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HCPCS code J7296: Kyleena, 19.5 mg system2026 Medicare rate & RVUs

Reports the Kyleena levonorgestrel-releasing intrauterine contraceptive system when a clinician furnishes the 19.5 mg device.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J7296

Kyleena, 19.5 mg system

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 J7296 →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 J7296 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 J7296 covers

J7296 identifies the Kyleena hormonal intrauterine contraceptive system, which contains 19.5 mg of levonorgestrel and is placed in the uterus for contraception. A gynecologist, family medicine clinician, or other qualified practitioner may furnish the device in an office or clinic. When the system is inserted during the encounter, the insertion is a separate service commonly represented by CPT 58300.

Medicare assigns this code status N and classifies it as not covered by statute. The HCPCS pricing designation indicates that Medicare Part B does not separately price the device. Report J7296 for one complete system, not as a per-milligram dose; the code identifies the device rather than the insertion service.

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 J7296 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

J7296 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

J7296 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
J7296 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 J7296 rate is calculated

Each of J7296’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 · J7296

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 J7296

J7296 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 · J7296

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

J7296 isn’t priced in this setting.

J7296 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • J7296

    Kyleena, 19.5 mg system0 wRVU

    Not priced

  • J7297

    Liletta IUD, 52 mg system0 wRVU

    Not priced

  • J7298

    Mirena IUD, 52 mg system0 wRVU

    Not priced

  • J7299

    Miudella IUD, copper device0 wRVU

    Not priced

  • J7295

    Vaginal ring, monthly, each0 wRVU

    Not priced

How to choose

J7297Liletta IUD52 mg system
J7297 identifies Liletta, a 52 mg levonorgestrel intrauterine system. Use J7296 for Kyleena, the 19.5 mg system.
J7298Mirena IUD52 mg system
J7298 identifies Mirena, a 52 mg levonorgestrel intrauterine system. J7296 is specific to Kyleena and its 19.5 mg system.
J7299Miudella IUDCopper device
J7299 identifies a copper intrauterine contraceptive system. J7296 identifies a hormonal system that releases levonorgestrel.
J7295Vaginal ringMonthly, each
J7295 identifies a monthly vaginal contraceptive system containing etonogestrel and ethinyl estradiol. J7296 identifies an intrauterine levonorgestrel system.

Codes related to J7296

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

Codes related to J7296
CodeHow it relatesNational office range
Often billed with
58300IUD insertionRepresents insertion when the Kyleena system is placed during the encounter.No office rate
Same family
J7297Liletta IUD, 52 mg systemLiletta levonorgestrel intrauterine system containing 52 mg.No office rate
J7298Mirena IUD, 52 mg systemMirena levonorgestrel intrauterine system containing 52 mg.No office rate
Used instead
J7299Miudella IUD, copper deviceIdentifies a copper intrauterine contraceptive system rather than a levonorgestrel system.No office rate
J7295Vaginal ring, monthly, eachIdentifies a monthly etonogestrel and ethinyl estradiol vaginal system.No office rate

J7296 billing questions

What does J7296 identify?

It identifies one Kyleena levonorgestrel-releasing intrauterine system containing 19.5 mg of levonorgestrel. It is the device supply, not the placement procedure.

Is insertion included in J7296?

No. The code identifies the Kyleena system. When insertion is performed, CPT 58300 commonly represents that separate service.

How many units should be reported?

Report one unit for one complete Kyleena system. The 19.5 mg amount identifies the system; it is not a per-milligram billing unit.

How does Medicare treat J7296?

Medicare assigns status N and classifies the device as not covered by statute. The HCPCS pricing designation also says it is not separately priced by Medicare Part B.

How is J7296 different from J7297 or J7298?

J7296 identifies Kyleena, a 19.5 mg levonorgestrel system. J7297 identifies Liletta and J7298 identifies Mirena, both 52 mg levonorgestrel systems.

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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