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See a sample rate comparisonHCPCS J7304 (Xulane) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Contraceptive supply, hormone containing patch, each
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Contraceptive Systems |
| Common Place of Service | 11 - Office None 71 - Public Health Clinic |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7304 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7304 by major payers:
$41.90
$42.81
$42.05
$40.10
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HCPCS J7304
5 of 25 sample ratesHigher to lower in this preview
Geisinger Bloomsburg Hospital
Geisinger Clinic
$76.75Published rateSlh Vista, Inc., Saint Louis University Hospital
St Louis University
$48.86Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$41.93Published rateChristus Health Ark-La-Tex, Christus St. Michael Health System
Christus Health Ark-La-Tex
$41.93Published rateQiuhua Lu
New York City Health And Hospitals Corporation
$32.88Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J7304 vs. Other Contraceptive Systems Codes
The HCPCS J7304 code is part of the Drugs Administered Other than Oral Method services used for Contraceptive Systems. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J7304 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| J7301-HCPCS | Moderate | Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg |
| J7304-HCPCS | Low | Contraceptive supply, hormone containing patch, each |
| J7306-HCPCS | Moderate | Levonorgestrel (contraceptive) implant system, including implants and supplies |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7304. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7304 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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