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Billing code 60281: Duct lesion excisionMedicare rate & RVUs

Sistrunk-type removal of a thyroglossal duct cyst or sinus, including the central hyoid segment, is reported for congenital midline neck lesions.

CMS RVU26DEffective Oct 1, 2026109 payment localities22 Medicare services in 2024

Medicare pays $525.40 for 60281 nationally in a facility.

Medicare rate · 60281

Duct lesion excision

Swap in your local Medicare rate.

Work RVUs
8.6
Total RVUs
15.73
Global days
090

National rate · 2026

$525.40

Facility setting, before claim adjustments.

See every locality for 60281 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 60281 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 60281 covers

This operation removes a thyroglossal duct cyst or sinus and its tract along with the central portion of the hyoid bone. It is commonly performed by an otolaryngologist or head and neck surgeon for a congenital midline neck lesion, often near the hyoid; patients may be children or adults. The procedure is typically performed in an operating room, with the extent documented in the operative report.

Report this code when the duct lesion is excised with hyoid bone resection; a simple lesion excision without that step is distinguished by 60280. Documentation should identify the lesion and describe removal of the tract and central hyoid segment. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 60281 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

60281 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$482.62
Alaska*Unavailable$662.87
ArizonaUnavailable$513.26
ArkansasUnavailable$477.34
AtlantaUnavailable$537.85
AustinUnavailable$532.54
BakersfieldUnavailable$533.22
Baltimore/Surr. CntysUnavailable$554.28
BeaumontUnavailable$504.76
BrazoriaUnavailable$516.67

60281 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
60281 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 60281 rate is calculated

Each of 60281’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 60281

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.60Practice expense 5.87Malpractice 1.26

15.7300 adjusted RVUs×$33.4009 conversion factor=$525.40

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 60281

60281 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 60281

Duct lesion excision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.82/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 60281

Duct lesion excision

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

60281 without 51 · national facility

$525.40

Duct lesion excision

60281-51 · Second procedure: 50%

$262.70

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

60281 compared with similar codes

Compare codes

60281 vs 60280 vs 60200 vs 60210: national Medicare rates

Swap in your local Medicare rate.

  • 60281
    Duct lesion excision · 8.6 wRVU
    —
  • 60280
    Duct lesion excision · 6.01 wRVU
    —
  • 60200
    Thyroid surgery · 9.77 wRVU
    —
  • 60210
    Thyroid surgery · 10.95 wRVU
    —

How to choose

60280Duct lesion excision
Choose 60281 when the thyroglossal duct lesion is removed with the central hyoid segment. 60280 describes the simpler excision without that step.
60200Thyroid surgery
60200 is for a cyst or adenoma arising in the thyroid gland. 60281 is for a thyroglossal duct lesion in the midline neck.
60210Thyroid surgery
60210 describes partial removal of a thyroid lobe. It is not the code for excision of a thyroglossal duct lesion and its tract.

Codes related to 60281

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 60281
CodeHow it relatesNational office range
Same family
60280Duct lesion excisionRelated thyroglossal duct lesion excision without the hyoid resection represented by 60281.No office rate
Used instead
60200Thyroid surgeryFor excision of a thyroid cyst or adenoma rather than a thyroglossal duct lesion.No office rate
60210Thyroid surgeryFor partial thyroid lobectomy when the lesion involves thyroid tissue requiring lobe resection.No office rate

60281 billing questions

How does 60281 differ from 60280?

60281 represents removal of the thyroglossal duct lesion with the central hyoid segment. Use 60280 for the simpler excision without hyoid bone removal.

Can modifier 50 be reported for a lesion on one side?

No. The anatomy and descriptor make bilateral adjustment inappropriate for this code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What operative documentation supports 60281?

Document the thyroglossal duct lesion and the operative removal of its tract with the central hyoid segment. The operative details distinguish this service from simple lesion excision.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 60281PPRRVU2026_Oct_nonQPP.csv, line 6,709 (RVU26D)

Open CMS sourceHow we calculate rates

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