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CPT 57170: Diaphragm or Cervical Cap Fitting and Instruction

CPT code 57170 represents the clinical service of fitting a diaphragm or cervical cap and instructing the patient on self-insertion. This procedure supports contraceptive care when the diaphragm is used and reproductive-assist or menstrual management when the cervical cap is used. Nationally, device fitting and patient education are important elements of outpatient reproductive health services because they affect patient autonomy, care quality, and potential downstream utilization.

Key payers relevant to coverage and reimbursement include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for device fitting, typical sites of service (ambulatory gynecology and family planning clinics), and the service type framed as device fitting and patient education. The publication covers benchmarks and contractual considerations where available, summarizes policy updates that affect coverage of contraceptive devices and reproductive-assist services, and explains coding implications for billing and claims processing.

This analysis equips clinical billing staff, practice managers, and policy analysts with concise context on CPT code 57170, its clinical uses, and the payer landscape to inform coding, claims submission, and administrative planning at a national level.

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Billing Code Overview

CPT code 57170 describes fitting a patient with a diaphragm or cervical cap and providing instruction on self-insertion. The diaphragm is fitted and taught to the patient as a contraceptive barrier device used to prevent sperm from entering the uterus during intercourse. The cervical cap is fitted and taught for collection of menstrual flow or to assist with artificial insemination; it is explicitly noted that the cervical cap is not a contraceptive.

Service type: Device fitting and patient education / contraceptive and reproductive health device service

Typical site of service: Outpatient gynecology clinic, family planning clinic, primary care clinic, or other ambulatory care setting

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related procedure codes.

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CPT 57170: Diaphragm or Cervical Cap Fitting and Instruction

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Get alerted when payer policies referencing 57170 are released or updated.

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Billing Code Overview

Service type: Device fitting and patient education / contraceptive and reproductive health device service

Typical site of service: Outpatient gynecology clinic, family planning clinic, primary care clinic, or other ambulatory care setting

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related procedure codes.

Clinical & Coding Specifications

Clinical Context

A 28-year-old woman presents to an outpatient gynecology clinic requesting fitting for a barrier method of contraception. The visit includes an initial counseling session regarding diaphragm options, pelvic exam for sizing, fitting of a diaphragm, instruction and supervised practice of self-insertion and removal, and discussion of spermicide use and follow-up. Typical workflow: check-in and intake including medical and allergy history; focused sexual and contraceptive history; pelvic exam to assess cervical anatomy and determine diaphragm size; provider fits a diaphragm or cervical cap; patient practices insertion and removal under supervision; documentation of size, device type, patient tolerance, and education provided; scheduling of follow-up or replacement as indicated. Typical site of service is an outpatient ambulatory clinic or physician office; procedure may also occur in family planning clinics or community health centers. The cervical cap variant may be fitted when the intent is for menstrual collection or assistance with insemination rather than contraception; the diaphragm is fitted specifically for contraception.

Coding Specifications

Modifier	Description	When to Use
`11`	Normally assigned professional component? (Note: CMS typically uses `26` for professional component)	Rarely used for global services; not commonly applied to diaphragm/cap fitting but may appear if institutional billing requires distinguishing professional work.
`22`	Increased procedural services	Use when the service required substantially greater work than typical (extensive counseling or complex anatomy requiring additional time).
`23`	Unusual procedural services	Use when procedure is performed under local anesthesia because of patient discomfort (rare application).
`26`	Professional component	Use if billing only the physician professional component separate from an institutional facility charge.
`50`	Bilateral procedure	Not typically applicable but used when bilateral anatomic considerations are documented (rarely used for this service).
`52`	Reduced services	Use when the provider documents that the service was partially reduced or not completed.
`53`	Discontinued procedure	Use if fitting attempt was started but discontinued due to patient intolerance or acute issue.
`59`	Distinct procedural service	Use when fitting is billed on the same day as another unrelated procedure to indicate separate services.
`73`	Discontinued outpatient hospital/ambulatory surgery prior to anesthesia	Use if the outpatient procedure was discontinued before anesthesia administration (uncommon for this service).
`78`	Unplanned return to the operating/procedure room	Use if patient requires an unplanned repeat fitting/procedure during same encounter time frame (rare).

