Medicare Global Surgery Coding and Billing Changes in 2025
Medicare’s billing and coding rules for global surgery packages have undergone several changes over the years. In 2025, the Centers for Medicare & Medicaid Services (CMS) have introduced updates aimed at improving transparency, documentation, and reimbursement accuracy in surgical care. These changes directly affect providers, coders, and billing teams involved in surgical servicebs.
This guide explores the key updates to Medicare Global Surgery coding and billing in 2025, how they impact healthcare professionals, and how to stay compliant.
What Is a Global Surgery Package?
A global surgery package includes all necessary services normally furnished by a surgeon before, during, and after a surgical procedure. These services are bundled into a single payment.
There are three main components:
- Pre-operative care (usually 1 day before surgery)
- Intra-operative care (actual surgical procedure)
- Post-operative care (0, 10, or 90 days depending on the procedure)
The number of days is referred to as the global period:
- 0-day: Minor procedures (e.g., biopsies)
- 10-day: Simple surgeries (e.g., skin lesion removal)
- 90-day: Major surgeries (e.g., hip replacement)
Why Medicare Updated Global Surgery Policies
CMS aims to:
- Improve billing transparency
- Ensure accurate documentation of services provided during the global period
- Prevent overpayments for services not actually delivered
- Align reimbursement with real-world clinical practice
Key Global Surgery Billing Changes in 2025
1. Expanded Reporting Requirements
CMS is requiring more detailed documentation of post-operative visits during the global period for selected procedures. This includes:
- Number of visits
- Visit types (telehealth or in-person)
- Provider specialty
- Level of service (low, moderate, high complexity)
This information must be submitted using new G-codes.
2. New Time-Based G-Codes
For certain procedures, providers must now report post-op services using G-codes that reflect:
- Time spent with the patient
- Type of post-op interaction
- Level of complexity of follow-up care
This will give Medicare better visibility into the actual services provided.
3. Reduced Bundling for Some Procedures
CMS is testing a partial unbundling approach for selected surgeries. This means post-op care may be billed separately for:
- High-risk procedures
- Surgeries with minimal follow-up visits
This allows providers to be fairly compensated when follow-up care is limited or not required.
4. More Audits and Compliance Checks
With new reporting comes more oversight. Medicare contractors will audit claims to ensure:
- Post-op visits occurred
- Documentation supports services billed
- G-codes match visit logs
Practices may face recoupments for unsupported or excessive billing.
How to Adapt Your Practice in 2025
✅ Train Billing and Coding Staff
Ensure coders understand:
- G-code requirements
- Time-based reporting
- Documentation standards
Train your billing team to: - Submit new data accurately
- Monitor claims for denials related to global packages
✅ Review Surgery Protocols
Identify:
- Which procedures are affected by the new rules
- Where in your workflow post-op services are delivered
- Who is responsible for documentation
Update workflows to capture necessary visit data clearly.
✅ Invest in EHR Customization
Update your electronic health records system to:
- Track global period dates
- Record post-op visits in a structured way
- Prompt providers to select appropriate G-codes
✅ Track Denials and Appeals
Pay close attention to:
- Rejected claims involving post-op care
- Overpayments due to bundled charges
- Opportunities to rebill under partial unbundling
Create an internal denial management system specifically for surgery-related billing.
Impacts on Surgeons and Healthcare Providers
🔹 Surgeons
Surgeons must document more details about post-op care. While this adds some administrative work, it also opens the door to better reimbursement for time-intensive cases.
🔹 Hospitals & Group Practices
Organizations must standardize post-op visit logging, especially if multiple providers manage post-surgical care.
🔹 Coders and Billers
Coding teams will need to understand new time-based codes and monitor CMS updates throughout 2025.
FAQs About 2025 Global Surgery Changes
Q: Will all surgeries be affected by these changes?
A: No. CMS has selected a sample group of high-volume and high-cost procedures for initial reporting requirements.
Q: Can post-op care now be billed separately?
A: In some cases, yes. CMS is allowing unbundled billing where data shows minimal follow-up occurs.
Q: What happens if we don’t use G-codes correctly?
A: Claims may be denied, or payments could be subject to audit and recoupment.
Final Thoughts
The 2025 Medicare global surgery coding and billing changes represent a big shift in how post-op care is tracked and reimbursed. By preparing early, training staff, and updating documentation processes, practices can stay compliant and protect their revenue.
Staying informed is key. Subscribe to CMS updates and work with a reliable medical billing partner who understands these changes inside and out.
Jane Smith – Medical Billing Specialist
With over 38 years of experience, Jane Smith helps healthcare providers manage billing, recover payments, and reduce claim denials. She specializes in insurance claims, provider credentialing, and revenue management, ensuring smooth financial operations so doctors can focus on patient care.
