We classify 3 types of global surgical packages based on the number of post-operative days:
0-Day Post-Operative Period (endoscopies and some minor procedures)
- No pre-operative period
- No post-operative days
- Generally, a visit on the procedure day isn’t payable as a separate service
10-Day Post-Operative Period (other minor procedures)
- No pre-operative period
- Generally, a visit on the procedure day isn’t payable as a separate service
- Total global period is 11 days; count the surgery day and the 10 days following the surgery day
90-Day Post-Operative Period (major procedures)
- 1-day pre-operative included
- Generally, the procedure day isn’t separately payable
- Total global period is 92 days; count 1 day before surgery, the day of surgery, and the 90 days following the surgery day
Note: We let the surgeon or other practitioners separately bill and get paid for a post-discharge home visit according to the Comprehensive Care for Joint Replacement Model (CJR) conditions. During the 90-day post-operative period, we continue applying all other global surgery billing rules.
Where can I find the covered surgical procedures’ post-operative periods?
The Medicare Physician Fee Schedule (PFS) Look-Up Tool outlines each procedure code, including the global surgery indicator. Under Modifier, select “Global” (Diagnostic Service) to display the global column in the tool.
The global surgical payment rules apply to procedure codes with global surgery indicators 000, 010, 090, and sometimes YYY:
- 000 codes identify endoscopies or some minor surgical procedures (0-day post-operative period).
- 010 codes identify other minor procedures (10-day post-operative period).
- 090 codes identify major surgeries (90-day post-operative period).
- YYY codes identify contractor-priced codes. MACs decide the global period. The global period for these codes is 0, 10, or 90 days.
Note: Not all contractor-priced codes have a YYY global surgical indicator. Sometimes we specify the global period as 000, 010, or 090.
