HCPCS Level II J9030: BCG Live Intravesical Instillation, 1 mg
Commercial payers pay $4 on average nationally for this procedure.
HCPCS Level II code J9030 describes administration of BCG live intravesical instillation, 1 mg, a bladder-directed antineoplastic biologic therapy delivered as an intravesical instillation for treatment or prophylaxis of superficial bladder cancer; the service type is intravesical drug instillation and the typical site of service is an outpatient urology or oncology clinic where bladder instillation procedures are performed.
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National Reimbursement Benchmarks
National commercial rates for J9030 center on an average BUCA commercial rate of $4.30; that serves as a useful mid-market reference point against payer-specific spreads. Blue Cross Blue Shield shows very tight dispersion with a P75–P25 range of $0.40, and Cigna also tight at $0.00 (no interquartile spread). UnitedHealth Group and Aetna present wider interquartile spreads at $0.40 and $1.70 respectively, indicating more variability in typical contracted rates.
Maximum-to-minimum differences reflect further heterogeneity: Aetna has the largest overall spread between its min and max ($182.30), while Blue Cross Blue Shield and Cigna sit near the lower end of variability. These contrasts highlight that commercial pricing for J9030 can be clustered around BUCA’s $4.30 for some payers but remains highly dispersed for others, particularly Aetna and UnitedHealth Group.