CPT 60225 Near‑Total Thyroidectomy Reimbursement | OpenPayer

Summary & Overview

CPT 60225: Near-Total Thyroidectomy

CPT code 60225 represents a near-total thyroidectomy: surgical removal of one whole thyroid lobe and most of the other lobe, with excision of the isthmus. This procedure is clinically significant for treating bilateral thyroid disease, including large multinodular goiter, toxic multinodular disease, and certain cases of thyroid malignancy where extensive resection is indicated. Nationally, accurate coding for 60225 matters for surgical quality measurement, reimbursement consistency, and tracking utilization of definitive thyroid surgery.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus the expected service type. The publication summarizes relevant benchmarks and coding guidance where available and highlights policy considerations that affect payment and utilization without providing specific clinical recommendations. Where payer-specific coverage details, modifiers, or diagnosis mappings are not available in the input, the publication notes that those data are not provided.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 60225thyroidectomyendocrine surgerysurgical procedurehospital servicesambulatory surgeryoperative codingthyroid disease

Billing Code Overview

CPT code 60225 describes a surgical procedure that removes one entire lobe of the thyroid gland and most of the opposite lobe, including surgical excision of the isthmus that connects the two lobes. This operation is a near-total or subtotal thyroidectomy intended to treat conditions affecting both lobes of the thyroid.

Service type: Surgical thyroidectomy
Typical site of service: Hospital operating room or ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45–65-year-old adult presenting with a symptomatic thyroid nodule or multinodular goiter causing compressive symptoms (dysphagia, neck discomfort, or airway sensation), a dominant suspicious thyroid mass on ultrasound with indeterminate/follicular neoplasm cytology, or a confirmed malignancy requiring definitive surgical management. The standard workflow begins with outpatient evaluation by an endocrinologist or otolaryngologist/head and neck surgeon. Preoperative workup includes thyroid function tests (TSH, free T4), neck ultrasound with nodule characterization, fine-needle aspiration biopsy when indicated, and cross-sectional imaging if substernal extension is suspected.

Perioperative planning includes informed consent, medical clearance, and review of vocal cord function (laryngoscopy) when malignancy or prior neck surgery is present. The procedure performed is a near-total thyroidectomy: removal of one entire thyroid lobe, removal of most of the contralateral lobe, and excision of the isthmus. Typical site of service is an outpatient or inpatient operating room in a hospital or ambulatory surgical center with general anesthesia. Postoperative care includes monitoring for hemorrhage, airway compromise, hypocalcemia from potential parathyroid compromise, and vocal cord function assessment; discharge timing varies from same day (ambulatory) to overnight observation depending on clinical factors.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)

CPT 60252: Total or Subtotal Thyroidectomy with Limited Neck Dissection

CPT-60271-THYROIDECTOMY-SUBSTERNAL-EXTENSION

CPT 60271: Thyroidectomy with Substernal Extension

CPT-60220-THYROID-LOBECTOMY-UNILATERAL

CPT 60220: Unilateral Thyroid Lobectomy

CPT-60210-THYROID-PARTIAL-LOBECTOMY-ISTHMUS-OPTIONAL

CPT 60210: Partial Thyroid Lobectomy, Isthmus Optional

CPT-60281-SISTRUNK-PROCEDURE-THYROGLOSSAL-DUCT-CYST-EXCISION

CPT 60281: Sistrunk Procedure for Thyroglossal Duct Cyst Excision

CPT-60260-COMPLETION-THYROIDECTOMY-REMOVAL-REMAINING-THYROID

CPT 60260: Completion Thyroidectomy, Removal of Remaining Thyroid

CPT-60100-THYROID-CORE-NEEDLE-BIOPSY-IMAGE-GUIDED

CPT 60100: Image-Guided Thyroid Core Needle Biopsy

CPT-60280-THYROGLOSSAL-DUCT-CYST-EXCISION

CPT 60280: Excision of Thyroglossal Duct Cyst

CPT-60240-TOTAL-THYROIDECTOMY

CPT 60240: Total Thyroidectomy

CPT-60254-TOTAL-OR-NEAR-TOTAL-THYROIDECTOMY-WITH-NECK-DISSECTION

CPT 60254: Total or Near-Total Thyroidectomy with Neck Dissection

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Taxonomy Code	Specialty	Notes
2080S0004X	Otolaryngology (ENT)	Head and neck surgeons commonly perform thyroidectomies.
2080P0206X	General Surgery	General surgeons with endocrine surgery training perform thyroid resections.
207L00000X	Endocrine Surgery	Surgeons specializing in endocrine procedures manage complex thyroid disease.
207RC0000X	Surgical Oncology	Surgical oncologists perform thyroid surgery when malignancy is present.
207RA0000X	Head and Neck Surgery	Specialists focusing on neck malignancies and reconstruction.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E04.0`	Nontoxic single thyroid nodule	Common indication when a dominant nodule causes symptoms or has indeterminate cytology.
`E04.1`	Nontoxic multinodular goiter	Indication for near-total thyroidectomy for symptomatic or enlarging multinodular disease.
`C73`	Malignant neoplasm of thyroid gland	Definitive surgical management for primary thyroid cancer often requires near-total thyroidectomy.
`E01.0`	Iodine-deficiency goiter	Less common in developed countries but may present with large goiter requiring resection.
`E05.90`	Thyrotoxicosis, unspecified, without thyrotoxic crisis	Hyperthyroid disease refractory to medical therapy or with obstructive symptoms may lead to surgical intervention.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`60220`	Subtotal thyroidectomy, unilateral, with or without isthmusectomy; for smaller unilateral resections	May be used when only one lobe and isthmus are removed rather than near-total bilateral resection.
`60240`	Thyroid lobectomy, unilateral, with isthmusectomy; for removal of a single lobe	Performed when disease is limited to one lobe and contralateral thyroid is left intact.
`60500`	Tracheostomy, temporary, less than 29 days	Rarely required emergently for airway compromise post-thyroidectomy; listed as potential perioperative airway procedure.
`60520`	Tracheostomy, permanent, 29 days or more	Applicable if long-term airway management becomes necessary after complications.
`76942`	Ultrasonic guidance for needle biopsy	Used preoperatively for fine-needle aspiration of thyroid nodules under ultrasound guidance.
`76536`	Ultrasound, soft tissues of head and neck (eg, thyroid)	Preoperative diagnostic imaging commonly performed to characterize nodules and guide management.

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