CPT code 42971: Bleeding control, complicated pharyngeal hemorrhage2026 Medicare rate & RVUs in Ohio

In Ohio, Medicare pays $386.69 for 42971 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 42971 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 42971 covers

This code describes operative control of complicated bleeding arising in the pharynx or nasopharynx. An otolaryngologist may perform the service for significant postoperative bleeding, including a difficult tonsillectomy-site hemorrhage, when the work is more involved than simple control. The operative note should identify the bleeding site, its context, the hemostatic work performed, and the circumstances supporting the complicated level.

Choose this level based on the complexity of hemorrhage control, not merely the fact that bleeding occurred. Distinguish it from simple control and from the more extensive level by documenting the actual operative work and clinical circumstances. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral adjustment is not appropriate. Assistant-at-surgery payment may be made; 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 Ohio compares for 42971

Across 109 of 109 payment localities, the facility rate for 42971 runs from $363.08 in Arkansas to $503.40 in Alaska. Ohio pays $386.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42971 rates by state

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

See 42971 in every payment locality

How the 42971 rate is calculated

Each of 42971’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 42971

42971 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 42971

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

How 42971 has changed in Ohio

Price 42971 for an earlier date of service

Where the Ohio rate applies

Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Ada
• Adamsville
• Addyston
• Adelphi
• Adena
• Ai
• Akron

Browse all communities in Ohio

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