CPT 60281: Duct lesion excisionMedicare rate & RVUs in Washington
Sistrunk-type removal of a thyroglossal duct cyst or sinus, including the central hyoid segment, is reported for congenital midline neck lesions.
CMS doesn’t publish an office rate for 60281 in Washington.
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 9 sections
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 in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $529.46 |
| Seattle (King Cnty) | Unavailable | $576.56 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.82/0.09 | Share 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.
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%).
60281 compared with similar codes
Compare codes
60281 vs 60280 vs 60200 vs 60210: national Medicare rates
Swap in your local Medicare rate.
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.
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
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