Taxonomy Code	Specialty	Notes
207Q00000X	Obstetrics & Gynecology	Most common specialty performing diaphragm/cervical cap fittings and counseling.
363L00000X	Family Medicine	Family physicians in ambulatory settings frequently provide contraceptive device fitting.
1835P0800X	Nurse Practitioner - Women’s Health	NPs specializing in women's health commonly perform fittings and patient education.
171M00000X	Physician Assistant	PAs in primary care or gynecology clinics often perform fittings under supervising physician.
367A00000X	Obstetrics & Gynecology Nursing	Advanced practice nurses or clinical staff who assist with education and fitting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z30.09`	Encounter for other general counseling and advice on contraception	Indicates visit for contraceptive counseling when diaphragm is chosen.
`Z30.430`	Encounter for insertion of diaphragm	Administrative code used to document diaphragm-related encounters.
`N93.9`	Abnormal uterine and vaginal bleeding, unspecified	Cervical cap may be used for menstrual collection in select cases; fitting relevant if anatomy affects device use.
`Z30.02`	Encounter for initial prescription of oral contraceptives	Related contraceptive counseling context when patient considers alternatives.
`Z30.9`	Encounter for contraceptive management, unspecified	General code for contraceptive management visits including device fitting.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57170`	Fitting of diaphragm or cervical cap, including education for self-insertion	Primary code describing the fitting and patient instruction; billed when device sizing and supervised insertion training are performed.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexity	Common E/M code used on the same day for counseling, history, and exam related to contraceptive counseling and fitting when separate E/M is billed.
`58300`	Insertion of intrauterine device (IUD)	Alternative contraceptive procedural code that may be performed during the same visit when patient elects a different method; documents relationship to contraceptive counseling and choice.
`99401`	Preventive counseling and risk factor reduction intervention, individual; approximately 15 minutes	Used for focused contraceptive counseling or education sessions related to device use when billed separately.
`99070`	Supplies and materials (eg, devices) provided by the physician over and above those usually included with the office visit	Used to report supply costs when the device (diaphragm or cervical cap) is furnished by the provider and payor allows supply charge.

CPT 57150: Vaginal Canal Washout with Medication Instillation

CPT-57155-GYNECOLOGIC-BRACHYTHERAPY-UTERINE-CERVICAL-IMPLANT

CPT 57155: Gynecologic Brachytherapy, Uterine and Cervical Implant

CPT-57156-VAGINAL-BRACHYTHERAPY-APPLICATOR-PLACEMENT

CPT 57156: Vaginal Applicator Placement for Brachytherapy

CPT-57160-PESSARY-FITTING-AND-INSERTION-VAGINAL-PROLAPSE

CPT 57160: Pessary Fitting and Insertion for Vaginal Wall Prolapse

CPT-57180-VAGINAL-HEMOSTASIS-INSERTION-OF-HEMOSTATIC-AGENT-OR-PACK

CPT 57180: Vaginal Hemostasis by Insertion of Hemostatic Agent or Pack

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Normally assigned professional component? (Note: CMS typically uses `26` for professional component)	Rarely used for global services; not commonly applied to diaphragm/cap fitting but may appear if institutional billing requires distinguishing professional work.
`22`	Increased procedural services	Use when the service required substantially greater work than typical (extensive counseling or complex anatomy requiring additional time).
`23`	Unusual procedural services	Use when procedure is performed under local anesthesia because of patient discomfort (rare application).
`26`	Professional component	Use if billing only the physician professional component separate from an institutional facility charge.
`50`	Bilateral procedure	Not typically applicable but used when bilateral anatomic considerations are documented (rarely used for this service).
`52`	Reduced services	Use when the provider documents that the service was partially reduced or not completed.
`53`	Discontinued procedure	Use if fitting attempt was started but discontinued due to patient intolerance or acute issue.
`59`	Distinct procedural service	Use when fitting is billed on the same day as another unrelated procedure to indicate separate services.
`73`	Discontinued outpatient hospital/ambulatory surgery prior to anesthesia	Use if the outpatient procedure was discontinued before anesthesia administration (uncommon for this service).
`78`	Unplanned return to the operating/procedure room	Use if patient requires an unplanned repeat fitting/procedure during same encounter time frame (rare).

