J7298 — Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg
J7298 is a HCPCS Level II code for levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg. It belongs to the Drugs Administered Other Than Oral Method section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Non-covered by statute
Excluded from coverage by the Social Security Act itself, not by a policy decision. No documentation and no appeal changes this one — an ABN is the relevant conversation.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusN
Non-covered service. Medicare does not cover it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J7298 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J7298
- Long descriptor
- Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg
- Short descriptor
- Mirena, 52 mg
- Added
- January 1, 2016
- BETOS
- P6C
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to J7298
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J7298 is not quite right, the correct code is very often within a few positions of it.
- J7211Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.
- J7212Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram
- J7213Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.
- J7214Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
- J7294Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each
- J7295Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each
- J7296Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg
- J7297Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg
- J7299Intrauterine copper contraceptive (miudella)
- J7300Intrauterine copper contraceptive (paragard)
- J7301Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg
- J7302Levonorgestrel-releasing intrauterine contraceptive system, 52 mgterminated
- J7303Contraceptive supply, hormone containing vaginal ring, eachterminated
- J7304Contraceptive supply, hormone containing patch, each
- J7306Levonorgestrel (contraceptive) implant system, including implants and supplies
- J7307Etonogestrel (contraceptive) implant system, including implant and supplies
Questions about J7298
What is HCPCS code J7298?
J7298 is a HCPCS Level II code for levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J7298?
The CMS HCPCS file marks J7298 as "Non-covered by statute". Excluded from coverage by the Social Security Act itself, not by a policy decision. No documentation and no appeal changes this one — an ABN is the relevant conversation.
How is J7298 paid under the physician fee schedule?
J7298 carries PFS status code N. Non-covered service. Medicare does not cover it.