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

CMS doesn’t publish an office rate for J7295 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

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 in California

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

29 of 29 payment localities

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.

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.

J7295 compared with similar codes

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.

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