General Surgery Billing Services

General surgery billing is governed by one rule that touches nearly every claim: the global surgical package. A single payment covers the operation plus the normal pre-operative and post-operative care around it, and anything billed separately inside that window needs a modifier and documentation that justifies the exception. Get the global period wrong and routine follow-up visits deny, complications get bundled, and staged procedures never pay.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for general surgery practices, built around global period and modifier rules.

General surgery billing challenges

Global periods are the core challenge. Medicare assigns each surgical code a global period of 0, 10, or 90 days: minor procedures carry 0 or 10 days, major operations carry 90 days, including the day before surgery and the day of surgery plus 90 days after. Routine post-operative visits, dressing changes, suture removal, and minor complications inside that window are already included in the surgical payment and must not be billed separately. They are tracked with CPT 99024 for post-operative follow-up visits, not with a standard visit code.
Modifiers are how legitimate exceptions get paid, and each one has a narrow use. Modifier 24 covers an unrelated evaluation and management service during the post-operative period. Modifier 25 covers a significant, separately identifiable visit on the same day as a minor procedure. Modifier 57 covers the decision for major surgery, on the day of or the day before the operation. Modifier 58 covers a staged or related procedure planned during the post-operative period. Modifier 78 covers an unplanned return to the operating room for a related complication. Modifier 79 covers an unrelated procedure during the post-operative period. Using 58 where 78 belongs, or 25 where 57 belongs, is one of the most common surgical denial patterns.
A third challenge is the operative session itself. Multiple procedures in one session, assistant surgeon and co-surgeon roles, and bilateral work each carry their own modifier and payer rules, and not all payers reimburse assistant or co-surgeon roles. Prior authorization for elective procedures, and medical necessity documentation that ties the diagnosis to the operation, must also be complete before the case, not reconstructed after a denial.

What MedPlus RCM handles for general surgery practices

• End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing, the full cycle.
• Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
• Provider credentialing and enrollment. End-to-end enrollment with commercial payers, Medicare, and Medicaid, plus re-credentialing maintenance.
• Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
• A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
• Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
  We serve general surgery practices of every size, from solo surgeons to multi-surgeon groups, across all 50 states.

Results general surgery practices can check

MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.

Frequently asked questions

What is included in the global surgical package?
The operation itself, normal pre-operative visits, and routine post-operative care including follow-up visits, dressing changes, suture removal, and minor complications, for 0, 10, or 90 days depending on the procedure.
When can a visit during the global period be billed?
When it is unrelated to the surgery, with modifier 24, or when it is the decision for a major surgery, with modifier 57. Routine post-operative care inside the window is included and is tracked with CPT 99024, not billed as a visit.
What is the difference between modifiers 58 and 78?
Modifier 58 is for a staged or planned related procedure during the post-operative period. Modifier 78 is for an unplanned return to the operating room for a related complication. Mixing them up is a common denial cause.
Do payers cover assistant surgeons?
It depends on the payer and the procedure. We verify assistant and co-surgeon coverage before the case and apply the correct modifiers, so the roles are billed only where the payer reimburses them.
How long does it take to switch our billing to MedPlus RCM?
Onboarding takes between 2 and 4 weeks depending on practice size, including data migration and payer clearinghouse setup.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.

Get a free financial audit

Find out where your general surgery practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
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