Dermatology · Texas

Dermatology commercial reimbursement in Texas

How Texas dermatology rates compare with the national market.

Dermatology in Texas

44 codes · 134 sampled providers
Index vs national
90
10% below
Rank among states
39 of 50
1 = highest
Codes above national
1 of 44
median code at 91%
Providers
134
sampled

What the data shows

1

Dermatology ranks 39th of 50 states in Texas with an index of 90 (100 = the specialty's national median), across 44 codes and 134 sampled providers.

2

Of the 44 dermatology codes with enough data in Texas, 1 pay above the national median and 43 below; the typical code sits at 91% of the national median.

3

Largest premium over the national median: CPT 96910 (Photchmtx tar&uvb/ptrltm&uvb) at 100%; largest discount: CPT 88305 (Tissue exam by pathologist) at 63%.

4

Measured against Medicare, Texas dermatology rates have a median of 90% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeTexasNationalGapProv.
96910
Photchmtx tar&uvb/ptrltm&uvb
$125$125+0%134
11603
Exc tr-ext mal+marg 2.1-3 cm
$260$267-3%134
17111
Destruction b9 lesions 15/>
$116$120-3%134
17000
Destruct premalg lesion
$67$69-4%134
14040
Tis trnfr f/c/c/m/n/a/g/h/f
$769$800-4%134

Lowest vs national

CodeTexasNationalGapProv.
88305
Tissue exam by pathologist
$43$68-37%134
88312
Special stains group 1
$61$96-36%134
88342
Imhchem/imcytchm 1st antb
$63$95-34%134
77280
Ther rad simulaj field smpl
$230$302-24%134
11102
Tangntl bx skin single les
$53$65-18%134

All dermatology codes in Texas

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeTexasNationalGap% of MedicareProvidersTINsLevel
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$125$125+0%109%134235
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$260$267-3%94%134241
CPT 17111
Destruction b9 lesions 15/>
$116$120-3%90%134241
CPT 17000
Destruct premalg lesion
$67$69-3%100%134242
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$769$800-4%100%134237
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$187$195-4%94%134235
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$218$228-4%91%134242
CPT 96574
Dbrdmt prmlg les w/pdt
$301$315-5%113%134233
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$275$289-5%88%134242
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$271$285-5%89%134242
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$154$163-5%89%134240
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$790$835-5%102%134240
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$265$280-5%89%134242
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$936$991-6%101%134240
CPT 14301
Tis trnfr any 30.1-60 sq cm
$1,091$1,155-6%97%134235
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$1,008$1,074-6%101%134236
CPT 17110
Destruction b9 les up to 14
$95$101-6%86%134242
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$1,010$1,078-6%101%134240
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$464$498-7%94%134241
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$122$132-7%84%134240
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$344$374-8%88%134242
CPT 99214
Office o/p est mod 30 min
$100$110-9%74%134245
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$359$398-10%86%134242
CPT 99213
Office o/p est low 20 min
$68$76-10%72%134246
CPT 99203
Office o/p new low 30 min
$95$106-10%81%134245
CPT 99204
Office o/p new mod 45 min
$146$163-10%82%134246
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$421$470-10%91%134241
CPT 99212
Office o/p est sf 10 min
$40$44-10%67%134245
CPT 17004
Destroy premal lesions 15/>
$137$154-11%85%134241
CPT 99205
Office o/p new hi 60 min
$189$211-11%80%134244
CPT 20610
Drain/inj joint/bursa w/o us
$62$70-11%90%134242
CPT 99215
Office o/p est hi 40 min
$137$155-11%71%134245
CPT 99202
Office o/p new sf 15 min
$62$70-11%82%134244
CPT 11302
Shave skin lesion 1.1-2.0 cm
$87$98-12%179%134241
CPT 17313
Mohs 1 stage t/a/l
$446$515-13%173%134240
CPT 11301
Shave skin lesion 0.6-1.0 cm
$73$85-14%175%134242
CPT 17311
Mohs 1 stage h/n/hf/g
$497$577-14%173%134240
CPT 93000
Electrocardiogram complete
$18$21-18%114%134244
CPT 11104
Punch bx skin single lesion
$66$81-18%173%134241
CPT 11102
Tangntl bx skin single les
$53$65-18%176%134241
CPT 77280
Ther rad simulaj field smpl
$230$302-24%85%134235
CPT 88342
Imhchem/imcytchm 1st antb
$63$95-34%57%134240
CPT 88312
Special stains group 1
$61$96-36%56%134240
CPT 88305
Tissue exam by pathologist
$43$68-37%61%134240

Frequently asked questions

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

Texas ranks 39th of 50 states with an index of 90; 1 of 44 codes are above the national median.

Which dermatology code has the biggest premium in Texas?

CPT 96910 (Photchmtx tar&uvb/ptrltm&uvb), at 100% 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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