Dermatology · New Jersey

Dermatology commercial reimbursement in New Jersey

How New Jersey dermatology rates compare with the national market.

Dermatology in New Jersey

44 codes · 99 sampled providers
Index vs national
83
17% below
Rank among states
45 of 50
1 = highest
Codes above national
0 of 44
median code at 84%
Providers
99
sampled

What the data shows

1

Dermatology ranks 45th of 50 states in New Jersey with an index of 83 (100 = the specialty's national median), across 44 codes and 99 sampled providers.

2

Of the 44 dermatology codes with enough data in New Jersey, 0 pay above the national median and 44 below; the typical code sits at 84% of the national median.

3

Largest premium over the national median: CPT 99204 (Office o/p new mod 45 min) at 96%; largest discount: CPT 96910 (Photchmtx tar&uvb/ptrltm&uvb) at 76%.

4

Measured against Medicare, New Jersey dermatology rates have a median of 83% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeNew JerseyNationalGapProv.
99204
Office o/p new mod 45 min
$156$163-4%99
99205
Office o/p new hi 60 min
$199$211-6%99
88305
Tissue exam by pathologist
$64$68-6%96
77280
Ther rad simulaj field smpl
$283$302-6%99
99212
Office o/p est sf 10 min
$41$44-7%99

Lowest vs national

CodeNew JerseyNationalGapProv.
96910
Photchmtx tar&uvb/ptrltm&uvb
$95$125-24%99
15260
Fth/gft fr n/e/e/l 20 sqcm/<
$854$1,078-21%99
11301
Shave skin lesion 0.6-1.0 cm
$68$85-20%99
17004
Destroy premal lesions 15/>
$123$154-20%99
14061
Tis trnfr e/n/e/l10.1-30sqcm
$860$1,074-20%99

All dermatology codes in New Jersey

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNew JerseyNationalGap% of MedicareProvidersTINsLevel
CPT 99204
Office o/p new mod 45 min
$156$163-4%88%99225
CPT 99205
Office o/p new hi 60 min
$199$211-6%84%99224
CPT 88305
Tissue exam by pathologist
$64$68-6%91%96216
CPT 77280
Ther rad simulaj field smpl
$283$302-6%105%99220
CPT 99212
Office o/p est sf 10 min
$41$44-7%70%99224
CPT 88342
Imhchem/imcytchm 1st antb
$87$95-9%79%96216
CPT 88312
Special stains group 1
$87$96-9%80%96216
CPT 99202
Office o/p new sf 15 min
$63$70-10%83%99225
CPT 93000
Electrocardiogram complete
$19$21-10%124%99220
CPT 96574
Dbrdmt prmlg les w/pdt
$283$315-10%106%99220
CPT 99203
Office o/p new low 30 min
$94$106-11%80%99224
CPT 99215
Office o/p est hi 40 min
$135$155-13%70%99223
CPT 99213
Office o/p est low 20 min
$66$76-13%69%99224
CPT 99214
Office o/p est mod 30 min
$95$110-14%70%99224
CPT 17000
Destruct premalg lesion
$59$69-14%89%99222
CPT 20610
Drain/inj joint/bursa w/o us
$59$70-15%86%99221
CPT 17111
Destruction b9 lesions 15/>
$102$120-15%78%99224
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$237$280-15%79%99223
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$420$498-16%86%99221
CPT 17110
Destruction b9 les up to 14
$85$101-16%77%99224
CPT 17313
Mohs 1 stage t/a/l
$433$515-16%168%99219
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$242$289-16%77%99222
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$237$285-17%78%99222
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$331$398-17%79%99222
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$389$470-17%84%99221
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$220$267-18%80%99221
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$188$228-18%78%99222
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$308$374-18%79%99223
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$134$163-18%77%99222
CPT 11104
Punch bx skin single lesion
$66$81-18%174%99223
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$811$991-18%88%99220
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$108$132-18%75%99221
CPT 11302
Shave skin lesion 1.1-2.0 cm
$79$98-19%164%99221
CPT 17311
Mohs 1 stage h/n/hf/g
$465$577-19%162%99219
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$673$835-19%87%99221
CPT 11102
Tangntl bx skin single les
$52$65-19%174%99223
CPT 14301
Tis trnfr any 30.1-60 sq cm
$930$1,155-19%83%99220
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$157$195-20%78%99221
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$643$800-20%84%99221
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$860$1,074-20%86%99220
CPT 17004
Destroy premal lesions 15/>
$123$154-20%76%99222
CPT 11301
Shave skin lesion 0.6-1.0 cm
$68$85-20%162%99222
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$854$1,078-21%85%99220
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$95$125-24%82%99220

Frequently asked questions

How do New Jersey dermatology rates compare with the rest of the country?

New Jersey ranks 45th of 50 states with an index of 83; 0 of 44 codes are above the national median.

Which dermatology code has the biggest premium in New Jersey?

CPT 99204 (Office o/p new mod 45 min), at 96% 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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