Dermatology · Illinois

Dermatology commercial reimbursement in Illinois

How Illinois dermatology rates compare with the national market.

Dermatology in Illinois

44 codes · 114 sampled providers
Index vs national
106
6% above
Rank among states
20 of 50
1 = highest
Codes above national
38 of 44
median code at 106%
Providers
114
sampled

What the data shows

1

Dermatology ranks 20th of 50 states in Illinois with an index of 106 (100 = the specialty's national median), across 44 codes and 114 sampled providers.

2

Of the 44 dermatology codes with enough data in Illinois, 38 pay above the national median and 6 below; the typical code sits at 106% of the national median.

3

Largest premium over the national median: CPT 93000 (Electrocardiogram complete) at 130%; largest discount: CPT 88312 (Special stains group 1) at 78%.

4

Measured against Medicare, Illinois dermatology rates have a median of 101% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeIllinoisNationalGapProv.
93000
Electrocardiogram complete
$28$21+30%113
96574
Dbrdmt prmlg les w/pdt
$364$315+16%113
99215
Office o/p est hi 40 min
$172$155+11%113
14040
Tis trnfr f/c/c/m/n/a/g/h/f
$888$800+11%113
14060
Tis trnfr e/n/e/l 10 sq cm/<
$924$835+11%113

Lowest vs national

CodeIllinoisNationalGapProv.
88312
Special stains group 1
$75$96-22%113
77280
Ther rad simulaj field smpl
$266$302-12%113
88342
Imhchem/imcytchm 1st antb
$86$95-10%113
11102
Tangntl bx skin single les
$62$65-4%113
99202
Office o/p new sf 15 min
$69$70-1%113

All dermatology codes in Illinois

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeIllinoisNationalGap% of MedicareProvidersTINsLevel
CPT 93000
Electrocardiogram complete
$28$21+30%180%113225
CPT 96574
Dbrdmt prmlg les w/pdt
$364$315+16%137%113226
CPT 99215
Office o/p est hi 40 min
$172$155+11%89%113228
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$888$800+11%116%113227
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$924$835+11%120%113229
CPT 17000
Destruct premalg lesion
$76$69+10%114%113229
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$1,183$1,078+10%118%113225
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$137$125+10%119%113225
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$1,085$991+10%117%113226
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$292$267+9%106%113229
CPT 20610
Drain/inj joint/bursa w/o us
$76$70+8%110%113226
CPT 14301
Tis trnfr any 30.1-60 sq cm
$1,250$1,155+8%112%113227
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$1,161$1,074+8%116%113225
CPT 99214
Office o/p est mod 30 min
$119$110+8%88%113230
CPT 17313
Mohs 1 stage t/a/l
$553$515+7%215%113226
CPT 99205
Office o/p new hi 60 min
$227$211+7%96%113228
CPT 99213
Office o/p est low 20 min
$81$76+7%85%113230
CPT 17311
Mohs 1 stage h/n/hf/g
$615$577+7%214%113227
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$308$289+6%99%113228
CPT 11302
Shave skin lesion 1.1-2.0 cm
$104$98+6%216%113229
CPT 17111
Destruction b9 lesions 15/>
$128$120+6%98%113229
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$242$228+6%101%113229
CPT 17110
Destruction b9 les up to 14
$108$101+6%97%113230
CPT 17004
Destroy premal lesions 15/>
$162$154+5%100%113229
CPT 99212
Office o/p est sf 10 min
$46$44+5%78%113230
CPT 99203
Office o/p new low 30 min
$110$106+4%94%113230
CPT 88305
Tissue exam by pathologist
$71$68+4%102%114230
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$488$470+4%106%113229
CPT 11301
Shave skin lesion 0.6-1.0 cm
$88$85+4%210%113229
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$517$498+4%105%113228
CPT 99204
Office o/p new mod 45 min
$169$163+4%95%113230
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$291$280+4%97%113229
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$295$285+3%97%113227
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$200$195+3%100%113225
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$134$132+2%93%113229
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$405$398+2%97%113229
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$166$163+2%95%113227
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$374$374+0%96%113228
CPT 11104
Punch bx skin single lesion
$80$81-1%211%113227
CPT 99202
Office o/p new sf 15 min
$69$70-1%92%113230
CPT 11102
Tangntl bx skin single les
$62$65-4%208%113227
CPT 88342
Imhchem/imcytchm 1st antb
$86$95-10%78%113228
CPT 77280
Ther rad simulaj field smpl
$266$302-12%99%113226
CPT 88312
Special stains group 1
$75$96-22%68%113227

Frequently asked questions

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

Illinois ranks 20th of 50 states with an index of 106; 38 of 44 codes are above the national median.

Which dermatology code has the biggest premium in Illinois?

CPT 93000 (Electrocardiogram complete), at 130% 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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