Medicare global surgery - date calculator
Global period calculator: when does the 90 days end?
Count the CMS global surgical period from a surgery date, using the counting rule in the Medicare Claims Processing Manual.
Global period dates
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Result
How CMS counts the days
For a major surgery, the contractor counts the one day immediately before the day of surgery, the day of surgery, and the 90 days immediately following it. CMS gives this example: surgery on January 5, preoperative period January 4, last day of the postoperative period April 5. For minor procedures it counts the day of surgery and the appropriate number of days following it, so a 10-day procedure on January 5 ends January 15 (Chapter 12, section 40.1.E).
The three global periods
| Indicator | Pre-op | Post-op | Days counted |
|---|---|---|---|
| 000 | none | none (day of procedure only) | 1 |
| 010 | none (visits on the day of surgery are included) | 10 days | 11 |
| 090 | 1 day before surgery | 90 days | 92 |
The 11-day and 92-day totals are stated in the CMS MLN global surgery booklet (December 2025).
What the global package includes
The fee schedule amount covers related services by the surgeon in any setting: preoperative visits after the decision to operate, intra-operative services, complications that do not need a return to the operating room, related follow-up visits, post-surgical pain management by the surgeon, most supplies, and miscellaneous services such as dressing changes and removal of sutures, staples and drains (Chapter 12, section 40.1.A).
What is payable separately
- The visit that results in the first decision to operate on the day before or day of a major surgery, billed with modifier 57. CMS says not to use modifier 57 with minor surgeries.
- A significant, separately identifiable E/M service by the same provider on the procedure day, billed with modifier 25.
- Visits unrelated to the surgical diagnosis, treatment of an underlying condition, diagnostic tests, and distinct procedures that are not re-operations or complication treatment (a new postoperative period starts).
- Treatment of a complication that requires a return trip to the operating room.
Shared care
When the surgeon and another provider agree on a transfer of care, the surgeon bills modifier 54 (surgical care only), the provider taking over postoperative management bills modifier 55, and a provider who does only preoperative care bills modifier 56. CMS says split global care billing does not apply to codes with a 0-day postoperative period (MLN booklet).
Limits of this calculator
It counts calendar days from a date you enter. It does not know which indicator a given code carries, whether a service is related to the surgery, or what your payer does. Codes marked YYY, ZZZ, XXX or MMM do not follow a fixed count; see the YYY and ZZZ pages. The row asked about the 90-day case; the calculator also covers 000 and 010 because they share one counting rule.
FAQ
How many days are in a 90-day global period?
CMS counts 92 days in total: the day before surgery, the day of surgery and the 90 days after it.
When does a 10-day global period end?
On the tenth day after the day of surgery. CMS counts the surgery day and the 10 days following it, so surgery on January 5 ends January 15.
Does a 000 global period have postoperative days?
No. The 000 indicator covers the day of the procedure only, and postoperative visits after that day are not included in the surgery payment.
Is the visit that decides on major surgery inside the global period?
No. The E/M visit that results in the first decision to operate, on the day before or day of a major surgery, can be billed separately with modifier 57.
Does the global period apply to others in the surgeon's group?
Providers in the same group practice with the same specialty must bill and accept payment as though they were a single physician, so the global package is billed as one.
Sources
Retrieved 2026-11-02 from the CMS documents below. Indicator meanings are paraphrased from the CMS definitions; no AMA CPT descriptors are reproduced. CMS revises the fee schedule and its manuals, so check the current text.
- CMS: Medicare Claims Processing Manual, Chapter 12, Physicians/Nonphysician Practitioners (Rev. 13753, issued 05-07-26): section 40.1, definition and duration of a global surgical package (retrieved 2026-11-02).
- CMS: MLN907166, Global Surgery booklet (December 2025): FAQs, modifier 54/55/56 and modifier 57 and 25 sections (retrieved 2026-11-02).
- CMS: Medicare Claims Processing Manual, Chapter 23, Fee Schedule Administration and Coding Requirements (Rev. 13701, issued 06-16-26): section 50.6, Global Surgery field values (retrieved 2026-11-02).
Not legal, billing or medical advice
This page explains published Medicare fee schedule indicators and CMS manual text. It cannot see your claim, your contract or any payer's policy, and the amounts it shows are illustrations, not claim prices. Confirm with your Medicare Administrative Contractor or payer before you bill, resubmit or appeal. Everything runs in your browser; nothing you enter is sent anywhere.