2013 Thyroidectomy Reimbursement Fact Sheet
SURGEON
CPT CODE1
60210
60212
60220
60225
60240
60252
60254
60260
60270
60271
60500
PROCEDURE
Partial thyroid lobectomy, unilateral; with or without isthmusectomy
Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy
Total thyroid lobectomy, unilateral; with or without isthmusectomy Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy
Thyroidectomy, total or complete
Thyroidectomy, total or subtotal for malignancy; with limited neck dissection
Thyroidectomy, total or subtotal for malignancy; with radical neck dissection Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid
Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach
Thyroidectomy, including substernal thyroid; cervical approach
Parathyroidectomy or exploration of parathyroid
APC
0114
0256
OUTPATIENT FACILITY
Hospital Outpatient Department
APC DESCRIPTION
Thyroid/Lymphadenectomy Procedures (CPT codes: 60210, 60212, 60220, 60225, 60240)
Level IV ENT Procedures (CPT codes: 60252, 60260, 60500, 60271)
Freestanding Ambulatory Surgery Center
CPT CODE
60210
60212
60220
60225
DESCRIPTION
Partial thyroid lobectomy, unilateral; with or without isthmusectomy
Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy
Total thyroid lobectomy, unilateral; with or without isthmusectomy Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy
NATIONAL AVERAGE MEDICARE PAYMENT2
$718
1,021
718
944
930
1,332
1,684
1,103
1,384
1,067
976
INPATIENT FACILITY
ICD-9 CODE4DESCRIPTION
06.2
Lobectomy, unilateral, thyroid
06.39
Thyroidectomy, other, partial
06.4
Thyroidectomy, complete
06.50
Thyroidectomy, substernal, not otherwise specified
06.51
Partial substernal thyroidectomy
06.52
Complete substernal thyroidectomy
NOTE: ICD-9 codes are grouped into Diagnoses Related Groups (DRGs) for Medicare reimbursement using a patient’s diagnoses, procedures performed, age, sex and discharge status.
One DRG is assigned to each inpatient stay.
MEDICARE PAYMENT3
$3,671
3,279
MEDICARE PAYMENT4
$2,060
2,060
2,060
2,060
DRG
625
626
627
DESCRIPTION
AVERAGE LENGTH OF STAY (DAYS)5
NATIONAL AVERAGE DRG PAYMENT5
Thyroid, parathyroid & thyroglossal procedures with MCC
6.8
$13,631
Thyroid, parathyroid & thyroglossal procedures with CC
2.9
7,023
Thyroid, parathyroid & thyroglossal procedures without CC/MCC
1.4
4,745
1 All Current Procedural Terminology (CPT) five-digit numeric codes, descriptions, numeric modifiers, instructions, guidelines, and other material are copyright 2013 American Medical Association. All Rights Reserved.
2 Federal Register, Vol. 77, No. 222, Friday, November 16, 2012/ Rules and Regulations. The 2013 Final Rule Physician Reimbursement Conversion Factor = $34.0230.
3 Federal Register, Vol. 77, No. 221, Thursday, November 15, 2012/ Rules and Regulations; Final Hospital Outpatient Payment.
4 Hospital ICD-9-CM 2010 Volumes 1, 2 & 3, 9th Revision-Clinical Modification, American Medical Association. Copyright © 2013 Saunders, an imprint of Elsevier, Inc.
5 Federal Register, Vol. 77, No. 170, Friday, August 31, 2012/ Rules and Regulations; Final National Average DRG Payment.
Physicians should refer to their provider Carrier Manual for their geographic payments.
The information contained in this document is provided for informational purposes only and represents no statement, promise, or guarantee by Ethicon concerning levels of reimbursement, payment, or charge. Similarly, all CPT, ICD-9 and HCPCS codes
are supplied for informational purposes only and represent no statement, promise, or guarantee by Ethicon that these codes will be appropriate or that reimbursement will be made. It is not intended to increase or maximize reimbursement by any payor.
CPT codes and descriptions are copyright 2013 American Medical Association. ICD-9 codes and descriptions are copyright 2013 World Health Organization’s Ninth Revision, International Classification of Diseases. HCPCS Level II codes and descriptions
are copyright 2013 the Centers for Medicare and Medicaid Services Healthcare Common Procedure Coding System. While we have made an effort to provide information that is current at the time of its issue, the information may not be as current or
comprehensive when you view it. We strongly recommend that you consult your counsel, reimbursement specialist or payor organization with regard to reimbursement policies.
Ethicon Reimbursement Support Program - (888) 750-1242 www.ethicon.com
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