Dermatology · Kentucky

Dermatology commercial reimbursement in Kentucky

How Kentucky dermatology rates compare with the national market.

Dermatology in Kentucky

44 codes · 112 sampled providers
Index vs national
85
15% below
Rank among states
41 of 50
1 = highest
Codes above national
1 of 44
median code at 85%
Providers
112
sampled

What the data shows

1

Dermatology ranks 41st of 50 states in Kentucky with an index of 85 (100 = the specialty's national median), across 44 codes and 112 sampled providers.

2

Of the 44 dermatology codes with enough data in Kentucky, 1 pay above the national median and 43 below; the typical code sits at 85% of the national median.

3

Largest premium over the national median: CPT 88305 (Tissue exam by pathologist) at 107%; largest discount: CPT 96574 (Dbrdmt prmlg les w/pdt) at 78%.

4

Measured against Medicare, Kentucky dermatology rates have a median of 86% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeKentuckyNationalGapProv.
88305
Tissue exam by pathologist
$73$68+7%112
17004
Destroy premal lesions 15/>
$149$154-3%112
17313
Mohs 1 stage t/a/l
$480$515-7%112
20610
Drain/inj joint/bursa w/o us
$64$70-8%112
17311
Mohs 1 stage h/n/hf/g
$527$577-9%112

Lowest vs national

CodeKentuckyNationalGapProv.
96574
Dbrdmt prmlg les w/pdt
$247$315-22%112
77280
Ther rad simulaj field smpl
$239$302-21%112
15260
Fth/gft fr n/e/e/l 20 sqcm/<
$860$1,078-20%112
11102
Tangntl bx skin single les
$52$65-20%112
12052
Intmd rpr face/mm 2.6-5.0 cm
$234$289-19%112

All dermatology codes in Kentucky

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeKentuckyNationalGap% of MedicareProvidersTINsLevel
CPT 88305
Tissue exam by pathologist
$73$68+7%104%112187
CPT 17004
Destroy premal lesions 15/>
$149$154-3%92%112190
CPT 17313
Mohs 1 stage t/a/l
$480$515-7%187%112187
CPT 20610
Drain/inj joint/bursa w/o us
$64$70-8%93%112188
CPT 17311
Mohs 1 stage h/n/hf/g
$527$577-9%184%112188
CPT 17000
Destruct premalg lesion
$62$69-10%93%112189
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$447$498-10%91%112188
CPT 93000
Electrocardiogram complete
$19$21-11%124%112187
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$355$398-11%85%112189
CPT 99202
Office o/p new sf 15 min
$62$70-11%82%112190
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$414$470-12%90%112189
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$143$163-12%82%112189
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$328$374-12%84%112189
CPT 11301
Shave skin lesion 0.6-1.0 cm
$74$85-13%177%112190
CPT 11302
Shave skin lesion 1.1-2.0 cm
$85$98-13%176%112189
CPT 88342
Imhchem/imcytchm 1st antb
$83$95-13%75%112186
CPT 11104
Punch bx skin single lesion
$70$81-13%184%112188
CPT 99203
Office o/p new low 30 min
$91$106-14%77%112190
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$715$835-14%93%112188
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$847$991-15%91%112188
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$195$228-15%81%112189
CPT 88312
Special stains group 1
$82$96-15%75%112186
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$112$132-15%78%112189
CPT 17110
Destruction b9 les up to 14
$86$101-16%77%112188
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$236$280-16%79%112188
CPT 14301
Tis trnfr any 30.1-60 sq cm
$969$1,155-16%86%112187
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$899$1,074-16%90%112189
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$163$195-16%81%112188
CPT 99215
Office o/p est hi 40 min
$129$155-17%67%112189
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$667$800-17%87%112188
CPT 99214
Office o/p est mod 30 min
$92$110-17%68%112190
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$237$285-17%78%112188
CPT 99204
Office o/p new mod 45 min
$135$163-17%76%112190
CPT 99212
Office o/p est sf 10 min
$37$44-17%62%112190
CPT 99213
Office o/p est low 20 min
$63$76-17%66%112190
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$220$267-17%80%112188
CPT 17111
Destruction b9 lesions 15/>
$98$120-18%76%112188
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$102$125-18%89%112188
CPT 99205
Office o/p new hi 60 min
$172$211-18%73%112189
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$234$289-19%75%112189
CPT 11102
Tangntl bx skin single les
$52$65-20%173%112189
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$860$1,078-20%86%112188
CPT 77280
Ther rad simulaj field smpl
$239$302-21%89%112185
CPT 96574
Dbrdmt prmlg les w/pdt
$247$315-22%93%112187

Frequently asked questions

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

Kentucky ranks 41st of 50 states with an index of 85; 1 of 44 codes are above the national median.

Which dermatology code has the biggest premium in Kentucky?

CPT 88305 (Tissue exam by pathologist), at 107% 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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