CPT Code 58300: IUD Insertion Billing Guide

What Is CPT Code 58300?

CPT code 58300 reports the insertion of an intrauterine device (IUD) into the uterine cavity for long-acting reversible contraception. It pays for the insertion procedure only, not the device. The IUD itself is billed separately on its own HCPCS J-code, usually with the National Drug Code on the claim line, which is exactly where most of the revenue and most of the denials sit.

Does 58300 include the IUD device? No. 58300 covers the insertion alone; the device is billed separately with its own J-code, usually with the NDC on the claim line.

Does CPT 58300 need a modifier? Usually not on 58300 itself. Modifiers attach to the same-day office visit (modifier 25) or a same-session removal (modifier 51), not to the insertion.

What is the difference between 58300 and 58301? 58300 is the insertion and 58301 is the removal. For a same-day replacement, report both, plus the J-code for the new device.

An IUD insertion is one of the most common in-office procedures in a gynecology practice, and CPT 58300 is the code that reports it. The mistake that quietly costs practices money is treating the claim as a single charge. 58300 pays for the insertion, the physician work of placing the device, and nothing else. The IUD itself, which can run several hundred dollars, is a separate charge on a separate code. Most of the revenue, and most of the denials, ride on that second line rather than on 58300. This guide covers what 58300 includes, how the device is billed alongside it, the codes for removal and replacement, the modifiers that belong on the claim, what drives reimbursement in 2026, and the documentation that keeps these claims clean.

The Procedure and the Device Are Two Charges

This is the heart of IUD billing. A complete IUD claim usually carries at least two lines: the insertion and the device.

58300 reports the insertion. This is the physician work, and on most fee schedules it is a modest amount.

The device is billed separately. Each IUD has a specific HCPCS J-code, and most payers also want the National Drug Code (NDC) on the device claim line.

Device	HCPCS code
ParaGard (copper)	J7300
Mirena (52 mg)	J7298
Liletta (52 mg)	J7297
Kyleena (19.5 mg)	J7296
Skyla (13.5 mg)	J7301

Across the billing companies we vet, a mismatched device code is the single most common reason these claims are denied, so confirm the current J-code for the exact device placed before the claim goes out.

How the device is supplied determines who collects for it:

• Buy-and-bill. The practice purchases the IUD, stocks it, and bills the payer for the device J-code, keeping the margin between acquisition cost and reimbursement. This captures device revenue but requires inventory, capital outlay, and benefit verification before placement.
• Patient-pay or specialty pharmacy. The patient obtains the device through a specialty pharmacy, and the practice bills only the insertion (58300) with no device revenue. No inventory risk, but no device margin either.

Either way, many commercial and Medicaid plans require prior authorization for the device, and sometimes for the procedure, so verify coverage before the insertion rather than after.

Companion Codes and Same-Visit Scenarios

IUD work clusters around a few predictable visit types, and each has a coding pattern.

Removal: 58301. When the patient wants the device out and is not replacing it, report 58301 for the removal alone.

Removal and reinsertion the same day: 58301 plus 58300. For a replacement, report the removal (58301) and the new insertion (58300), typically with modifier 51 on the second procedure (some payers prefer 59), plus the J-code for the new device.

A same-day counseling visit: E/M with modifier 25. Because 58300 has no global period, a significant, separately identifiable E/M visit on the same day, such as the counseling where the patient decides on the IUD, can be billed in addition to the insertion. Modifier 25 goes on the E/M code, not on 58300.

A failed insertion: an E/M, not 58300. If the device cannot be placed, for example because of cervical stenosis, do not report 58300. Report the appropriate E/M for the exam and counseling instead. A discontinued-procedure modifier (53) may apply in limited cases depending on payer policy.

It also helps to know what is not 58300:

• Removing an IUD is 58301, not 58300.
• A contraceptive implant such as Nexplanon uses the implant codes and its own J-code, not 58300.
• Ultrasound performed purely to guide a difficult placement is generally not separately billable; a distinct, medically necessary diagnostic transvaginal ultrasound (CPT 76830) is reported on its own code only when it is its own documented study, subject to payer bundling rules.

Does CPT 58300 Need a Modifier?

In a straightforward insertion, no modifier is needed on 58300 itself. Modifiers enter in specific scenarios, and the most important ones attach to the visit rather than the procedure. A same-day office visit takes modifier 25 on the E/M code, a same-session removal takes modifier 51, and a Medicare contraceptive claim uses modifier GY.

Modifier 25 on a same-day E/M: when a significant, separately identifiable visit is performed on the same day as the insertion. The modifier attaches to the E/M code, not to 58300.

Modifier 51 (multiple procedures): when a removal (58301) and an insertion (58300) are performed in the same session. Some payers prefer modifier 59 here, so confirm the payer rule.

Modifier 59 or an X{EPSU} modifier: to identify a distinct procedural service when an edit would otherwise bundle two codes, and only when documentation supports it.

Modifier 53 (discontinued procedure): in the limited case where an insertion is started and then abandoned, subject to payer policy. When the device is simply never placed, the cleaner choice is to bill the E/M rather than 58300.

Modifier GY (statutorily excluded): for a Medicare beneficiary, where contraceptive IUD insertion is not a covered benefit.

Is IUD Insertion Covered by Insurance?

For most commercial plans, yes. Under the Affordable Care Act, non-grandfathered plans must cover at least one form of every FDA-approved contraceptive method, including IUDs, with no patient cost-sharing. In practice that means the insertion and the device are typically paid at 100 percent in network, though grandfathered plans and certain exemptions can change the picture.

