CPT code 42960: Throat bleeding control, simple control2026 Medicare rate & RVUs in New Mexico

In New Mexico, Medicare pays $143.48 for 42960 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 42960 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 42960 covers

CPT 42960 covers straightforward control of bleeding from the oropharynx, including bleeding that occurs during or after a throat procedure. A familiar situation is a post-tonsillectomy bleed treated with local hemostasis. An otolaryngologist or other physician managing the bleeding may perform the service in an office, emergency department, or surgical setting. The code describes control of the throat bleeding, not repair of a throat wound.

Select this level when the control is simple; cases requiring hospitalization for complicated bleeding or a secondary surgical procedure fall into different codes. Document the bleeding site, its cause when known, the hemostatic work performed, and the circumstances supporting the level selected. The 10-day global period includes related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How New Mexico compares for 42960

Across 109 of 109 payment localities, the facility rate for 42960 runs from $131.77 in Arkansas to $182.45 in Alaska. New Mexico pays $143.48. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42960 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 42960 in every payment locality

How the 42960 rate is calculated

Each of 42960’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 42960

42960 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 42960

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 42960 has changed in New Mexico

Price 42960 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

• Abeytas
• Abiquiu
• Acomita Lake
• Adelino
• Agua Fria
• Alamillo
• Alamo
• Alamogordo

Browse all communities in New Mexico

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates