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HCPCS code J7295: Vaginal ring, monthly, each2026 Medicare rate & RVUs

Reports one monthly vaginal contraceptive ring that releases ethinyl estradiol and etonogestrel for pregnancy prevention.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J7295

Vaginal ring, monthly, each

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for J7295 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What J7295 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What J7295 covers

This code identifies a vaginal ring that releases ethinyl estradiol at 0.015 mg per 24 hours and etonogestrel at 0.12 mg per 24 hours. It is a combined hormonal contraceptive intended for monthly use. A clinician may prescribe or manage the contraceptive, while the patient typically places and removes the ring vaginally. The code represents the ring as a product, not a separately described insertion procedure.

One unit represents one monthly vaginal ring, not a measured amount of hormone or a 24-hour supply. Medicare’s physician fee schedule status is N, meaning the item is not covered. The HCPCS coverage classification also identifies it as not covered by statute, and the HCPCS pricing method says it is not separately priced by Medicare Part B.

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 J7295 pays more and less

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

109 of 109 payment localities

J7295 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

J7295 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
J7295 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the J7295 rate is calculated

Each of J7295’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 · J7295

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 J7295

J7295 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 · J7295

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

J7295 isn’t priced in this setting.

J7295 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J7295

    Vaginal ring, monthly, each0 wRVU

    Not priced

  • J7294

    Yearly vaginal system, contraceptive system0 wRVU

    Not priced

  • J7296

    Kyleena, 19.5 mg system0 wRVU

    Not priced

  • J7299

    Miudella IUD, copper device0 wRVU

    Not priced

How to choose

J7294Yearly vaginal systemContraceptive system
J7294 identifies a vaginal ring with segesterone acetate and ethinyl estradiol. J7295 identifies the ethinyl estradiol and etonogestrel monthly ring.
J7296Kyleena19.5 mg system
J7296 is a levonorgestrel intrauterine contraceptive, not a vaginal ring. Use the code matching the contraceptive product supplied.
J7299Miudella IUDCopper device
J7299 identifies a copper intrauterine contraceptive; J7295 identifies a combined hormonal vaginal ring.

Codes related to J7295

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to J7295
CodeHow it relatesNational office range
Used instead
J7294Yearly vaginal system, contraceptive systemAnother hormonal vaginal contraceptive ring, with a different drug combination and use duration.No office rate
J7296Kyleena, 19.5 mg systemLevonorgestrel intrauterine contraceptive as an alternative contraceptive method.No office rate
J7297Liletta IUD, 52 mg systemLevonorgestrel intrauterine contraceptive as an alternative contraceptive method.No office rate
J7298Mirena IUD, 52 mg systemLevonorgestrel intrauterine contraceptive as an alternative contraceptive method.No office rate
J7299Miudella IUD, copper deviceCopper intrauterine contraceptive as a nonhormonal alternative method.No office rate

J7295 billing questions

What does one unit of J7295 represent?

One unit represents one monthly vaginal ring. The stated hormone quantities are release rates per 24 hours, not the total contents of the ring.

Is J7295 for the ring or its insertion?

J7295 identifies the ring product, one ring per unit. It does not describe a separate insertion procedure.

How is J7295 different from J7294?

J7295 is the ethinyl estradiol and etonogestrel monthly ring. J7294 identifies a different vaginal contraceptive ring containing segesterone acetate and ethinyl estradiol.

Does Medicare cover or separately price J7295?

No. Its physician fee schedule status is N, its HCPCS coverage classification is not covered by statute, and it is not separately priced by Medicare Part B.

Does J7295 include a separate contraceptive counseling or insertion service?

The code identifies one ring as a product; it does not describe counseling or an insertion service. Do not treat those services as units of J7295.

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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