General surgery billing
General surgery billing services
We handle billing for general surgeons and surgical groups, from consults and office procedures to hospital and ASC surgery and the global period that follows. Claims go out within 24 hours of receiving charges, every denial is worked within 5 business days, and pricing starts at 2.5% of collections.
- Global period tracking for 0, 10 and 90-day procedures
- Surgical modifiers (57, 58, 78, 79, 24, 51, 80) applied correctly
- Prior authorizations checked before elective cases
Why general surgery billing is different
Surgical billing is about the global period
Most surgical payments cover a package: the procedure plus related care before and after it. Knowing what falls inside that package, and what does not, is where surgeons win or lose revenue.
Global surgical package
Major procedures usually carry a 90-day global period and minor procedures 0 or 10 days. Routine follow-up inside that window is not paid separately and is often reported with 99024 for tracking.
Decision for surgery
An E/M the day before or the day of a major surgery is part of the package unless it is the visit where the decision to operate was made. That visit is billed with modifier 57.
Returns and new problems
Care during the global period needs the right modifier: 58 for a planned or staged procedure, 78 for an unplanned return to the OR for a related problem, 79 for an unrelated procedure, and 24 for an unrelated office visit.
Multiple procedures
When several procedures are done in one session, payers usually pay the highest-valued one in full and reduce the others. Modifier 51 and correct sequencing make sure the reductions are applied the right way.
Assistants and co-surgeons
Assistant at surgery (80, 82 or AS for non-physicians) and co-surgery (62) are paid only for certain procedures. We check the payer’s list before billing so the claim is not denied outright.
Hernia repair codes
Anterior abdominal hernia repairs are coded by approach, total defect size, whether the hernia is reducible or incarcerated, and whether it is recurrent. Mesh is included in these codes, so it is not billed separately.
Common codes
General surgery codes we review on every claim
| Code(s) | What it is | What we watch for |
|---|---|---|
| 47562 / 47563 | Laparoscopic cholecystectomy / with cholangiography | Cholangiography documented when 47563 is billed |
| 44970 | Laparoscopic appendectomy | Global period and any related return to the OR (modifier 78) |
| 49591–49618 | Anterior abdominal hernia repair, by approach, size and type | Defect size and reducible vs incarcerated status in the op note |
| 49650 / 49505 | Inguinal hernia repair, laparoscopic / open | Initial vs recurrent and modifier 50 or RT/LT for bilateral cases |
| 19301 / 19303 | Partial and total mastectomy | Laterality and separately billable lymph node procedures |
| 99202–99215 with 57 or 24 | Office visits linked to surgery | Decision-for-surgery vs unrelated visits inside the global period |
| 99024 | Post-op follow-up included in the global package | Tracked at no charge so global visits are not billed by mistake |
Codes and rules change. We check current CPT guidance and each payer’s policy before submission.
Common denials we prevent
Surgical denials we stop before they happen
Surgical denials usually come from global period conflicts, missing modifiers and missing authorizations. We check all three before the claim goes out.
- Office visits inside the global period billed without modifier 24 or 57
- Return trips to the OR billed without modifier 58, 78 or 79
- Multiple procedures sequenced so the highest-paying one is reduced
- Assistant surgeon claims for procedures the payer does not pay assistants for
- Elective surgery performed without a required prior authorization
- Bilateral procedures billed with the wrong modifier or unit count for that payer
What we handle
Everything between the operating room and the payment
- Insurance eligibility and benefits checks before consults and surgery
- Charge entry and coding review of op notes, modifiers and global periods
- Claim submission within 24 hours of receiving charges
- Payment posting and ERA reconciliation
- Denial correction, resubmission and appeals within 5 business days
- A/R follow-up on unpaid and underpaid claims
- Commercial, Medicare and Medicaid credentialing, plus hospital and ASC location enrollment
- Patient statements and balance tracking
- Monthly reporting on collections, denials and A/R
Pricing
Clear pricing for surgical practices
Billing starts at 2.5% of collections, or a flat monthly fee. There is no setup fee and no long-term contract. Credentialing starts at $80 per payer, and 5 commercial payers are credentialed free when you sign up for billing.
Common questions
When do you use modifier 57?
On the E/M visit where the decision to perform a major surgery was made, when that visit falls on the day before or the day of surgery. Without it, most payers treat the visit as part of the global package.
How do you bill a return to the OR during the global period?
It depends on why. A planned or staged procedure uses modifier 58, an unplanned related return uses 78, and an unrelated procedure uses 79. The op note needs to support the choice.
Do you track global periods so we do not bill follow-up visits by mistake?
Yes. We track each procedure’s global period and report routine follow-up with 99024 at no charge, while billing unrelated visits with modifier 24 when the note supports it.
Do you bill for assistant surgeons?
Yes, when the payer allows an assistant for that procedure. We use modifier 80 or 82 for physicians and AS for PAs and NPs, and we check the payer’s list before submission.
Do you handle prior authorizations for elective surgery?
We check whether an authorization is required and whether one is on file before the claim goes out. We can also help your team request authorizations as part of a dedicated staff arrangement.
Is general surgery your main specialty?
No. Our core focus is behavioral health, and we bill general surgery and other specialties with the same team, the same promises and CPB-certified billers on the team.
Find out what your claims are leaving on the table
Tell us about your practice. We will review 90 days of claims and show you what is recoverable, at no cost.
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