateDYSPORT 500 U
15054-0530-06-NDCModerateDYSPORT (SINGLE USE) 300 U
J0585-HCPCSLowInjection, onabotulinumtoxinA, 1 unit
J0586-HCPCSLowInjection, abobotulinumtoxinA, 5 Units

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0586. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J0586 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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