Dermatology · Virginia

Dermatology commercial reimbursement in Virginia

How Virginia dermatology rates compare with the national market.

Dermatology in Virginia

44 codes · 121 sampled providers
Index vs national
85
15% below
Rank among states
42 of 50
1 = highest
Codes above national
0 of 44
median code at 85%
Providers
121
sampled

What the data shows

1

Dermatology ranks 42nd of 50 states in Virginia with an index of 85 (100 = the specialty's national median), across 44 codes and 121 sampled providers.

2

Of the 44 dermatology codes with enough data in Virginia, 0 pay above the national median and 44 below; the typical code sits at 85% of the national median.

3

Largest premium over the national median: CPT 96910 (Photchmtx tar&uvb/ptrltm&uvb) at 97%; largest discount: CPT 88312 (Special stains group 1) at 62%.

4

Measured against Medicare, Virginia dermatology rates have a median of 83% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeVirginiaNationalGapProv.
96910
Photchmtx tar&uvb/ptrltm&uvb
$121$125-4%120
88305
Tissue exam by pathologist
$64$68-6%120
17000
Destruct premalg lesion
$65$69-6%121
99215
Office o/p est hi 40 min
$144$155-7%120
14040
Tis trnfr f/c/c/m/n/a/g/h/f
$739$800-8%120

Lowest vs national

CodeVirginiaNationalGapProv.
88312
Special stains group 1
$59$96-38%120
88342
Imhchem/imcytchm 1st antb
$69$95-27%120
11104
Punch bx skin single lesion
$61$81-25%121
11102
Tangntl bx skin single les
$49$65-25%121
11301
Shave skin lesion 0.6-1.0 cm
$64$85-24%121

All dermatology codes in Virginia

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeVirginiaNationalGap% of MedicareProvidersTINsLevel
CPT 96910
Photchmtx tar&uvb/ptrltm&uvb
$121$125-3%105%120223
CPT 88305
Tissue exam by pathologist
$64$68-6%92%120215
CPT 17000
Destruct premalg lesion
$65$69-6%98%121224
CPT 99215
Office o/p est hi 40 min
$144$155-7%75%120223
CPT 14040
Tis trnfr f/c/c/m/n/a/g/h/f
$739$800-8%96%120222
CPT 99205
Office o/p new hi 60 min
$194$211-8%82%120223
CPT 96574
Dbrdmt prmlg les w/pdt
$287$315-9%107%119222
CPT 14041
Tis trnfr f/c/c/m/n/a/g/h/f
$899$991-9%97%120222
CPT 99214
Office o/p est mod 30 min
$100$110-9%74%120223
CPT 14060
Tis trnfr e/n/e/l 10 sq cm/<
$755$835-9%98%121222
CPT 14061
Tis trnfr e/n/e/l10.1-30sqcm
$965$1,074-10%97%120222
CPT 15260
Fth/gft fr n/e/e/l 20 sqcm/<
$969$1,078-10%97%121222
CPT 99213
Office o/p est low 20 min
$68$76-11%71%120223
CPT 99204
Office o/p new mod 45 min
$143$163-12%81%120223
CPT 99212
Office o/p est sf 10 min
$38$44-14%64%120223
CPT 99203
Office o/p new low 30 min
$91$106-14%77%120223
CPT 14301
Tis trnfr any 30.1-60 sq cm
$997$1,155-14%89%120222
CPT 77280
Ther rad simulaj field smpl
$259$302-14%96%119214
CPT 11602
Exc tr-ext mal+marg 1.1-2 cm
$195$228-14%81%121223
CPT 11603
Exc tr-ext mal+marg 2.1-3 cm
$229$267-14%83%121222
CPT 17004
Destroy premal lesions 15/>
$131$154-15%81%121223
CPT 13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$401$470-15%87%121222
CPT 17282
Dstr mal ls f/e/e/n/l/m1.1-2
$166$195-15%83%120222
CPT 13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$418$498-16%85%121222
CPT 17111
Destruction b9 lesions 15/>
$101$120-16%78%121223
CPT 12052
Intmd rpr face/mm 2.6-5.0 cm
$242$289-16%78%121223
CPT 17262
Dstrj mal les t/a/l 1.1-2.0
$136$163-17%78%121222
CPT 12032
Intmd rpr s/a/t/ext 2.6-7.5
$234$280-17%78%121223
CPT 99202
Office o/p new sf 15 min
$58$70-17%77%120222
CPT 12042
Intmd rpr n-hf/genit2.6-7.5
$237$285-17%78%121222
CPT 13121
Cmplx rpr s/a/l 2.6-7.5 cm
$327$398-18%78%121223
CPT 13101
Cmplx rpr trunk 2.6-7.5 cm
$307$374-18%79%121223
CPT 17261
Dstrj mal les t/a/l .6-1.0cm
$108$132-18%75%121222
CPT 17110
Destruction b9 les up to 14
$83$101-18%75%121224
CPT 20610
Drain/inj joint/bursa w/o us
$57$70-18%83%119223
CPT 17313
Mohs 1 stage t/a/l
$406$515-21%158%121223
CPT 17311
Mohs 1 stage h/n/hf/g
$453$577-21%158%121223
CPT 11302
Shave skin lesion 1.1-2.0 cm
$77$98-22%159%121223
CPT 93000
Electrocardiogram complete
$16$21-24%105%119216
CPT 11301
Shave skin lesion 0.6-1.0 cm
$64$85-24%154%121222
CPT 11102
Tangntl bx skin single les
$49$65-25%162%121224
CPT 11104
Punch bx skin single lesion
$61$81-25%159%121224
CPT 88342
Imhchem/imcytchm 1st antb
$69$95-27%63%120215
CPT 88312
Special stains group 1
$59$96-38%54%120214

Frequently asked questions

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

Virginia ranks 42nd of 50 states with an index of 85; 0 of 44 codes are above the national median.

Which dermatology code has the biggest premium in Virginia?

CPT 96910 (Photchmtx tar&uvb/ptrltm&uvb), at 97% 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 Virginia dermatology contracts

Compare your rates with these medians.

Request a rate benchmark