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Synthesis and Regulation of Thyroid Hormones

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...

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Updated: Jan 6, 2026

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

Published on: September 20, 2024

Reimbursement for Thyroid Surgery and Potential Solutions.

Philip R Brauer¹, David Octeau¹, Benjamin Wajsberg¹

¹Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio.

JAMA Otolaryngology-- Head & Neck Surgery

|October 16, 2025

Summary

This summary is machine-generated.

Medicare reimbursement for thyroid surgery has significantly declined by nearly 40% since 2000, impacting total thyroidectomy rates the most. These unsustainable trends necessitate proactive measures to ensure patient access to thyroid surgical care.

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Area of Science:

Health Economics
Surgical Reimbursement Analysis
Medicare Policy

Background:

Medicare payment models are undergoing reform discussions, highlighted by a 2024 US Senate Committee on Finance white paper.
Understanding historical reimbursement trends is crucial for informing future Medicare payment reforms.

Purpose of the Study:

To analyze trends in Medicare reimbursement for thyroid surgery from 2000 to 2023.
To provide economic evidence for ongoing Medicare payment reform discussions.

Main Methods:

Retrospective economic evaluation using Centers for Medicare & Medicaid Services' Physician Fee Schedule data (2000-2023).
Reimbursement data adjusted for inflation to 2023 US dollars.
Analysis of national average reimbursement, compound annual growth rate, and Pearson correlation coefficient.

Main Results:

Medicare reimbursement for thyroid surgery decreased by 38.7% ($1517.59 to $929.55) after inflation adjustment.
Total thyroidectomy reimbursement saw the largest decline (47.8%, $1803.16 to $942.07).
Compound annual growth rate adjusted for inflation was -2.1%, with zero growth in work relative value units from 2012-2023.

Conclusions:

A significant decrease in thyroid surgery reimbursement rates, particularly for total thyroidectomy, indicates unsustainable trends.
Current reimbursement trends may impact patient access to essential thyroid surgical procedures.
Thyroid surgeons should proactively address reimbursement challenges to maintain access to care.