No office rate
42970 is for simple control of pharyngeal or nasopharyngeal bleeding; 42971 is for the complicated level, supported by the documented circumstances and operative work.
On this page
CMS RVU26D · Effective 2026-10-01
42971 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$405.61
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
ENT surgery
About 42971: Complicated pharyngeal hemorrhage control
Reports operative control of complicated bleeding from the pharynx or nasopharynx, such as significant postoperative hemorrhage requiring more than simple treatment.
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.
CMS billing rules for 42971
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.44 · 54%
- Practice expense (office) RVU4.60 · 38%
- Malpractice RVU0.93 · 8%
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.
42971 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
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.
No office rate
42961 belongs to the oropharyngeal hemorrhage series. Use it when the coded site is oropharyngeal, rather than pharyngeal or nasopharyngeal.
The same code, a different location
How does Austin compare?
42971 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 42971
Office
Unavailable
Facility
$388.96
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 42971
Office
Unavailable
Facility
$426.31
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 42971
Office
Unavailable
Facility
$442.28
No comparable office rate is available.
Miami
Florida · 42971
Office
Unavailable
Facility
$453.60
No comparable office rate is available.
Chicago
Illinois · 42971
Office
Unavailable
Facility
$442.31
No comparable office rate is available.
Manhattan
New York · 42971
Office
Unavailable
Facility
$456.67
No comparable office rate is available.
Alaska*
Alaska · 42971
Office
Unavailable
Facility
$503.40
No comparable office rate is available.
Alabama
Alabama · 42971
Office
Unavailable
Facility
$367.12
No comparable office rate is available.
Arkansas
Arkansas · 42971
Office
Unavailable
Facility
$363.08
No comparable office rate is available.
Arizona
Arizona · 42971
Office
Unavailable
Facility
$390.57
No comparable office rate is available.
Bakersfield
California · 42971
Office
Unavailable
Facility
$406.50
No comparable office rate is available.
Chico
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
El Centro
California · 42971
Office
Unavailable
Facility
$403.96
No comparable office rate is available.
Fresno
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Hanford-Corcoran
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Madera
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Merced
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Modesto
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Napa
California · 42971
Office
Unavailable
Facility
$446.94
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 42971
Office
Unavailable
Facility
$422.08
No comparable office rate is available.
Redding
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Rest Of California
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 42971
Office
Unavailable
Facility
$413.86
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 42971
Office
Unavailable
Facility
$418.18
No comparable office rate is available.
Salinas
California · 42971
Office
Unavailable
Facility
$416.49
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 42971
Office
Unavailable
Facility
$422.15
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 42971
Office
Unavailable
Facility
$466.43
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 42971
Office
Unavailable
Facility
$465.38
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 42971
Office
Unavailable
Facility
$476.97
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 42971
Office
Unavailable
Facility
$472.65
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 42971
Office
Unavailable
Facility
$410.41
No comparable office rate is available.
Santa Cruz-Watsonville
California · 42971
Office
Unavailable
Facility
$422.95
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 42971
Office
Unavailable
Facility
$416.92
No comparable office rate is available.
Santa Rosa-Petaluma
California · 42971
Office
Unavailable
Facility
$426.88
No comparable office rate is available.
Stockton
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Vallejo
California · 42971
Office
Unavailable
Facility
$445.41
No comparable office rate is available.
Visalia
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Yuba City
California · 42971
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Colorado
Colorado · 42971
Office
Unavailable
Facility
$405.42
No comparable office rate is available.
Connecticut
Connecticut · 42971
Office
Unavailable
Facility
$422.46
No comparable office rate is available.
Delaware
Delaware · 42971
Office
Unavailable
Facility
$395.90
No comparable office rate is available.
Fort Lauderdale
Florida · 42971
Office
Unavailable
Facility
$426.90
No comparable office rate is available.
Rest Of Florida
Florida · 42971
Office
Unavailable
Facility
$408.67
No comparable office rate is available.
Atlanta
Georgia · 42971
Office
Unavailable
Facility
$409.16
No comparable office rate is available.
Rest Of Georgia
Georgia · 42971
Office
Unavailable
Facility
$389.18
No comparable office rate is available.
