Issue #8Specialty Billing 6 min read
Orthopedic & Surgical Billing Optimization: Bundled Payment Strategies
Managing major joint replacement coding, global surgical package rules, and Assistant Surgeon modifier compliance.
Dr. Amanda Vance, CPC, CPMA
Chief Medical Coding Officer
Published March 2026
Executive Summary & Key Highlights
- Global surgery package 90-day post-op billing rules
- Modifier 80, 81, and 82 assistant surgeon documentation
- Durable Medical Equipment (DME) orthopedic supply billing
90 Days
Global Surgical Period Window
Routine post-op care cannot be billed separately during this window without specific surgical modifiers.
1. Post-Operative Billing Boundaries
Routine post-op care within a 90-day global period cannot be billed separately. However, treatment of complications requiring a return to the operating room must be billed with Modifier 78.
Actionable Practice Implementation Checklist
1
Verify post-operative visit documentation during the 90-day global period to append Modifier 78 if re-operation occurs2
Document medical necessity for assistant surgeons upfront to append Modifier 80 accurately3
Separate DME supply billing from surgical facility fees to ensure proper insurance processingNever Miss a Healthcare RCM Update
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Dr. Amanda Vance, CPC, CPMA
Chief Medical Coding Officer
Specialist in healthcare billing compliance, ICD-10 coding audits, and commercial payer dispute resolutions.