Global Period Calculator: How Surgical Global Days Are Counted
A surgical global period is the block of time in which routine care connected to an operation is already paid for inside the procedure fee. Medicare assigns each surgical CPT code a global indicator of 000, 010 or 090, and the end date is simply the date of surgery plus that number of post-operative days.
The three global indicators
- 000 — endoscopies and minor procedures: same-day related care only, no post-operative days.
- 010 — minor surgery: the day of the procedure plus 10 days of follow-up.
- 090 — major surgery: one pre-operative day, the day of surgery, plus 90 days of follow-up.
- XXX, YYY, ZZZ and MMM are non-standard indicators used for codes with no global concept, contractor-priced codes, add-on codes and maternity services.
What the surgical package includes
The package covers pre-operative visits after the decision for surgery (the day before for 090 codes), the operation itself, all additional medical or surgical services required because of complications that do not return the patient to the operating room, post-operative visits, dressing changes, wound-care and drain removal, and routine supplies. What it does not include is the initial consultation or evaluation at which the decision for major surgery was made — that is billed separately with modifier 57 — along with treatment of the underlying condition unrelated to recovery, diagnostic tests, distinct unrelated procedures, and any return to the operating room for a complication.
Modifiers that break the global
- 24 — unrelated evaluation and management service during a post-operative period.
- 25 — significant, separately identifiable E/M on the same day as a minor procedure.
- 57 — decision for surgery, used the day before or the day of a major procedure.
- 58 — staged or more extensive procedure planned at the time of the original surgery.
- 78 — unplanned return to the operating room for a related complication.
- 79 — unrelated procedure by the same physician during the post-operative period.
Counting the days correctly
The day of surgery is day zero, so a 010 procedure on 2 October ends on 12 October and a 090 procedure on the same day ends on 31 December. All days are calendar days, including weekends and holidays. Medicare Administrative Contractors such as Palmetto GBA publish the same rules, and the authoritative global-day value for any code sits in the global column of the Medicare Physician Fee Schedule relative value file, which is refreshed every year.
Key takeaways — Global Period Calculator
- Global end date = date of surgery + 0, 10 or 90 days; 090 codes also include the day before.
- Routine follow-up is bundled; unrelated care is billed with modifiers 24, 25, 57, 58, 78 or 79.
- Always confirm the global indicator in the current MPFS file — values change annually.