Summary & Overview
CPT 60280: Excision of Thyroglossal Duct Cyst
CPT code 60280 denotes surgical excision of a thyroglossal duct cyst, a congenital midline neck lesion arising from residual thyroglossal duct tissue. The procedure is clinically important because removal prevents recurrent infection and addresses the small but present risk of malignancy within the cyst. Nationally, this code maps to definitive management of a well-defined surgical condition and is commonly billed when patients undergo operative excision in ambulatory surgical centers or hospital operating rooms.
Key payers covered in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context, typical sites of service, and common billing considerations tied to the procedure. The publication outlines available benchmarks where present and notes areas where input data are not available. It also provides a concise summary of the procedural indication, expected care setting, and common documentation elements that support billing for excision of a thyroglossal duct cyst.
This summary is intended to orient clinicians, billing professionals, and policy audiences to the clinical purpose of CPT code 60280, the primary payer landscape in national analyses, and the types of operational and coding topics that follow in the full publication. Data not available in the input are explicitly noted in detailed sections.
Billing Code Overview
CPT code 60280 describes the surgical removal of a thyroglossal duct cyst, a congenital midline neck cyst that persists when a segment of the thyroglossal duct fails to involute during embryonic development. The procedure is performed to prevent infection, reduce the risk of recurrence, and address potential malignancy within the cyst.
Service type: Surgical excision of congenital neck cyst
Typical site of service: Ambulatory surgical center or hospital operating room, with the procedure performed by a surgeon experienced in head and neck surgery.
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient presents with a palpable, midline cervical mass that moves with tongue protrusion and swallowing. The mass has episodically become tender and inflamed, consistent with recurrent infection of a thyroglossal duct cyst. Ultrasound confirms a well-defined cystic lesion immediately inferior to the hyoid bone without suspicious intralesional vascularity. Thyroid function tests are normal and a radionuclide scan shows normally functioning orthotopic thyroid tissue. The clinical workflow includes preoperative evaluation (history, neck exam, imaging), informed consent for a Sistrunk procedure (CPT 60280) to remove the cyst and the central portion of the hyoid bone to reduce recurrence risk, perioperative anesthesia assessment, intraoperative removal of the cyst with excision of the tract to the foramen cecum, specimen submission to pathology, and routine postoperative follow-up for wound check and assessment for complications such as infection, seroma, hemorrhage, or recurrent fistula formation. Typical site of service is an ambulatory surgery center or hospital outpatient department; inpatient admission is uncommon but may occur for complex infections or comorbid conditions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use if a significant E/M is documented and performed on the same day as (note: was not in the raw modifier list; do not include if adhering strictly to provided list). |