Dermatology · New York

Dermatology commercial reimbursement in New York

How New York dermatology rates compare with the national market.

Dermatology in New York

44 codes · 107 sampled providers
Index vs national
102
2% above
Rank among states
22 of 50
1 = highest
Codes above national
29 of 44
median code at 103%
Providers
107
sampled

What the data shows

1

Dermatology ranks 22nd of 50 states in New York with an index of 102 (100 = the specialty's national median), across 44 codes and 107 sampled providers.

2

Of the 44 dermatology codes with enough data in New York, 29 pay above the national median and 15 below; the typical code sits at 103% of the national median.

3

Largest premium over the national median: CPT 11104 (Punch bx skin single lesion) at 143%; largest discount: CPT 93000 (Electrocardiogram complete) at 88%.

4

Measured against Medicare, New York dermatology rates have a median of 103% 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 YorkNationalGapProv.
11104
Punch bx skin single lesion
$116$81+43%107
11102
Tangntl bx skin single les
$92$65+41%107
11301
Shave skin lesion 0.6-1.0 cm
$110$85+30%107
11302
Shave skin lesion 1.1-2.0 cm
$124$98+26%107
17313
Mohs 1 stage t/a/l
$617$515+20%107

Lowest vs national

CodeNew YorkNationalGapProv.
93000
Electrocardiogram complete
$19$21-12%106
88342
Imhchem/imcytchm 1st antb
$84$95-12%106
88312
Special stains group 1
$88$96-8%106
88305
Tissue exam by pathologist
$65$68-5%106
14061
Tis trnfr e/n/e/l10.1-30sqcm
$1,031$1,074-4%107

All dermatology codes in New York

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNew YorkNationalGap% of MedicareProvidersTINsLevel
CPT 11104
Punch bx skin single lesion
$116$81+43%304%107202
CPT 11102
Tangntl bx skin single les
$92$65+41%305%107203
CPT 11301
Shave skin lesion 0.6-1.0 cm
$110$85+30%263%107206
CPT 11302
Shave skin lesion 1.1-2.0 cm
$124$98+27%257%107205
CPT 17313
Mohs 1 stage t/a/l
$617$515+20%240%107203
CPT 77280
Ther rad simulaj field smpl
$354$302+17%131%106205
CPT 17311
Mohs 1 stage h/n/hf/g
$658$577+14%230%107206
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$149$132+13%103%107204
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$181$163+11%104%107205
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$434$398+9%104%107205
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$408$374+9%104%107206
CPT 14301
Tis trnfr any 30.1-60 sq cm
$1,260$1,155+9%112%107206
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$248$228+9%103%107205
CPT 99202
Office o/p new sf 15 min
$75$70+8%100%107207
CPT 99215
Office o/p est hi 40 min
$165$155+7%86%107206
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$207$195+6%104%107203
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$283$267+6%103%107205
CPT 99212
Office o/p est sf 10 min
$47$44+6%79%107207
CPT 96574
Dbrdmt prmlg les w/pdt
$330$315+5%124%107205
CPT 99203
Office o/p new low 30 min
$111$106+5%94%107206
CPT 99204
Office o/p new mod 45 min
$168$163+3%95%107207
CPT 99214
Office o/p est mod 30 min
$114$110+3%84%107207
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$481$470+2%104%107205
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$817$800+2%106%107205
CPT 99213
Office o/p est low 20 min
$77$76+2%81%107207
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$508$498+2%103%107204
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$997$991+1%108%107205
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$286$285+0%94%107204
CPT 99205
Office o/p new hi 60 min
$212$211+0%90%107206
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$834$835-0%108%107205
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$1,077$1,078-0%108%107206
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$279$280-0%93%107206
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$287$289-1%92%106205
CPT 17110
Destruction b9 les up to 14
$100$101-1%90%107208
CPT 20610
Drain/inj joint/bursa w/o us
$68$70-2%99%106204
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$122$125-2%107%107206
CPT 17111
Destruction b9 lesions 15/>
$117$120-3%90%107205
CPT 17000
Destruct premalg lesion
$67$69-3%101%107206
CPT 17004
Destroy premal lesions 15/>
$148$154-4%91%107205
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$1,031$1,074-4%103%107205
CPT 88305
Tissue exam by pathologist
$65$68-5%93%106201
CPT 88312
Special stains group 1
$88$96-9%80%106201
CPT 88342
Imhchem/imcytchm 1st antb
$84$95-12%76%106201
CPT 93000
Electrocardiogram complete
$19$21-12%122%106206

Frequently asked questions

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

New York ranks 22nd of 50 states with an index of 102; 29 of 44 codes are above the national median.

Which dermatology code has the biggest premium in New York?

CPT 11104 (Punch bx skin single lesion), at 143% 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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