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The Ring pessary is primarily used for a  mild first-degree uterine prolapse or a cystocele.  The Ring pessary with knob may also relieve stress urinary incontinence.  Both pessaries are available with or without a supporting membrane.

HCPCS Reimbursement Code for Pessary - A4562
Code for Office Visit - 99214
CPT Code for Fitting & Insertion - 57160
 

  SKU # Description Price  
 
Pessary - Ring 1610175 Ring Pessary Without Support, 1.75" #0 $45
 
 
Pessary - Ring 1610200 Ring Pessary Without Support, 2" #1 $45
 
 
Pessary - Ring 1610225 Ring Pessary Without Support, 2.25" #2 $45
 
 
Pessary - Ring 1610250 Ring Pessary Without Support, 2.5" #3 $45
 
 
Pessary - Ring 1610275 Ring Pessary Without Support, 2.75" #4 $45
 
 
Pessary - Ring 1610300 Ring Pessary Without Support, 3" #5 $45
 
 
Pessary - Ring 1610325 Ring Pessary Without Support, 3.25" #6 $45
 
 
Pessary - Ring 1610350 Ring Pessary Without Support, 3.5" #7 $45
 
 
Pessary - Ring 1610375 Ring Pessary Without Support, 3.75" #8 $45
 
 
Pessary - Ring 1610400 Ring Pessary Without Support, 4" #9 $45
 
 
Pessary - Ring 1611175 Ring Pessary With Support, 1.75" #0 $45
 
 
Pessary - Ring 1611200 Ring Pessary With Support, 2" #1 $45
 
 
Pessary - Ring 1611225 Ring Pessary With Support, 2.25" #2 $45
 
 
Pessary - Ring 1611250 Ring Pessary With Support, 2.5" #3 $45
 
 
Pessary - Ring 1611275 Ring Pessary With Support, 2.75" #4 $45
 
 
Pessary - Ring 1611300 Ring Pessary With Support, 3" #5 $45
 
 
Pessary - Ring 1611325 Ring Pessary With Support, 3.25" #6 $45
 
 
Pessary - Ring 1611350 Ring Pessary With Support, 3.5" #7 $45
 
 
Pessary - Ring 1611375 Ring Pessary With Support, 3.75" #8 $45
 
 
Pessary - Ring 1611400 Ring Pessary With Support, 4" #9 $45
 
 
Pessary - Ring with Knob 1619175 Ring Pessary With Knob Without Support, 1.75" #0 $45
 
 
Pessary - Ring with Knob 1619200 Ring Pessary With Knob Without Support, 2" #1 $45
 
 
Pessary - Ring with Knob 1619225 Ring Pessary With Knob Without Support, 2.25" #2 $45
 
 
Pessary - Ring with Knob 1619250 Ring Pessary With Knob Without Support, 2.5" #3 $45
 
 
Pessary - Ring with Knob 1619275 Ring Pessary With Knob Without Support, 2.75" #4 $45
 
 
Pessary - Ring with Knob 1619300 Ring Pessary With Knob Without Support, 3" #5 $45
 
 
Pessary - Ring with Knob 1619325 Ring Pessary With Knob Without Support, 3.25" #6 $45
 
 
Pessary - Ring with Knob 1619350 Ring Pessary With Knob Without Support, 3.5" #7 $45
 
 
Pessary - Ring with Knob 1620175 Ring Pessary With Knob With Support, 1.75" #0 $45
 
 
Pessary - Ring with Knob 1620200 Ring Pessary With Knob With Support, 2" #1 $45
 
 
Pessary - Ring with Knob 1620225 Ring Pessary With Knob With Support, 2.25" #2 $45
 
 
Pessary - Ring with Knob 1620250 Ring Pessary With Knob With Support, 2.5" #3 $45
 
 
Pessary - Ring with Knob 1620275 Ring Pessary With Knob With Support, 2.75" #4 $45
 
 
Pessary - Ring with Knob 1620300 Ring Pessary With Knob With Support, 3" #5 $45
 
 
Pessary - Ring with Knob 1620325 Ring Pessary With Knob With Support, 3.25" #6 $45
 
 
Pessary - Ring with Knob 1620350 Ring Pessary With Knob With Support, 3.5" #7 $45
 
 
 
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