CPT Global Surgery Package Rules: 000, 010 & 090 Post-Op Days
The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) define surgical payments through Global Surgery Periods. All standard preoperative evaluations, intraoperative surgical services, and routine postoperative follow-ups are bundled into a single CPT procedure payment.
Billing separate Evaluation and Management (E/M) services during an active global surgical window without valid qualifying billing modifiers results in immediate claim denials. Use our Global Surgery Calculator to compute exact post-op expiration dates and billing resumption windows.
CMS Global Period Classifications & Post-Op Timelines
| Global Code | Procedure Type | Pre-Op Window | Post-Op Window Scope | Separate Billing Resumes |
|---|---|---|---|---|
| 000 Days | Endoscopies & Minor Diagnostics (e.g., CPT 46600) | Day of procedure only | Day of procedure only (no post-op days) | Post-Op Day 1 |
| 010 Days | Minor Surgical Procedures (e.g., CPT 11402) | Day of procedure only | Surgery date + 10 full calendar days | Post-Op Day 11 |
| 090 Days | Major Surgical Operations (e.g., CPT 49591, 50080) | 1 day prior to surgery | Surgery date + 90 full calendar days | Post-Op Day 91 |
High-Volume CPT Procedures & Global Window Reference
| CPT Code | Procedure Description | Global Days | Billing Policy Note |
|---|---|---|---|
| CPT 11402 | Excision benign lesion (trunk/arms/legs, 1.1–2.0 cm) | 010 Days | Routine suture removal is non-billable during 10 days. |
| CPT 46600 | Diagnostic anoscopy | 000 Days | Unrelated E/M on same day requires Modifier 25. |
| CPT 49591 / 49650 | Laparoscopic / open abdominal hernia repair | 090 Days | Pre-op E/M 1 day prior and all 90-day follow-ups bundled. |
| CPT 50080 | Percutaneous nephrostolithotomy (kidney stone surgery) | 090 Days | Staged second-look procedures require Modifier 58. |
Medical Billing Modifiers for Global Surgical Windows
When care during a post-op window falls outside standard routine recovery, specific CPT modifiers must be appended:
Unrelated Evaluation & Management (E/M) service provided by the same physician during a post-op period.
Significant, separately identifiable E/M service on the exact day of a minor 000-day or 010-day procedure.
Staged or planned related procedure by the same surgeon during the original post-op period.
78: Unplanned return to OR for complications. 79: Completely unrelated surgery during post-op.
