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

In Washington, DC area, Medicare pays $507.23 for 42962 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 42962 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 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.

How Washington, DC area compares for 42962

Across 109 of 109 payment localities, the facility rate for 42962 runs from $415.18 in Arkansas to $574.40 in Alaska. Washington, DC area pays $507.23. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42962 rates by state

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

See 42962 in every payment locality

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

Codes related to 42962

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

How 42962 has changed in Washington, DC area

Price 42962 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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