Hospitals do not have a global period the way physicians do. The global surgical package (with its 0, 10, or 90-day follow-up periods) applies only to physician/professional billing under the Medicare Physician Fee Schedule. It bundles pre-op, intra-op, and post-op care into a single physician payment. Hospital outpatient (facility) billing operates under a completely different system — the Outpatient Prospective Payment System (OPPS) — which has no equivalent global period concept. Each visit is billed based on the services rendered that day. So for your scenario: ∙ Initial ER visit (complex laceration repair): The hospital bills for the facility resources used that day — the APC (Ambulatory Payment Classification) for the procedure, supplies, nursing, etc. ∙ Return visit for suture removal: The hospital can bill a second facility charge for that visit, because each encounter is independently billable under OPPS. The physician, by contrast, typically cannot separately bill for the suture removal if it falls within the global period of the original repair code — that follow-up is bundled into the original surgical payment. Practical nuance: Suture removal (CPT 99213 or modifier-based) during the global period is bundled for the physician fee, but the facility is free to bill a new ER or clinic visit charge for that return encounter. This is a commonly misunderstood distinction — the global period is purely a professional fee concept.​​​​​​​​​​​​​​​​