CPT code 42971: Bleeding control, complicated pharyngeal hemorrhage2026 Medicare rate & RVUs in Oregon
Reports operative control of complicated bleeding from the pharynx or nasopharynx, such as significant postoperative hemorrhage requiring more than simple treatment.
CMS doesn’t publish an office rate for 42971 in Oregon.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
Where 42971 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | $412.35 |
| Rest of Oregon | Unavailable | $389.97 |
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.
How the rate is built · 42971
RVUs × geographic indexes × conversion factor
Work6.44
6.44 RVUs× 1.000 GPCI
Practice expense4.60
4.60 RVUs× 1.000 GPCI
Malpractice0.93
0.93 RVUs× 1.000 GPCI
Adjusted RVUs
11.9700
Conversion factor
$33.4009
Medicare rate
$399.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 42971
42971 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42971
Bleeding control, complicated pharyngeal hemorrhage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 42971
Bleeding control, complicated pharyngeal hemorrhage
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42971 without 51 · national facility
$399.81
Bleeding control, complicated pharyngeal hemorrhage
42971-51 · Second procedure: 50%
$199.91
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
42971 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 42970Bleeding controlNasopharyngeal, with packing
- 42970 is for simple control of pharyngeal or nasopharyngeal bleeding; 42971 is for the complicated level, supported by the documented circumstances and operative work.
- 42972Nasal bleeding controlPosterior, endoscopic
- 42972 is the more extensive level in this hemorrhage-control series. Select it only when the record supports that greater extent, rather than complicated control alone.
- 42961Hemorrhage controlComplicated, hospitalization required
- 42961 belongs to the oropharyngeal hemorrhage series. Use it when the coded site is oropharyngeal, rather than pharyngeal or nasopharyngeal.
42971 billing questions
How does 42971 differ from 42970?
42970 is the simple-control level. Use 42971 when the documented hemorrhage control is complicated; the operative details and circumstances should support that distinction.
When is 42972 more appropriate?
42972 represents the more extensive level of control. The record should support that greater extent of operative work rather than merely describing a difficult or significant bleed.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used to represent bilateral services.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant-at-surgery be paid?
CMS permits assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple procedure reduction.
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
Show the CMS file lines behind this rate
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