The practical catch is that “covered with no cost-sharing” still depends on correct coding and, often, prior authorization. A claim that omits the device J-code, uses the wrong J-code, or skips a required prior auth can still deny even when the benefit is generous. One question we hear constantly from practice managers is why a fully covered IUD still bounced back unpaid, and the answer is almost always on the device line or the authorization, not the benefit itself. Medicare is the major exception, and postpartum placement follows separate rules, both covered below.

CPT 58300 Reimbursement in 2026

The insertion and the device are paid on two different tracks, and the device is usually the larger figure.

The insertion (58300) is a modest, 0-day global procedure carrying roughly 3.31 RVUs. Commercial and Medicaid payers price it off a physician fee schedule; industry estimates put the commercial allowable for the insertion itself around $75 to $125, though the actual figure depends entirely on payer, contract, geography, and place of service.

The device is the main dollar. Buy-and-bill practices are reimbursed for the J-code, often near the device average wholesale price. Hormonal IUDs commonly reimburse in the several-hundred-dollar range and copper devices somewhat higher, but ranges vary widely by product and payer. Whether that gets paid depends on two unglamorous details: a correct device J-code with the NDC on the claim line, and prior authorization secured before placement.

Two payer-specific realities round this out:

Medicare generally does not cover contraceptive IUD insertion. On the Medicare Physician Fee Schedule, 58300 carries an “N” (non-covered) status because contraceptive devices are a statutory exclusion, so a contraceptive insertion billed to Medicare auto-denies, and modifier GY signals that. Per CMS Medicare Administrative Contractor guidance (for example, Noridian), the narrow exception is a progestin IUD placed to treat a condition such as endometrial hyperplasia rather than for contraception. In that case the contraceptive code will deny, and the service is reported with the unlisted procedure code 58999 and a diagnosis supporting the therapeutic use.

Used this way, a progestin IUD can be a uterus-preserving alternative to more invasive options such as a laparoscopic hysterectomy (CPT 58571) for a patient who is not a surgical candidate or wishes to preserve fertility.

Postpartum insertion is highly payer and state specific. An IUD placed immediately after delivery may be bundled into the global obstetric package (CPT 59400) by some payers and separately payable by others. Many state Medicaid programs have expanded coverage of immediate postpartum LARC, so keep a payer-by-payer policy on file.

Because the device amount, the procedure amount, and the coverage rules all vary by payer and change over time, do not hard-code a figure. Verify the current allowable for both the procedure and the device against each payer contracted rate and contraceptive policy before you bill. In our experience matching providers with billing partners, the practices that keep a living payer-policy grid for LARC collect materially more than those that treat every IUD claim the same.

58300 vs 58301: Insertion vs Removal

58300 reports IUD insertion and 58301 reports IUD removal. They are separate procedures for opposite actions. For a same-day replacement you report both, typically with modifier 51 on the second procedure, plus the J-code for the new device. Watch the same-day payer rules closely, because many payers will not pay both lines.

Factor	58300	58301
Action	Insertion of IUD	Removal of IUD
Approx. RVUs	3.31	3.33
Device J-code	Yes, new device billed	No device billed
Same-day pairing	With 58301 for replacement	With 58300 for replacement
Global period	0 days	0 days

Here is the trap. There is no NCCI edit that bundles 58300 and 58301, yet many payers still refuse to pay both on the same day, and some will pay only the lower-valued line. Because 58300 is about 3.31 RVUs and 58301 about 3.33 RVUs, the removal is marginally the higher-valued code, so a payer that pays only one on a same-day replacement may pay the removal. The most common issue we see providers run into is treating that same-day rule as universal when it is entirely payer-specific. Strong operators keep a payer-level list of who pays both, who pays one, and which one, and they bill accordingly instead of reflexively appending a modifier and hoping.

Common 58300 Denials and How to Prevent Them

Every IUD claim fails in a handful of predictable ways. Here are the denials we see most often and how to prevent each one:

• Device line missing or mismatched. 58300 is billed with no device line, or the wrong J-code is used. Prevent it by reporting the correct device-specific J-code on the same claim and confirming it matches the exact device placed.
• NDC missing from the device line. The J-code is reported without the National Drug Code. Prevent it by adding the NDC whenever the payer requires it.
• Prior authorization not obtained. The insertion is performed before the device or procedure is authorized. Prevent it by verifying benefits and securing prior auth before placement.
• E/M billed without modifier 25. A same-day visit is bundled into the insertion. Prevent it by appending modifier 25 to the E/M when a significant, separately identifiable visit is documented.
• 58300 billed for a failed insertion. The code is reported when the device was never placed. Prevent it by billing the appropriate E/M instead, since 58300 requires a completed insertion.
• Diagnosis mismatch. The diagnosis does not support the service. Prevent it by linking the correct code, typically Z30.430 for insertion of an intrauterine contraceptive device, or the therapeutic diagnosis when the IUD treats a medical condition.
• Same-day 58300 and 58301 both denied. A replacement is billed with both lines to a payer that pays only one. Prevent it by checking the payer same-day policy and billing to that rule.
• Medicare contraceptive denial. A contraceptive insertion is billed to Medicare and auto-denies. Prevent it by recognizing the statutory non-coverage, using modifier GY, and reserving 58999 for the documented therapeutic exception.

Frequently Asked Questions