I don't have many balance mods or straight-up new content, however, I do have a few that chance the game in subtle, but very positive ways, if those are up your alley.
If you don't have New Vegas Script Extender (NVSE), get it ASAP. New Vegas Mod Manager is also great for... well, yeah, what it says.
A couple of technical ones: the FNV 4GB patch removes a lot of the game's crashing and stuttering, plus allows it to use more RAM. You'll find it on the NVSE page if you use NVSE; if you don't, there's another version on the Nexus somewhere. Additionally, there's the New Vegas Stutter Remover, which uses script injections to fix a lot of the game's buggy code, improve performance, and generally make the game more stable. It works brilliantly for me, and has removed almost all stuttering while also allowing me to disable v-sync without the game running too fast. Unfortunately, it has yet to be updated for the latest patch, but keep the link on hand in case it is:
http://www.newvegasnexus.com/downloads/ ... p?id=34832
As for actual gameplay mods,
1)
Brighter Larger Radius Pip-Boy Light, makes the flashlight actually useful.
2) Bindable Pip-Boy Light, allows you to set up a custom key to turn the light on and off. Unfortunately I can't find any links to it at the moment.
http://www.newvegasnexus.com/downloads/ ... p?id=35631 may be a reasonable alternative.
3)
Easy Unlocking and Hacking, makes the mini-games super easy when you pass the skill check for lockpicking and hacking. Removes a lot of tedium.
4)
Sprint Mod, allows you to sprint faster when holding down a key. Consumes AP as stamina, giving more incentive to increase agility, both for combat and exploration.
5)
New Vegas Map Markers, adds a bunch of map markers to certain locations around New Vegas, mostly concentrated around the Strip. Extremely useful if you ever get tired of crossing through Freeside all the time.
6)
Inventory Sorters, adds prefixes to inventory items to make it much easier to find them in the inventory list (i.e. food items marked with [FOOD], healing items marked with [AID]).
7)
Sensible Dismemberment, significantly reduces chances of dismembering and exploding limbs, while allowing certain weapons to dismember in more logical/realistic ways, i.e. a shotgun will no longer decapitate, but it will still cause heads to explode.
8)
Immersive Karma, removes messages for gaining and losing karma, as well as sound effects.
9)
Karma-Less Petty Crime NV, stealing no longer causes karma loss.
10)
Community Bugfix Compilation Patch, what it says on the tin. More or less New Vegas' version of the Fallout 3 Unofficial patch, albeit less extensive.
Last, unless you have an alternative you prefer, DarN's new UI for New Vegas, similar in function to the ones he made for Fallout 3 and Oblivion, can be found here:
http://ui.darnified.net/wip/DUIFONV/v1/DUINVv04.7z Unfortunately, DarN has apparently disappeared off the face of the earth, so it hasn't been updated in a long while, but it still works just fine.