Billing code 42972: Nasal bleeding controlMedicare rate & RVUs in Nevada
Report this service when a physician uses endoscopy to control a posterior nasal hemorrhage, such as severe epistaxis requiring operative hemostasis.
CMS doesn’t publish an office rate for 42972 in Nevada.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
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.
42972 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $438.70 |
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
Swap in your local Medicare rate.
Work 7.40Practice expense 4.83Malpractice 1.08
All indexes start 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
| 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 · 42972
Nasal bleeding control
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
42972 without 51 · national facility
$444.57
Nasal bleeding control
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%).
42972 compared with similar codes
Compare codes
42972 vs 42970 vs 42971 vs 42961: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 42970Bleeding control
- 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 control
- 42971 is for subsequent control using posterior packing and/or cautery; 42972 describes endoscopic posterior nasal hemorrhage control.
- 42961Hemorrhage control
- 42961 concerns complicated oropharyngeal hemorrhage requiring hospitalization. Choose 42972 for endoscopic control of a posterior nasal bleed.
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
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