Dermatology · North Carolina

Dermatology commercial reimbursement in North Carolina

How North Carolina dermatology rates compare with the national market.

Dermatology in North Carolina

44 codes · 125 sampled providers
Index vs national
97
3% below
Rank among states
30 of 50
1 = highest
Codes above national
10 of 44
median code at 97%
Providers
125
sampled

What the data shows

1

Dermatology ranks 30th of 50 states in North Carolina with an index of 97 (100 = the specialty's national median), across 44 codes and 125 sampled providers.

2

Of the 44 dermatology codes with enough data in North Carolina, 10 pay above the national median and 34 below; the typical code sits at 97% of the national median.

3

Largest premium over the national median: CPT 11102 (Tangntl bx skin single les) at 138%; largest discount: CPT 88312 (Special stains group 1) at 67%.

4

Measured against Medicare, North Carolina dermatology rates have a median of 95% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeNorth CaroNationalGapProv.
11102
Tangntl bx skin single les
$89$65+38%125
11104
Punch bx skin single lesion
$108$81+34%125
17313
Mohs 1 stage t/a/l
$569$515+11%125
99212
Office o/p est sf 10 min
$48$44+9%125
17311
Mohs 1 stage h/n/hf/g
$621$577+8%125

Lowest vs national

CodeNorth CaroNationalGapProv.
88312
Special stains group 1
$64$96-33%117
88342
Imhchem/imcytchm 1st antb
$75$95-22%117
88305
Tissue exam by pathologist
$55$68-20%117
96910
Photchmtx tar&uvb/ptrltm&uvb
$107$125-15%125
77280
Ther rad simulaj field smpl
$258$302-14%117

All dermatology codes in North Carolina

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNorth CaroliNationalGap% of MedicareProvidersTINsLevel
CPT 11102
Tangntl bx skin single les
$89$65+38%297%125227
CPT 11104
Punch bx skin single lesion
$108$81+34%284%125227
CPT 17313
Mohs 1 stage t/a/l
$569$515+11%221%125225
CPT 99212
Office o/p est sf 10 min
$48$44+9%81%125227
CPT 17311
Mohs 1 stage h/n/hf/g
$621$577+8%216%125225
CPT 17004
Destroy premal lesions 15/>
$162$154+5%100%125226
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$134$132+2%93%125227
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$163$163+0%94%125227
CPT 17111
Destruction b9 lesions 15/>
$120$120+0%93%125227
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$374$374+0%96%125226
CPT 17110
Destruction b9 les up to 14
$101$101-0%91%125227
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$397$398-0%95%125225
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$986$991-0%106%125225
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$279$280-1%93%125226
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$465$470-1%101%125225
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$1,060$1,074-1%106%125225
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$193$195-1%96%125226
CPT 99202
Office o/p new sf 15 min
$68$70-1%91%125228
CPT 11302
Shave skin lesion 1.1-2.0 cm
$96$98-2%199%125226
CPT 99204
Office o/p new mod 45 min
$159$163-2%90%125229
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$487$498-2%99%125225
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$277$285-3%91%125226
CPT 99203
Office o/p new low 30 min
$103$106-3%87%125227
CPT 99215
Office o/p est hi 40 min
$150$155-3%78%125227
CPT 99214
Office o/p est mod 30 min
$106$110-4%78%125227
CPT 99213
Office o/p est low 20 min
$73$76-4%77%125228
CPT 17000
Destruct premalg lesion
$66$69-4%100%125227
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$218$228-4%91%125227
CPT 14301
Tis trnfr any 30.1-60 sq cm
$1,100$1,155-5%98%125225
CPT 11301
Shave skin lesion 0.6-1.0 cm
$80$85-5%192%125227
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$274$289-5%88%125225
CPT 99205
Office o/p new hi 60 min
$200$211-5%85%125228
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$789$835-6%102%125225
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$755$800-6%98%125226
CPT 20610
Drain/inj joint/bursa w/o us
$66$70-6%95%125227
CPT 96574
Dbrdmt prmlg les w/pdt
$294$315-7%110%125226
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$248$267-7%90%125227
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$998$1,078-7%100%125225
CPT 93000
Electrocardiogram complete
$19$21-12%122%117111
CPT 77280
Ther rad simulaj field smpl
$258$302-14%96%117109
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$107$125-15%93%125226
CPT 88305
Tissue exam by pathologist
$55$68-20%78%117111
CPT 88342
Imhchem/imcytchm 1st antb
$75$95-22%68%117111
CPT 88312
Special stains group 1
$64$96-33%59%117111

Frequently asked questions

How do North Carolina dermatology rates compare with the rest of the country?

North Carolina ranks 30th of 50 states with an index of 97; 10 of 44 codes are above the national median.

Which dermatology code has the biggest premium in North Carolina?

CPT 11102 (Tangntl bx skin single les), at 138% 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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