Orthopedics · global periods
Orthopedics global periods.
The orthopedic procedures with a CMS global package, and how long it runs. Inside the package, routine post-operative visits are 99024; anything else needs the right modifier.
Procedures and their global period.
Global periods as assigned in the 2025 CMS Physician Fee Schedule. Commercial payers usually follow CMS but may not. Confirm before billing.
| Code | Description | Work RVU | Global |
|---|---|---|---|
20610 | Arthrocentesis, aspiration or injection, major joint or bursa (knee, shoulder, hip), without ultrasound | 0.79 | 000 |
20611 | Same as 20610, with ultrasound guidance and permanent recording | — | 000 |
20605 | Arthrocentesis or injection, intermediate joint (wrist, elbow, ankle) | 0.68 | 000 |
20600 | Arthrocentesis or injection, small joint (fingers, toes) | 0.66 | 000 |
20550 | Injection, single tendon sheath, ligament or aponeurosis | 0.75 | 000 |
20553 | Trigger point injections, three or more muscles | 0.75 | 000 |
27447 | Total knee arthroplasty | 19.60 | 090 |
27130 | Total hip arthroplasty | 19.60 | 090 |
23472 | Total shoulder arthroplasty (glenoid and humeral) | 22.13 | 090 |
29881 | Knee arthroscopy with meniscectomy, medial or lateral | 5.19 | 090 |
29880 | Knee arthroscopy with meniscectomy, medial and lateral | — | 090 |
29827 | Shoulder arthroscopy with rotator cuff repair | 15.59 | 090 |
29888 | Arthroscopically aided anterior cruciate ligament repair or reconstruction | — | 090 |
64721 | Carpal tunnel release (neuroplasty, median nerve at carpal tunnel) | 4.12 | 090 |
25600 | Closed treatment of distal radial fracture, without manipulation | — | 090 |
25605 | Closed treatment of distal radial fracture, with manipulation | — | 090 |
27786 | Closed treatment of distal fibular fracture, without manipulation | — | 090 |
28296 | Bunion correction with distal metatarsal osteotomy | — | 090 |
29125 | Application of short arm splint, static | — | 000 |
000- 0-day global: the visit on the day of the procedure is included; visits afterwards are billed.
090- 90-day global: the day before, the day of and 90 days of routine post-operative care are included.
Inside the package.
- Included: the day before (90-day only), the day of, routine post-operative visits (report 99024), dressing changes, suture removal and the usual complications treated in the office.
- Not included: a return to the operating room (modifier 78), an unrelated problem (24 for a visit, 79 for a procedure), a staged procedure (58), and the visit where surgery was decided (57 for 90-day, 25 for 10-day).
- The receptionist’s post-op confirmation calls and screening pages fall inside the package too; they cost the practice minutes, not claims.
A receptionist that knows orthopedic calls.
Post-op screening forms your surgeons approve, the on-call paged with answers, and confirmation calls before and after the operation.