Hawaii, Guam
Hawaii · 42971
Office
Unavailable
Facility
$407.78
No comparable office rate is available.
Iowa
Iowa · 42971
Office
Unavailable
Facility
$368.02
No comparable office rate is available.
Idaho
Idaho · 42971
Office
Unavailable
Facility
$371.15
No comparable office rate is available.
East St. Louis
Illinois · 42971
Office
Unavailable
Facility
$419.01
No comparable office rate is available.
Rest Of Illinois
Illinois · 42971
Office
Unavailable
Facility
$403.93
No comparable office rate is available.
Suburban Chicago
Illinois · 42971
Office
Unavailable
Facility
$429.44
No comparable office rate is available.
Indiana
Indiana · 42971
Office
Unavailable
Facility
$372.63
No comparable office rate is available.
Kansas
Kansas · 42971
Office
Unavailable
Facility
$369.65
No comparable office rate is available.
Kentucky
Kentucky · 42971
Office
Unavailable
Facility
$380.11
No comparable office rate is available.
New Orleans
Louisiana · 42971
Office
Unavailable
Facility
$394.97
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 42971
Office
Unavailable
Facility
$380.84
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 42971
Office
Unavailable
Facility
$435.02
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 42971
Office
Unavailable
Facility
$405.09
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 42971
Office
Unavailable
Facility
$421.83
No comparable office rate is available.
Rest Of Maryland
Maryland · 42971
Office
Unavailable
Facility
$401.26
No comparable office rate is available.
Rest Of Maine
Maine · 42971
Office
Unavailable
Facility
$375.78
No comparable office rate is available.
Southern Maine
Maine · 42971
Office
Unavailable
Facility
$386.96
No comparable office rate is available.
Detroit
Michigan · 42971
Office
Unavailable
Facility
$415.74
No comparable office rate is available.
Rest Of Michigan
Michigan · 42971
Office
Unavailable
Facility
$390.45
No comparable office rate is available.
Minnesota
Minnesota · 42971
Office
Unavailable
Facility
$382.40
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 42971
Office
Unavailable
Facility
$389.72
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 42971
Office
Unavailable
Facility
$392.50
No comparable office rate is available.
Rest Of Missouri
Missouri · 42971
Office
Unavailable
Facility
$377.80
No comparable office rate is available.
Mississippi
Mississippi · 42971
Office
Unavailable
Facility
$370.34
No comparable office rate is available.
Montana**
Montana · 42971
Office
Unavailable
Facility
$399.75
No comparable office rate is available.
North Carolina
North Carolina · 42971
Office
Unavailable
Facility
$378.30
No comparable office rate is available.
North Dakota**
North Dakota · 42971
Office
Unavailable
Facility
$381.36
No comparable office rate is available.
Nebraska
Nebraska · 42971
Office
Unavailable
Facility
$368.66
No comparable office rate is available.
New Hampshire
New Hampshire · 42971
Office
Unavailable
Facility
$402.23
No comparable office rate is available.
Northern Nj
New Jersey · 42971
Office
Unavailable
Facility
$440.06
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 42971
Office
Unavailable
Facility
$425.56
No comparable office rate is available.
New Mexico
New Mexico · 42971
Office
Unavailable
Facility
$393.30
No comparable office rate is available.
Nevada**
Nevada · 42971
Office
Unavailable
Facility
$394.77
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 42971
Office
Unavailable
Facility
$469.23
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 42971
Office
Unavailable
Facility
$430.61
No comparable office rate is available.
Queens
New York · 42971
Office
Unavailable
Facility
$455.27
No comparable office rate is available.
Rest Of New York
New York · 42971
Office
Unavailable
Facility
$382.90
No comparable office rate is available.
Ohio
Ohio · 42971
Office
Unavailable
Facility
$386.69
No comparable office rate is available.
Oklahoma
Oklahoma · 42971
Office
Unavailable
Facility
$376.44
No comparable office rate is available.
Portland
Oregon · 42971
Office
Unavailable
Facility
$412.35
No comparable office rate is available.
Rest Of Oregon
Oregon · 42971
Office
Unavailable
Facility
$389.97
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 42971
Office
Unavailable
Facility
$415.98
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 42971
Office
Unavailable
Facility
$385.50
No comparable office rate is available.
