The following components constitute a common global surgical package when performed by the same physician:

• Preoperative Visits: Preoperative visits after the decision is made to operate beginning with the day before the day of surgery for major procedures and the day of surgery for minor procedures.
• Intraoperative Services : Intraoperative services that are normally a usual and necessary part of a surgical procedure.
• Complications Following Surgery: All routine additional medical or surgical services required of the surgeon during the postoperative period of the surgery including complications which do not require additional trips to the operating room; also includes writing orders, talking with the family, evaluating the patient in the post-anesthesia recovery area.

Duration of Global Period :

• 0 days for endoscopies or certain minor procedures for which the physician visits the patient on the same day as the procedure.
• 10 days for most minor surgeries.
• 90 days for major surgeries.

1. Determining the Duration of a Global Period:

Example (Major Surgery): To determine the global period for major surgeries, count 1 day immediately before the day of surgery, the day of surgery, and the 90 days immediately following the day of surgery.

Example (Minor Procedure): Count the day of surgery and the appropriate number of days immediately following the date of surgery.

2. Physicians Who Furnish Part of a Global Surgical Package:

Where physicians agree on the transfer of care during the global period, instruct them to add the appropriate CPT-4 modifier to the surgical procedure code:

• “-54” for surgical care only; or
• “-55” for postoperative management only.