Home Drug Codes J Codes J7296 · KYLEENA
Updated July 1st, 2026

KYLEENA J Code: J7296

Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg

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Medicare Payment Limit ?
Not published
CMS publishes none for Q3 2026
APC Payment Limit ?
Not published
CMS publishes none for Q3 2026
ASP ?
No current ASP
Not available for Q3 2026
WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg
HCPCS Added Date January 1, 2018
Manufacturer Bayer Pharmaceutical
Route of Administration Intrauterine
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Intrauterine Device

About KYLEENA

Kyleena is a medication aligned to the HCPCS J Code: J7296 for billing, pricing, and reimbursement purposes in the United States. This Women's Health medication is administered via the intrauterine route and manufactured by Bayer Pharmaceutical.

Manufacturers, reach out to us to add more information.

NDC Code Information

1 NDC package is crosswalked to J7296. Package detail is available to logged-in subscribers.

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KYLEENA Pricing & Reimbursement

J7296 Private Payer Reimbursement
$1,226.62 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

KYLEENA CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
58300 Insertion, intrauterine device
Not on the CMS JW / JZ list

CMS does not include Kyleena (J7296) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7296. Wastage billing guide →

KYLEENA Medically Unlikely Edits (MUE)

The most billing units of J7296 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 19.5 mg.

Practitioner Office & Hospital Outpatient
0 units / day
Not payable in this setting

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

KYLEENA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Prevention of pregnancy
Drug Class
Inhibit Ovum Fertilization [PE]Progesterone Congeners [CS]Progestin [EPC]Progestin-containing Intrauterine System [EPC]

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Frequently Asked Questions

Is there an available Kyleena billing and coding guide?
Billing and coding information for KYLEENA can be found through Bayer. Visit Here →
Are there any available Kyleena patient assistance programs?
KYLEENA patient assistance information can be found through Bayer. Visit Here →
Where can I find Kyleena prescribing information?
KYLEENA prescribing information can be found at the link below: Visit Here →
Where can I find Kyleena side effect information?
Information regarding KYLEENA's side effects can be found at MedlinePlus Visit Here →
Does billing KYLEENA require JZ/JW wastage modifiers?
CMS does not include KYLEENA (J7296) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7296. For more information, visit the link below.

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