CPT code 42962: Throat bleeding control, secondary surgical intervention2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 42962 in California.

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

What 42962 covers

This service controls bleeding in the oropharynx through a secondary surgical intervention. A typical situation is a patient returning for operative treatment of bleeding after tonsillectomy. An otolaryngologist or another surgeon qualified to treat the bleeding source may perform the service in a hospital or other surgical setting. The operative work addresses active or recurrent hemorrhage, rather than simply repairing a throat wound or treating bleeding from a different anatomic site.

Select this level when the record supports secondary surgical intervention; distinguish it from simple control and the neighboring complicated level based on the documented service. The operative report should identify the bleeding site, its primary or recurrent nature, and the intervention used to achieve hemostasis. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; 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.

Where 42962 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 42962 rate is calculated

Each of 42962’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 42962

42962 has a 90-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

42962 compared with similar codes

How to choose

42960Throat bleeding controlSimple control

42960 describes simple control of primary or recurrent oropharyngeal bleeding. This code represents control involving secondary surgical intervention.

42961Hemorrhage controlComplicated, hospitalization required

42961 is the complicated level requiring hospitalization. This code is distinguished by secondary surgical intervention, as documented in the operative report.

42970Bleeding controlNasopharyngeal, with packing

Use the 42970 family when the bleeding site and procedure fit its pharynx or nasopharynx hemorrhage-control levels; this code is for oropharyngeal bleeding requiring secondary surgical intervention.

42900Pharyngeal repairWound closure

42900 repairs a throat wound. Report this code when the service is surgical control of primary or recurrent oropharyngeal hemorrhage, not wound repair.

Codes related to 42962

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

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