HCPCS code J7296: Kyleena, 19.5 mg system2026 Medicare rate & RVUs in Missouri
Reports the Kyleena levonorgestrel-releasing intrauterine contraceptive system when a clinician furnishes the 19.5 mg device.
CMS doesn’t publish an office rate for J7296 in Missouri.
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 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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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
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
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J7296 isn’t priced in this setting.
J7296 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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