Dermatology · Rhode Island
Dermatology commercial reimbursement in Rhode Island
How Rhode Island dermatology rates compare with the national market.
Dermatology in Rhode Island
44 codes · 48 sampled providers
Index vs national
105
5% above
Rank among states
21 of 50
1 = highest
Codes above national
31 of 44
median code at 105%
Providers
48
sampled
What the data shows
1
Dermatology ranks 21st of 50 states in Rhode Island with an index of 105 (100 = the specialty's national median), across 44 codes and 48 sampled providers.
2
Of the 44 dermatology codes with enough data in Rhode Island, 31 pay above the national median and 13 below; the typical code sits at 105% of the national median.
3
Largest premium over the national median: CPT 99215 (Office o/p est hi 40 min) at 120%; largest discount: CPT 20610 (Drain/inj joint/bursa w/o us) at 93%.
4
Measured against Medicare, Rhode Island 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
All dermatology codes in Rhode Island
Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
| Code | Rhode Island | National | Gap | % of Medicare | Providers | TINs | Level |
|---|---|---|---|---|---|---|---|
| CPT 99215 Office o/p est hi 40 min | $186 | $155 | +20% | 97% | 48 | 63 | |
| CPT 88342 Imhchem/imcytchm 1st antb | $113 | $95 | +18% | 102% | 48 | 65 | |
| CPT 99214 Office o/p est mod 30 min | $129 | $110 | +17% | 95% | 48 | 63 | |
| CPT 88312 Special stains group 1 | $112 | $96 | +17% | 102% | 48 | 65 | |
| CPT 99205 Office o/p new hi 60 min | $245 | $211 | +16% | 103% | 48 | 63 | |
| CPT 99213 Office o/p est low 20 min | $88 | $76 | +16% | 92% | 48 | 63 | |
| CPT 12042 Intmd rpr n-hf/genit2.6-7.5 | $323 | $285 | +13% | 106% | 48 | 63 | |
| CPT 99204 Office o/p new mod 45 min | $183 | $163 | +12% | 103% | 48 | 63 | |
| CPT 13121 Cmplx rpr s/a/l 2.6-7.5 cm | $442 | $398 | +11% | 106% | 48 | 61 | |
| CPT 77280 Ther rad simulaj field smpl | $333 | $302 | +10% | 124% | 48 | 63 | |
| CPT 13101 Cmplx rpr trunk 2.6-7.5 cm | $409 | $374 | +10% | 105% | 48 | 63 | |
| CPT 88305 Tissue exam by pathologist | $75 | $68 | +10% | 107% | 48 | 66 | |
| CPT 99212 Office o/p est sf 10 min | $49 | $44 | +9% | 82% | 48 | 63 | |
| CPT 12052 Intmd rpr face/mm 2.6-5.0 cm | $314 | $289 | +9% | 101% | 48 | 62 | |
| CPT 99203 Office o/p new low 30 min | $115 | $106 | +9% | 98% | 48 | 63 | |
| CPT 11302 Shave skin lesion 1.1-2.0 cm | $107 | $98 | +9% | 220% | 48 | 63 | |
| CPT 11301 Shave skin lesion 0.6-1.0 cm | $92 | $85 | +9% | 220% | 48 | 63 | |
| CPT 17261 Dstrj mal les t/a/l .6-1.0cm | $142 | $132 | +7% | 98% | 48 | 63 | |
| CPT 99202 Office o/p new sf 15 min | $74 | $70 | +7% | 99% | 48 | 63 | |
| CPT 13132 Cmplx rpr f/c/c/m/n/ax/g/h/f | $499 | $470 | +6% | 108% | 48 | 63 | |
| CPT 17111 Destruction b9 lesions 15/> | $127 | $120 | +6% | 98% | 48 | 63 | |
| CPT 17313 Mohs 1 stage t/a/l | $542 | $515 | +5% | 210% | 48 | 61 | |
| CPT 17004 Destroy premal lesions 15/> | $162 | $154 | +5% | 100% | 48 | 63 | |
| CPT 17262 Dstrj mal les t/a/l 1.1-2.0 | $171 | $163 | +5% | 99% | 48 | 63 | |
| CPT 12032 Intmd rpr s/a/t/ext 2.6-7.5 | $293 | $280 | +4% | 98% | 48 | 63 | |
| CPT 13152 Cmplx rpr e/n/e/l 2.6-7.5 cm | $515 | $498 | +3% | 105% | 48 | 61 | |
| CPT 11104 Punch bx skin single lesion | $83 | $81 | +3% | 219% | 48 | 63 | |
| CPT 11102 Tangntl bx skin single les | $67 | $65 | +3% | 223% | 48 | 63 | |
| CPT 17282 Dstr mal ls f/e/e/n/l/m1.1-2 | $196 | $195 | +1% | 98% | 48 | 62 | |
| CPT 14040 Tis trnfr f/c/c/m/n/a/g/h/f | $801 | $800 | +0% | 104% | 48 | 62 | |
| CPT 17311 Mohs 1 stage h/n/hf/g | $578 | $577 | +0% | 201% | 48 | 62 | |
| CPT 11603 Exc tr-ext mal+marg 2.1-3 cm | $266 | $267 | -0% | 96% | 48 | 63 | |
| CPT 14060 Tis trnfr e/n/e/l 10 sq cm/< | $831 | $835 | -0% | 108% | 48 | 62 | |
| CPT 96574 Dbrdmt prmlg les w/pdt | $313 | $315 | -1% | 117% | 48 | 64 | |
| CPT 96910 Photchmtx tar&uvb/ptrltm&uvb | $124 | $125 | -1% | 108% | 48 | 64 | |
| CPT 17000 Destruct premalg lesion | $68 | $69 | -1% | 103% | 48 | 63 | |
| CPT 14041 Tis trnfr f/c/c/m/n/a/g/h/f | $974 | $991 | -2% | 105% | 48 | 62 | |
| CPT 11602 Exc tr-ext mal+marg 1.1-2 cm | $224 | $228 | -2% | 93% | 48 | 63 | |
| CPT 15260 Fth/gft fr n/e/e/l 20 sqcm/< | $1,057 | $1,078 | -2% | 106% | 48 | 62 | |
| CPT 14301 Tis trnfr any 30.1-60 sq cm | $1,133 | $1,155 | -2% | 101% | 48 | 62 | |
| CPT 14061 Tis trnfr e/n/e/l10.1-30sqcm | $1,050 | $1,074 | -2% | 105% | 48 | 61 | |
| CPT 17110 Destruction b9 les up to 14 | $97 | $101 | -4% | 87% | 48 | 63 | |
| CPT 93000 Electrocardiogram complete | $20 | $21 | -6% | 130% | 48 | 55 | |
| CPT 20610 Drain/inj joint/bursa w/o us | $65 | $70 | -7% | 95% | 48 | 54 |
Frequently asked questions
How do Rhode Island dermatology rates compare with the rest of the country?
Rhode Island ranks 21st of 50 states with an index of 105; 31 of 44 codes are above the national median.
Which dermatology code has the biggest premium in Rhode Island?
CPT 99215 (Office o/p est hi 40 min), at 120% 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.
Benchmark your Rhode Island dermatology contracts
Compare your rates with these medians.