Summary & Overview
CPT 60254: Total or Near-Total Thyroidectomy with Neck Dissection
Headline: CPT code 60254 captures total or near-total thyroidectomy combined with extensive neck dissection for removal of malignant lymph nodes.
Lead: CPT code 60254 represents a high-acuity head and neck surgical procedure — removal of the entire or most of the thyroid gland, including the isthmus, performed with comprehensive neck dissection to address malignant lymph nodes. This code matters nationally because it denotes major surgical care with implications for hospital resources, perioperative risk, and payer coverage policies.
Key payers covered: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Overview: This publication explains the clinical scope and billing context for CPT code 60254, and summarizes what readers will learn. Key elements include: benchmark payment considerations and common billing modifiers (listed separately), typical sites of service and clinical indications, and how this code is used in claims for major thyroid cancer surgery. The report outlines operational considerations for coding and documentation, clarifies where to expect inpatient versus outpatient billing, and highlights common scenarios that trigger use of CPT code 60254. Data not available in the input for payer-specific rates, associated taxonomies, ICD-10 pairings, and related service-line items are noted as unavailable. The summary is intended for clinicians, billing professionals, and policy analysts seeking a concise national view of this high-acuity surgical code.
Billing Code Overview
CPT code 60254 describes a surgical procedure that removes the entire thyroid gland (total thyroidectomy) or most of the thyroid (near-total thyroidectomy), including the isthmus. The procedure also includes an extensive neck dissection to remove neck structures and malignant lymph nodes when indicated.
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Service type: Major head and neck surgical procedure involving thyroidectomy with comprehensive neck dissection
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Typical site of service: Hospital inpatient or outpatient surgical center, depending on clinical complexity and extent of neck dissection
Clinical & Coding Specifications
Clinical Context
A typical patient is a 52-year-old female presenting with a palpable thyroid mass, hoarseness, and cervical lymphadenopathy. Diagnostic workup includes ultrasound of the neck showing a dominant thyroid nodule with suspicious features, fine-needle aspiration cytology consistent with papillary thyroid carcinoma, and cross-sectional imaging demonstrating metastatic cervical nodes. The multidisciplinary team (endocrine surgery, otolaryngology–head & neck surgery, medical oncology) reviews staging and recommends surgical management. The operative plan is 60254: total thyroidectomy with comprehensive neck dissection to remove involved lymph node basins. Preoperative workflow includes informed consent, cessation of anticoagulants per protocol, baseline labs (CBC, coagulation, TSH), anesthetic evaluation, and localization imaging. Intraoperative steps include general anesthesia, collar incision, careful dissection of the thyroid lobes and isthmus to remove essentially all thyroid tissue, identification and preservation of recurrent laryngeal nerves and parathyroid glands if possible, and formal neck dissection with removal of malignant lymph node levels as indicated. Postoperative workflow includes airway monitoring in PACU, calcium and PTH surveillance, vocal cord assessment, pain control, wound care, and coordination of adjuvant therapy (radioactive iodine or external beam radiation) as indicated. Documentation should clearly state extent of thyroid resection, neck dissection levels, laterality, pathological findings, and any intraoperative complications.
Coding Specifications
| Modifier | Description | When to Use |
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