Dermatology · Ohio

Dermatology commercial reimbursement in Ohio

How Ohio dermatology rates compare with the national market.

Dermatology in Ohio

44 codes · 115 sampled providers
Index vs national
95
5% below
Rank among states
31 of 50
1 = highest
Codes above national
5 of 44
median code at 95%
Providers
115
sampled

What the data shows

1

Dermatology ranks 31st of 50 states in Ohio with an index of 95 (100 = the specialty's national median), across 44 codes and 115 sampled providers.

2

Of the 44 dermatology codes with enough data in Ohio, 5 pay above the national median and 39 below; the typical code sits at 95% of the national median.

3

Largest premium over the national median: CPT 11104 (Punch bx skin single lesion) at 117%; largest discount: CPT 88312 (Special stains group 1) at 81%.

4

Measured against Medicare, Ohio dermatology rates have a median of 93% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeOhioNationalGapProv.
11104
Punch bx skin single lesion
$94$81+17%115
11102
Tangntl bx skin single les
$72$65+11%115
93000
Electrocardiogram complete
$23$21+8%115
88305
Tissue exam by pathologist
$73$68+6%115
11301
Shave skin lesion 0.6-1.0 cm
$89$85+5%115

Lowest vs national

CodeOhioNationalGapProv.
88312
Special stains group 1
$78$96-19%114
88342
Imhchem/imcytchm 1st antb
$79$95-17%114
96910
Photchmtx tar&uvb/ptrltm&uvb
$108$125-14%115
15260
Fth/gft fr n/e/e/l 20 sqcm/<
$977$1,078-9%115
99205
Office o/p new hi 60 min
$192$211-9%115

All dermatology codes in Ohio

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeOhioNationalGap% of MedicareProvidersTINsLevel
CPT 11104
Punch bx skin single lesion
$94$81+17%247%115177
CPT 11102
Tangntl bx skin single les
$72$65+11%239%115177
CPT 93000
Electrocardiogram complete
$23$21+8%150%115176
CPT 88305
Tissue exam by pathologist
$73$68+6%104%115177
CPT 11301
Shave skin lesion 0.6-1.0 cm
$89$85+5%213%115177
CPT 99202
Office o/p new sf 15 min
$69$70-0%92%115178
CPT 17313
Mohs 1 stage t/a/l
$510$515-1%198%115176
CPT 17311
Mohs 1 stage h/n/hf/g
$569$577-1%198%115176
CPT 11302
Shave skin lesion 1.1-2.0 cm
$97$98-1%200%115177
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$490$498-2%100%115177
CPT 17004
Destroy premal lesions 15/>
$151$154-2%93%115177
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$461$470-2%100%115177
CPT 99203
Office o/p new low 30 min
$103$106-2%88%115178
CPT 20610
Drain/inj joint/bursa w/o us
$67$70-3%98%115176
CPT 14301
Tis trnfr any 30.1-60 sq cm
$1,114$1,155-4%99%115176
CPT 17111
Destruction b9 lesions 15/>
$116$120-4%89%115177
CPT 17110
Destruction b9 les up to 14
$97$101-4%87%115178
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$156$163-4%90%115177
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$949$991-4%102%115177
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$379$398-5%91%115177
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$217$228-5%90%115177
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$1,024$1,074-5%103%115176
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$275$289-5%88%115177
CPT 99215
Office o/p est hi 40 min
$147$155-5%76%115178
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$185$195-5%92%115177
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$270$285-5%89%115177
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$265$280-6%88%115177
CPT 17000
Destruct premalg lesion
$65$69-6%98%115178
CPT 77280
Ther rad simulaj field smpl
$283$302-6%105%115178
CPT 96574
Dbrdmt prmlg les w/pdt
$296$315-6%111%115176
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$350$374-6%90%115177
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$782$835-6%101%115177
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$123$132-6%86%115177
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$747$800-7%97%115177
CPT 99213
Office o/p est low 20 min
$71$76-7%74%115178
CPT 99214
Office o/p est mod 30 min
$103$110-7%76%115178
CPT 99204
Office o/p new mod 45 min
$150$163-8%85%115178
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$245$267-8%89%115176
CPT 99212
Office o/p est sf 10 min
$41$44-9%68%115178
CPT 99205
Office o/p new hi 60 min
$192$211-9%81%115178
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$977$1,078-9%98%115177
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$108$125-14%94%115177
CPT 88342
Imhchem/imcytchm 1st antb
$79$95-17%72%114174
CPT 88312
Special stains group 1
$78$96-19%71%114175

Frequently asked questions

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

Ohio ranks 31st of 50 states with an index of 95; 5 of 44 codes are above the national median.

Which dermatology code has the biggest premium in Ohio?

CPT 11104 (Punch bx skin single lesion), at 117% 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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