Dermatology · California

Dermatology commercial reimbursement in California

How California dermatology rates compare with the national market.

Dermatology in California

44 codes · 98 sampled providers
Index vs national
92
8% below
Rank among states
35 of 50
1 = highest
Codes above national
12 of 44
median code at 93%
Providers
98
sampled

What the data shows

1

Dermatology ranks 35th of 50 states in California with an index of 92 (100 = the specialty's national median), across 44 codes and 98 sampled providers.

2

Of the 44 dermatology codes with enough data in California, 12 pay above the national median and 32 below; the typical code sits at 93% of the national median.

3

Largest premium over the national median: CPT 88305 (Tissue exam by pathologist) at 141%; largest discount: CPT 77280 (Ther rad simulaj field smpl) at 83%.

4

Measured against Medicare, California dermatology rates have a median of 93% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeCaliforniaNationalGapProv.
88305
Tissue exam by pathologist
$96$68+41%97
11104
Punch bx skin single lesion
$96$81+19%97
11102
Tangntl bx skin single les
$77$65+18%97
93000
Electrocardiogram complete
$25$21+16%97
99202
Office o/p new sf 15 min
$77$70+11%98

Lowest vs national

CodeCaliforniaNationalGapProv.
77280
Ther rad simulaj field smpl
$249$302-17%98
96910
Photchmtx tar&uvb/ptrltm&uvb
$106$125-15%98
17313
Mohs 1 stage t/a/l
$441$515-14%97
17311
Mohs 1 stage h/n/hf/g
$500$577-13%97
12042
Intmd rpr n-hf/genit2.6-7.5
$248$285-13%98

All dermatology codes in California

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeCaliforniaNationalGap% of MedicareProvidersTINsLevel
CPT 88305
Tissue exam by pathologist
$96$68+41%137%97348
CPT 11104
Punch bx skin single lesion
$96$81+19%253%97347
CPT 11102
Tangntl bx skin single les
$77$65+18%255%97347
CPT 93000
Electrocardiogram complete
$25$21+17%162%97346
CPT 99202
Office o/p new sf 15 min
$77$70+11%103%98348
CPT 99212
Office o/p est sf 10 min
$47$44+5%78%98348
CPT 88342
Imhchem/imcytchm 1st antb
$100$95+5%91%97348
CPT 88312
Special stains group 1
$100$96+4%91%97347
CPT 99203
Office o/p new low 30 min
$109$106+3%93%98348
CPT 99204
Office o/p new mod 45 min
$167$163+3%94%98348
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$480$470+2%104%98349
CPT 99213
Office o/p est low 20 min
$77$76+2%81%98348
CPT 17110
Destruction b9 les up to 14
$100$101-1%90%98349
CPT 99214
Office o/p est mod 30 min
$107$110-3%79%98348
CPT 17000
Destruct premalg lesion
$67$69-3%101%98349
CPT 11301
Shave skin lesion 0.6-1.0 cm
$81$85-5%194%97347
CPT 17004
Destroy premal lesions 15/>
$147$154-5%90%98349
CPT 99205
Office o/p new hi 60 min
$202$211-5%85%98347
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$466$498-6%95%98349
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$370$398-7%89%98349
CPT 96574
Dbrdmt prmlg les w/pdt
$293$315-7%110%98349
CPT 17111
Destruction b9 lesions 15/>
$111$120-7%86%98349
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$150$163-8%87%98349
CPT 11302
Shave skin lesion 1.1-2.0 cm
$91$98-8%187%97347
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$344$374-8%88%98349
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$257$280-8%86%98349
CPT 14301
Tis trnfr any 30.1-60 sq cm
$1,057$1,155-9%94%98349
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$209$228-9%87%98349
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$905$991-9%98%98349
CPT 20610
Drain/inj joint/bursa w/o us
$64$70-9%92%97345
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$120$132-9%83%98349
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$177$195-9%88%98346
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$262$289-10%84%98349
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$970$1,074-10%97%98349
CPT 99215
Office o/p est hi 40 min
$139$155-10%72%98348
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$751$835-10%97%98349
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$718$800-10%94%98349
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$237$267-11%86%98349
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$958$1,078-11%96%98349
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$248$285-13%81%98349
CPT 17311
Mohs 1 stage h/n/hf/g
$500$577-13%174%97347
CPT 17313
Mohs 1 stage t/a/l
$441$515-14%171%97347
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$106$125-15%93%98349
CPT 77280
Ther rad simulaj field smpl
$249$302-17%93%98348

Frequently asked questions

How do California dermatology rates compare with the rest of the country?

California ranks 35th of 50 states with an index of 92; 12 of 44 codes are above the national median.

Which dermatology code has the biggest premium in California?

CPT 88305 (Tissue exam by pathologist), at 141% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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