HCPCS code J7295: Vaginal ring, monthly, each2026 Medicare rate & RVUs in New York
Reports one monthly vaginal contraceptive ring that releases ethinyl estradiol and etonogestrel for pregnancy prevention.
CMS doesn’t publish an office rate for J7295 in New York.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | Unavailable |
| NYC suburbs and Long Island, NY | Unavailable | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | Unavailable |
| Queens, NY | Unavailable | Unavailable |
| Rest of New York | Unavailable | Unavailable |
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
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
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J7295 isn’t priced in this setting.
J7295 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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