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CPT code 42972: Nasal bleeding control, posterior, endoscopic2026 Medicare rate & RVUs

Report this service when a physician uses endoscopy to control a posterior nasal hemorrhage, such as severe epistaxis requiring operative hemostasis.

CMS RVU26DEffective Oct 1, 2026109 payment localities12 Medicare services in 2024

Medicare pays $444.57 for 42972 nationally in a facility.

Medicare rate · 42972

Nasal bleeding control, posterior, endoscopic

Office or facility?

Work RVUs
7.4
Total RVUs
13.31
Global days
090

National rate · 2026

$444.57

Facility setting, before claim adjustments.

See every locality for 42972 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 42972 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 42972 covers

This service is endoscopic control of bleeding originating in the posterior nose. An otolaryngologist typically performs it in a hospital or operating room when a posterior nasal hemorrhage needs direct endoscopic visualization and treatment, such as cautery or another hemostatic maneuver. The record should identify the posterior nasal source and describe the endoscopic approach and work used to stop the bleeding.

Choose this code for endoscopic posterior nasal hemorrhage control, rather than the related codes for posterior packing or cautery without endoscopy, or for a subsequent packing-related visit. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 42972 pays more and less

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

109 of 109 payment localities

42972 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$408.74
AlaskaUnavailable$562.44
ArizonaUnavailable$434.37
ArkansasUnavailable$404.32
Atlanta, GAUnavailable$455.14
Austin, TXUnavailable$450.30
Bakersfield, CAUnavailable$450.64
Baltimore area, MDUnavailable$468.85
Beaumont, TXUnavailable$427.49
Brazoria, TXUnavailable$437.16

42972 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
42972 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 42972 rate is calculated

Each of 42972’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 · 42972

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.40

7.40 RVUs× 1.000 GPCI

Practice expense4.83

4.83 RVUs× 1.000 GPCI

Malpractice1.08

1.08 RVUs× 1.000 GPCI

Adjusted RVUs

13.3100

Conversion factor

$33.4009

Medicare rate

$444.57

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 42972

42972 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 42972

Nasal bleeding control, posterior, endoscopic

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 42972

Nasal bleeding control, posterior, endoscopic

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

42972 without 51 · national facility

$444.57

Nasal bleeding control, posterior, endoscopic

42972-51 · Second procedure: 50%

$222.29

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%).

When to use modifier 51

42972 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 42972

    Nasal bleeding control, posterior, endoscopic7.4 wRVU

    Not priced

  • 42970

    Bleeding control, nasopharyngeal, with packing5.67 wRVU

    Not priced

  • 42971

    Bleeding control, complicated pharyngeal hemorrhage6.44 wRVU

    Not priced

  • 42961

    Hemorrhage control, complicated, hospitalization required5.63 wRVU

    Not priced

How to choose

42970Bleeding controlNasopharyngeal, with packing
Use 42970 for initial posterior nasal bleeding control with posterior packing and/or cautery. Use 42972 when endoscopy is used to control the posterior bleed.
42971Bleeding controlComplicated pharyngeal hemorrhage
42971 is for subsequent control using posterior packing and/or cautery; 42972 describes endoscopic posterior nasal hemorrhage control.
42961Hemorrhage controlComplicated, hospitalization required
42961 concerns complicated oropharyngeal hemorrhage requiring hospitalization. Choose 42972 for endoscopic control of a posterior nasal bleed.

Codes related to 42972

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

Codes related to 42972
CodeHow it relatesNational office range
Same family
42970Bleeding control, nasopharyngeal, with packingInitial posterior nasal bleeding control using posterior packing and/or cautery.No office rate
42971Bleeding control, complicated pharyngeal hemorrhageSubsequent posterior nasal bleeding control using packing and/or cautery.No office rate
Used instead
42960Throat bleeding control, simple controlFor oropharyngeal hemorrhage rather than posterior nasal bleeding.No office rate
42961Hemorrhage control, complicated, hospitalization requiredFor complicated oropharyngeal hemorrhage requiring hospitalization.No office rate
42962Throat bleeding control, secondary surgical interventionFor oropharyngeal hemorrhage requiring secondary surgical procedures.No office rate

42972 billing questions

How does this differ from 42970?

42972 is for endoscopic control of a posterior nasal bleed. 42970 describes initial control using posterior packing and/or cautery without the endoscopic approach.

When is 42971 used instead?

42971 describes subsequent control of posterior nasal bleeding with packing and/or cautery. Use 42972 when the service is endoscopic control.

Can nasal endoscopy be billed separately?

The endoscopic approach is part of 42972. Document how endoscopy was used to identify and control the posterior nasal bleeding.

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply to this service, and modifier 50 is inappropriate.

What does the 90-day global period include?

It includes the day-before preoperative visit and 90 days of related postoperative care.

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
RVUs for 42972PPRRVU2026_Oct_nonQPP.csv, line 5,106 (RVU26D)

Open CMS sourceHow we calculate rates

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