NCCI Global Surgical Package Policy
Medicare's global surgical package bundles preoperative, intraoperative, and routine postoperative care into a single payment for the surgical CPT code, with global periods of 0, 10, or 90 days.
Primary source
MLN Booklet — Global Surgery →https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/globallsurgery-icn907166.pdf
Verified May 23, 2026 · This is the authoritative regulator URL. The summary below is a research aid; the linked source controls.
Additional sources
The Medicare Global Surgery package bundles preoperative visits (the day before for major surgery; same day for minor), intraoperative services that are a normal part of the procedure, complications not requiring return to the operating room, post-surgical pain management, and routine postoperative visits into a single payment.
Global period lengths from the Medicare Physician Fee Schedule:
- 000-day (minor): same-day visit included; no postoperative period.
- 010-day (minor): same-day visit included; 10 days postoperative.
- 090-day (major): day-before and same-day visits included; 90 days postoperative.
- MMM (maternity): bundled global obstetric package.
- XXX, YYY, ZZZ: special concepts (no global, contractor-priced, related-procedure codes).
Modifiers for global-period reporting:
- 24: unrelated E/M during postoperative period.
- 25: significant E/M same day as a minor procedure.
- 57: decision for surgery (major).
- 58: staged or related procedure during global.
- 78: return to OR for related procedure during global.
- 79: unrelated procedure during global.
Documentation must support the modifier — particularly 24 (different diagnosis) and 79 (different anatomy or unrelated condition).
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Related across the archive
- RegulationNCCI Policy Manual OverviewThe National Correct Coding Initiative is the CMS coding edits program that prevents improper Medicare payment due to incorrect code reporting; the Policy Manual is the authoritative coding-policy reference.
- RegulationNCCI Chapter 11: Evaluation and Management ServicesNCCI policy on bundling and separately reporting E/M services with procedures, including modifier 25 use and global surgical package interactions.
- RegulationNCCI Modifier Overrides (Modifier 59 and X{EPSU})Modifier 59 (and its more specific subsets XE, XS, XP, XU) is the principal mechanism for overriding a PTP edit when a procedure is distinct or independent from another performed on the same day.
- RegulationModifier 25: Significant, Separately Identifiable E/M ServiceModifier 25 is appended to an E/M code when the E/M is significant and separately identifiable from another procedure or service performed on the same day by the same provider.
- RegulationNCCI Chapter 10: Pathology and Laboratory PoliciesNCCI policies for clinical laboratory services, including panel-vs-component coding, automated multi-channel chemistry rules, and Date of Service rules for lab tests.
- RegulationNCCI Chapter 9: Radiology PoliciesNCCI policies specific to radiology services, including component coding rules (technical and professional), supervision and interpretation services, and contrast/non-contrast bundling.
- GlossaryGlobal PeriodThe period of time during which the payer considers most related preoperative and postoperative services bundled into the surgical fee.
- GlossaryModifier 24CPT modifier indicating an unrelated E/M service performed by the same provider during a postoperative global period.
Last reviewed May 23, 2026 · Citation verified May 23, 2026
Research aid, not legal advice. This summary is an administrative research aid prepared by D3rx. It does not certify compliance, provide legal advice, replace counsel, or guarantee an audit outcome. For authoritative regulatory text follow the primary source link at the top of this page. The practice remains responsible for reviewing, adopting, and maintaining its compliance program.