Puerto Rico
Puerto Rico · 42971
Office
Unavailable
Facility
$401.03
No comparable office rate is available.
Rhode Island
Rhode Island · 42971
Office
Unavailable
Facility
$405.61
No comparable office rate is available.
South Carolina
South Carolina · 42971
Office
Unavailable
Facility
$383.47
No comparable office rate is available.
South Dakota**
South Dakota · 42971
Office
Unavailable
Facility
$379.18
No comparable office rate is available.
Tennessee
Tennessee · 42971
Office
Unavailable
Facility
$371.45
No comparable office rate is available.
Utah
Utah · 42971
Office
Unavailable
Facility
$387.42
No comparable office rate is available.
Virginia
Virginia · 42971
Office
Unavailable
Facility
$388.06
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 42971
Office
Unavailable
Facility
$401.03
No comparable office rate is available.
Vermont
Vermont · 42971
Office
Unavailable
Facility
$382.93
No comparable office rate is available.
Rest Of Washington
Washington · 42971
Office
Unavailable
Facility
$403.32
No comparable office rate is available.
Seattle (King Cnty)
Washington · 42971
Office
Unavailable
Facility
$439.76
No comparable office rate is available.
Wisconsin
Wisconsin · 42971
Office
Unavailable
Facility
$371.86
No comparable office rate is available.
West Virginia
West Virginia · 42971
Office
Unavailable
Facility
$393.07
No comparable office rate is available.
Wyoming**
Wyoming · 42971
Office
Unavailable
Facility
$391.73
No comparable office rate is available.
See how rates vary across the country
42971 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 42971 in Austin
Multiple payment areas
- 42971 in Barton Creek
- 42971 in Bee Cave
- 42971 in Briarcliff
- 42971 in Cedar Park
Multiple payment areas
- 42971 in Creedmoor
Multiple payment areas
- 42971 in Elgin
Multiple payment areas
- 42971 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 42971 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$446.17
$405.61 × 110% = $446.17
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 42971 in Austin.
PPRRVU2026_Oct_nonQPP.csv
5,105
- Code
- 42971
- Physician work
- 6.44
- Practice expense
- 4.60
- Malpractice
- 0.93
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.44 | × 1.002 | 6.4529 |
| Practice expense | 4.60 | × 1.058 | 4.8668 |
| Malpractice | 0.93 | × 0.886 | 0.8240 |
| Total RVUs | 12.1437 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$405.61
Open 42971 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.44 | 1.002 |
| Practice expense | 4.6 | 1.058 |
| Malpractice | 0.93 | 0.886 |
(6.44 × 1.002 + 4.6 × 1.058 + 0.93 × 0.886) × $33.4009 = $405.61
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
42971 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $405.61 | RVU26D |
| 2026-07-01 | Not available in this setting | $405.61 | RVU26C |
| 2026-04-01 | Not available in this setting | $405.61 | RVU26B |
| 2026-01-01 | Not available in this setting | $405.61 | RVU26A |
| 2025-10-01 | Not available in this setting | $451.01 | RVU25D |
| 2025-07-01 | Not available in this setting | $451.01 | RVU25C |
| 2025-04-01 | Not available in this setting | $451.01 | RVU25B |
| 2025-01-01 | Not available in this setting | $451.01 | RVU25A |
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,10242961,,Control throat bleeding,A,,5.63,4.71,NA,4.71,,0.82,11.16,11.16,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,10342962,,Control throat bleeding,A,,7.22,5.43,NA,5.43,,1.06,13.71,13.71,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,10442970,,Control nose/throat bleeding,A,,5.67,4.41,NA,4.41,,0.83,10.91,10.91,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,10542971,,Control nose/throat bleeding,A,,6.44,4.60,NA,4.60,,0.93,11.97,11.97,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,10642972,,Control nose/throat bleeding,A,,7.40,4.83,NA,4.83,,1.08,13.31,13.31,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,10742975,,Dise eval slp do brth flx dx,A,,1.54,0.75,NA,0.75,,0.21,2.50,2.50,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31575,33.4009,09,0,99,0.00,0.00,0.00
5,10842999,,Unlisted px phrnx adnd/tnsl,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858