Taxonomy Code	Specialty	Notes
207Q00000X	Obstetrics & Gynecology	Most common specialty performing diaphragm/cervical cap fittings and counseling.
363L00000X	Family Medicine	Family physicians in ambulatory settings frequently provide contraceptive device fitting.
1835P0800X	Nurse Practitioner - Women’s Health	NPs specializing in women's health commonly perform fittings and patient education.
171M00000X	Physician Assistant	PAs in primary care or gynecology clinics often perform fittings under supervising physician.
367A00000X	Obstetrics & Gynecology Nursing	Advanced practice nurses or clinical staff who assist with education and fitting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z30.09`	Encounter for other general counseling and advice on contraception	Indicates visit for contraceptive counseling when diaphragm is chosen.
`Z30.430`	Encounter for insertion of diaphragm	Administrative code used to document diaphragm-related encounters.
`N93.9`	Abnormal uterine and vaginal bleeding, unspecified	Cervical cap may be used for menstrual collection in select cases; fitting relevant if anatomy affects device use.
`Z30.02`	Encounter for initial prescription of oral contraceptives	Related contraceptive counseling context when patient considers alternatives.
`Z30.9`	Encounter for contraceptive management, unspecified	General code for contraceptive management visits including device fitting.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57170`	Fitting of diaphragm or cervical cap, including education for self-insertion	Primary code describing the fitting and patient instruction; billed when device sizing and supervised insertion training are performed.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexity	Common E/M code used on the same day for counseling, history, and exam related to contraceptive counseling and fitting when separate E/M is billed.
`58300`	Insertion of intrauterine device (IUD)	Alternative contraceptive procedural code that may be performed during the same visit when patient elects a different method; documents relationship to contraceptive counseling and choice.
`99401`	Preventive counseling and risk factor reduction intervention, individual; approximately 15 minutes	Used for focused contraceptive counseling or education sessions related to device use when billed separately.
`99070`	Supplies and materials (eg, devices) provided by the physician over and above those usually included with the office visit	Used to report supply costs when the device (diaphragm or cervical cap) is furnished by the provider and payor allows supply charge.

CPT 57150: Vaginal Canal Washout with Medication Instillation

CPT-57155-GYNECOLOGIC-BRACHYTHERAPY-UTERINE-CERVICAL-IMPLANT

CPT 57155: Gynecologic Brachytherapy, Uterine and Cervical Implant

CPT-57156-VAGINAL-BRACHYTHERAPY-APPLICATOR-PLACEMENT

CPT 57156: Vaginal Applicator Placement for Brachytherapy

CPT-57160-PESSARY-FITTING-AND-INSERTION-VAGINAL-PROLAPSE

CPT 57160: Pessary Fitting and Insertion for Vaginal Wall Prolapse

CPT-57180-VAGINAL-HEMOSTASIS-INSERTION-OF-HEMOSTATIC-AGENT-OR-PACK

CPT 57180: Vaginal Hemostasis by Insertion of Hemostatic Agent or Pack

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 57170: Diaphragm or Cervical Cap Fitting and Instruction

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Billing Code Overview

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CPT 57170: Diaphragm or Cervical Cap Fitting and Instruction

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 57170: Diaphragm or Cervical Cap Fitting and Instruction

Sign up for cpt 57170 policy alerts

Billing Code Overview

CPT 57170: Diaphragm or Cervical Cap Fitting and Instruction

Sign up for cpt 57170 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical activities are included under CPT 57170?

Who performs and where is the diaphragm or cervical cap fitting typically provided?

What other CPT codes might appear on the same claim or in related encounters?

Which billing modifiers might be applicable to CPT 57170?

Which diagnosis codes are commonly associated with CPT 57170 claims?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical activities are included under CPT 57170?

Who performs and where is the diaphragm or cervical cap fitting typically provided?

What other CPT codes might appear on the same claim or in related encounters?

Which billing modifiers might be applicable to CPT 57170?

Which diagnosis codes are commonly associated with CPT 57170 claims?

References