Dermatology · Massachusetts

Dermatology commercial reimbursement in Massachusetts

How Massachusetts dermatology rates compare with the national market.

Dermatology in Massachusetts

44 codes · 116 sampled providers
Index vs national
148
48% above
Rank among states
8 of 50
1 = highest
Codes above national
44 of 44
median code at 149%
Providers
116
sampled

What the data shows

1

Dermatology ranks 8th of 50 states in Massachusetts with an index of 148 (100 = the specialty's national median), across 44 codes and 116 sampled providers.

2

Of the 44 dermatology codes with enough data in Massachusetts, 44 pay above the national median and 0 below; the typical code sits at 149% of the national median.

3

Largest premium over the national median: CPT 99214 (Office o/p est mod 30 min) at 171%; largest discount: CPT 88305 (Tissue exam by pathologist) at 127%.

4

Measured against Medicare, Massachusetts dermatology rates have a median of 144% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMassachuseNationalGapProv.
99214
Office o/p est mod 30 min
$188$110+71%116
99215
Office o/p est hi 40 min
$263$155+70%116
99205
Office o/p new hi 60 min
$356$211+68%116
99204
Office o/p new mod 45 min
$261$163+60%116
99213
Office o/p est low 20 min
$122$76+60%116

Lowest vs national

CodeMassachuseNationalGapProv.
88305
Tissue exam by pathologist
$87$68+27%116
93000
Electrocardiogram complete
$28$21+32%112
20610
Drain/inj joint/bursa w/o us
$98$70+41%112
13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$664$470+41%116
14301
Tis trnfr any 30.1-60 sq cm
$1,642$1,155+42%116

All dermatology codes in Massachusetts

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMassachusettNationalGap% of MedicareProvidersTINsLevel
CPT 99214
Office o/p est mod 30 min
$188$110+71%139%116242
CPT 99215
Office o/p est hi 40 min
$263$155+70%137%116242
CPT 99205
Office o/p new hi 60 min
$356$211+68%150%116242
CPT 99204
Office o/p new mod 45 min
$261$163+61%147%116242
CPT 99213
Office o/p est low 20 min
$122$76+60%128%116242
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$196$125+57%171%116237
CPT 17000
Destruct premalg lesion
$108$69+56%163%116241
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$1,250$800+56%163%116236
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$1,296$835+55%168%116237
CPT 99212
Office o/p est sf 10 min
$69$44+55%116%116241
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$1,664$1,074+55%167%116236
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$1,522$991+54%164%116235
CPT 17111
Destruction b9 lesions 15/>
$185$120+54%142%116239
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$299$195+53%149%116236
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$1,649$1,078+53%165%116236
CPT 99203
Office o/p new low 30 min
$161$106+52%137%116242
CPT 11302
Shave skin lesion 1.1-2.0 cm
$149$98+52%308%116238
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$438$289+52%141%116240
CPT 11301
Shave skin lesion 0.6-1.0 cm
$128$85+52%307%116239
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$431$285+51%141%116239
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$424$280+51%141%116241
CPT 17110
Destruction b9 les up to 14
$152$101+49%136%116241
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$195$132+48%135%116239
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$550$374+47%141%116238
CPT 17313
Mohs 1 stage t/a/l
$756$515+47%294%116238
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$335$228+47%139%116239
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$391$267+46%142%116237
CPT 99202
Office o/p new sf 15 min
$102$70+46%135%116242
CPT 88342
Imhchem/imcytchm 1st antb
$139$95+46%126%116237
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$723$498+45%147%116237
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$236$163+45%136%116239
CPT 96574
Dbrdmt prmlg les w/pdt
$457$315+45%171%116236
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$576$398+45%138%116237
CPT 88312
Special stains group 1
$139$96+45%127%116237
CPT 17311
Mohs 1 stage h/n/hf/g
$834$577+44%291%116238
CPT 11102
Tangntl bx skin single les
$94$65+44%311%116240
CPT 77280
Ther rad simulaj field smpl
$435$302+44%161%116235
CPT 11104
Punch bx skin single lesion
$116$81+44%305%116240
CPT 17004
Destroy premal lesions 15/>
$221$154+44%136%116237
CPT 14301
Tis trnfr any 30.1-60 sq cm
$1,642$1,155+42%147%116236
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$664$470+41%144%116238
CPT 20610
Drain/inj joint/bursa w/o us
$98$70+41%142%112136
CPT 93000
Electrocardiogram complete
$28$21+32%184%112135
CPT 88305
Tissue exam by pathologist
$87$68+27%124%116239

Frequently asked questions

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

Massachusetts ranks 8th of 50 states with an index of 148; 44 of 44 codes are above the national median.

Which dermatology code has the biggest premium in Massachusetts?

CPT 99214 (Office o/p est mod 30 min), at 171% 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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