Surgery CPT Codes: Ranges, Global Periods and Modifiers

Surgery CPT codes are the five-digit codes in the Surgery section of CPT, which falls within the 10000 to 69999 range and is organized by body system. Choosing the right code starts with the operative report: the procedure, the approach, the anatomic site and what was actually done. Billing it correctly then depends on two Medicare concepts most payers borrow: the global surgical package, which bundles routine care before and after the procedure into its payment, and a set of modifiers that report the exceptions when the record supports them.

The rules below are Medicare's, from CMS's global surgery guidance, the Medicare Claims Processing Manual and the National Correct Coding Initiative (NCCI) policy manual. Commercial payers and Medicaid plans often follow similar rules but set their own global periods and modifier policies, so check the payer's policy for the date of service. Payment varies by payer and locality; for Medicare, use the Physician Fee Schedule look-up.

How is the surgery section organized?

By body system. CMS's NCCI policy manual follows the same ranges, one chapter each:

Some examples, described in our own words, with their 2026 Medicare global period:

Always check the global indicator in the fee schedule for the specific code and year. For specialty detail, see the guides to orthopedic billing, arm fracture treatment codes and wound care CPT codes.

What does the global surgical package include?

Medicare pays for most surgical procedures as a package. The global indicator in the Physician Fee Schedule tells you which package applies:

• 000: endoscopies and some minor procedures. No preoperative or postoperative days; a visit on the procedure day generally isn't paid separately.
• 010: other minor procedures. The procedure day and the 10 days after it.
• 090: major procedures. The day before, the day of surgery and the 90 days after it.
• ZZZ: add-on codes, billed with a primary procedure and covered by the primary procedure's global period.
• XXX: the global concept doesn't apply. YYY: the MAC sets the global period.

The package includes preoperative visits after the decision to operate (from the day before a major procedure, or the day of a minor one), the usual intraoperative services, complications that don't need a return to the operating room, routine postoperative visits, postoperative pain management by the surgeon, supplies, and routine care such as dressing changes, suture and staple removal and removal of drains, lines and casts.

It doesn't include the visit where the decision to perform a major procedure was made, visits for unrelated problems, treatment of the underlying condition, diagnostic tests, distinct procedures during the postoperative period, a return to the operating room for complications, and critical care unrelated to the surgery. The global package applies in every setting: hospital, ambulatory surgical center or office.

Which modifiers apply to surgical claims?

Each applies only when the operative report or the record documents it.

Around the global period:

• 57: the visit, on the day of or the day before a major procedure, where the decision to operate was made. Not used with 000 or 010 procedures.
• 25: a significant, separately identifiable visit on the same day as a minor procedure. The decision to perform a minor procedure is part of the procedure.
• 24: an unrelated visit during the postoperative period. CMS says documentation supporting it must be sent.
• 58: a staged or related procedure during the postoperative period, planned at the time of the first procedure, more extensive than it, or therapy after a diagnostic procedure. A new global period starts.
• 78: an unplanned return to the operating or procedure room for a related procedure during the postoperative period.
• 79: an unrelated procedure during the postoperative period. A new global period starts.
• 54, 55 and 56: surgical care only, postoperative management only and preoperative care only, when care is split between practitioners under a transfer-of-care agreement kept in the record.

At the operative session:

• 51: additional procedures by the same surgeon on the same day. Medicare's billing instructions say to report the major procedure without the modifier and the additional procedures with it; Medicare reduces payment for the additional procedures when the fee schedule's multiple-procedure indicator applies.
• 50: a bilateral procedure, reported on one line for Medicare, unless the code already describes a bilateral or "unilateral or bilateral" procedure.
• 22: substantially greater work than usually required. Medicare requires a concise statement of how the service differed from the usual and the operative report; without them, the claim is paid at the normal rate. It applies only to codes with a 000, 010 or 090 global period.
• 62 and 66: two surgeons of different specialties each performing part of one procedure (co-surgery), or a surgical team.
• 80, 81, 82 and AS: assistant-at-surgery services, which Medicare pays only for procedures where it allows an assistant.
• 59 and XE, XS, XP, XU: distinct procedures that would otherwise be bundled by an NCCI edit, only when the record shows a separate site, encounter or practitioner. The CO-97 guide explains when they apply.

What does the operative report need to show?

• the procedure performed, the approach, the anatomic site and laterality
• each separately reportable procedure, and why it was needed
• anything unusual, such as extra time, difficulty or complications, for modifier 22
• the indication for surgery, so the diagnosis codes support medical necessity

If a procedure started with one approach fails and is converted to another, such as laparoscopic to open, only the completed procedure is reported; a diagnostic laparoscopy isn't billed in place of the failed one. Components that are part of a more comprehensive procedure aren't billed separately.

What Medicare changes should surgical practices watch?

• Reporting of postoperative visits. Practitioners in groups of 10 or more in nine states (Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon and Rhode Island) must report postoperative visits for certain procedures with code 99024. In the CY 2027 Physician Fee Schedule proposed rule (July 2026), CMS proposes pausing this data collection.
• Visits on the day of a procedure. The same proposed rule would reduce payment when an office visit is billed on the same day as a procedure with a 0, 10 or 90-day global period.

Check the CY 2027 final rule, expected in November 2026, before January 2027.

Where do surgical claims go wrong?

• Follow-up visits billed inside the global period, or unrelated visits never billed because staff assumed they were included.
• Modifiers added by default, such as 25 on every same-day visit or 59 on every second procedure.
• Unbundling: billing components, supplies or routine postoperative care that the package already includes.
• Codes chosen from the schedule, not the operative report, or a report that doesn't describe what was billed.

For billing support, see Highview's physician billing service, and billing by specialty.

Sources

• CMS, Global Surgery booklet, MLN907166 (December 2025): global indicators, what the package includes and excludes, modifiers 24, 25, 50, 54–58, 62, 66, 78–82 and AS, multiple surgeries, 99024 reporting.
• CMS, Medicare Claims Processing Manual, Chapter 12, sections 40.2.A.10 (modifier 22), 40.4 and 40.6 (multiple surgeries and modifier 51).
• CMS, Medicare NCCI Policy Manual (effective January 1, 2026): chapters 3 to 8 (surgery code ranges by body system) and Chapter 1 (NCCI PTP-associated modifiers; procedures converted to another approach).
• CMS, PFS Relative Value Files, RVU26D: 2026 status and global periods for the codes listed; definitions of the global indicators.
• CMS, CY 2027 Physician Fee Schedule proposed rule fact sheet: proposed same-day visit reduction and pause of global surgery data collection.
• CMS, Search the Physician Fee Schedule.