Dermatology · West Virginia
Dermatology commercial reimbursement in West Virginia
How West Virginia dermatology rates compare with the national market.
Dermatology in West Virginia
44 codes · 31 sampled providers
Index vs national
101
1% above
Rank among states
24 of 50
1 = highest
Codes above national
27 of 44
median code at 101%
Providers
31
sampled
What the data shows
1
Dermatology ranks 24th of 50 states in West Virginia with an index of 101 (100 = the specialty's national median), across 44 codes and 31 sampled providers.
2
Of the 44 dermatology codes with enough data in West Virginia, 27 pay above the national median and 17 below; the typical code sits at 101% of the national median.
3
Largest premium over the national median: CPT 11104 (Punch bx skin single lesion) at 132%; largest discount: CPT 88312 (Special stains group 1) at 64%.
4
Measured against Medicare, West Virginia dermatology rates have a median of 102% 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 West Virginia
Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
| Code | West Virgini | National | Gap | % of Medicare | Providers | TINs | Level |
|---|---|---|---|---|---|---|---|
| CPT 11104 Punch bx skin single lesion | $107 | $81 | +32% | 281% | 31 | 47 | |
| CPT 11102 Tangntl bx skin single les | $85 | $65 | +32% | 284% | 31 | 47 | |
| CPT 13152 Cmplx rpr e/n/e/l 2.6-7.5 cm | $571 | $498 | +15% | 116% | 31 | 47 | |
| CPT 17004 Destroy premal lesions 15/> | $175 | $154 | +14% | 108% | 31 | 47 | |
| CPT 17313 Mohs 1 stage t/a/l | $582 | $515 | +13% | 226% | 31 | 47 | |
| CPT 13121 Cmplx rpr s/a/l 2.6-7.5 cm | $440 | $398 | +11% | 105% | 31 | 47 | |
| CPT 17311 Mohs 1 stage h/n/hf/g | $630 | $577 | +9% | 220% | 31 | 47 | |
| CPT 13101 Cmplx rpr trunk 2.6-7.5 cm | $406 | $374 | +9% | 104% | 31 | 47 | |
| CPT 88305 Tissue exam by pathologist | $74 | $68 | +8% | 105% | 31 | 47 | |
| CPT 17282 Dstr mal ls f/e/e/n/l/m1.1-2 | $210 | $195 | +8% | 105% | 31 | 47 | |
| CPT 99215 Office o/p est hi 40 min | $165 | $155 | +7% | 86% | 31 | 47 | |
| CPT 11301 Shave skin lesion 0.6-1.0 cm | $90 | $85 | +6% | 216% | 31 | 47 | |
| CPT 11302 Shave skin lesion 1.1-2.0 cm | $104 | $98 | +6% | 215% | 31 | 47 | |
| CPT 20610 Drain/inj joint/bursa w/o us | $73 | $70 | +5% | 107% | 31 | 47 | |
| CPT 99205 Office o/p new hi 60 min | $222 | $211 | +5% | 94% | 31 | 47 | |
| CPT 93000 Electrocardiogram complete | $22 | $21 | +4% | 144% | 31 | 47 | |
| CPT 17261 Dstrj mal les t/a/l .6-1.0cm | $137 | $132 | +4% | 95% | 31 | 47 | |
| CPT 17262 Dstrj mal les t/a/l 1.1-2.0 | $168 | $163 | +4% | 97% | 31 | 47 | |
| CPT 12052 Intmd rpr face/mm 2.6-5.0 cm | $294 | $289 | +2% | 94% | 31 | 47 | |
| CPT 77280 Ther rad simulaj field smpl | $306 | $302 | +1% | 113% | 31 | 47 | |
| CPT 12042 Intmd rpr n-hf/genit2.6-7.5 | $289 | $285 | +1% | 95% | 31 | 47 | |
| CPT 99204 Office o/p new mod 45 min | $164 | $163 | +1% | 93% | 31 | 47 | |
| CPT 17111 Destruction b9 lesions 15/> | $121 | $120 | +1% | 93% | 31 | 47 | |
| CPT 14041 Tis trnfr f/c/c/m/n/a/g/h/f | $1,000 | $991 | +1% | 108% | 31 | 47 | |
| CPT 13132 Cmplx rpr f/c/c/m/n/ax/g/h/f | $472 | $470 | +0% | 102% | 31 | 47 | |
| CPT 14060 Tis trnfr e/n/e/l 10 sq cm/< | $837 | $835 | +0% | 108% | 31 | 47 | |
| CPT 14061 Tis trnfr e/n/e/l10.1-30sqcm | $1,074 | $1,074 | +0% | 108% | 31 | 47 | |
| CPT 14040 Tis trnfr f/c/c/m/n/a/g/h/f | $797 | $800 | -0% | 104% | 31 | 47 | |
| CPT 99203 Office o/p new low 30 min | $105 | $106 | -0% | 89% | 31 | 47 | |
| CPT 12032 Intmd rpr s/a/t/ext 2.6-7.5 | $278 | $280 | -1% | 93% | 31 | 47 | |
| CPT 14301 Tis trnfr any 30.1-60 sq cm | $1,140 | $1,155 | -1% | 102% | 31 | 47 | |
| CPT 99212 Office o/p est sf 10 min | $44 | $44 | -2% | 73% | 31 | 47 | |
| CPT 15260 Fth/gft fr n/e/e/l 20 sqcm/< | $1,060 | $1,078 | -2% | 106% | 31 | 47 | |
| CPT 99202 Office o/p new sf 15 min | $68 | $70 | -3% | 90% | 31 | 47 | |
| CPT 96574 Dbrdmt prmlg les w/pdt | $305 | $315 | -3% | 114% | 31 | 47 | |
| CPT 17000 Destruct premalg lesion | $66 | $69 | -4% | 100% | 31 | 47 | |
| CPT 99214 Office o/p est mod 30 min | $105 | $110 | -5% | 78% | 31 | 47 | |
| CPT 11603 Exc tr-ext mal+marg 2.1-3 cm | $251 | $267 | -6% | 91% | 31 | 47 | |
| CPT 11602 Exc tr-ext mal+marg 1.1-2 cm | $212 | $228 | -7% | 88% | 31 | 47 | |
| CPT 99213 Office o/p est low 20 min | $69 | $76 | -9% | 72% | 31 | 47 | |
| CPT 17110 Destruction b9 les up to 14 | $89 | $101 | -13% | 80% | 31 | 47 | |
| CPT 96910 Photchmtx tar&uvb/ptrltm&uvb | $109 | $125 | -13% | 95% | 31 | 47 | |
| CPT 88342 Imhchem/imcytchm 1st antb | $68 | $95 | -28% | 62% | 31 | 47 | |
| CPT 88312 Special stains group 1 | $61 | $96 | -36% | 56% | 31 | 47 |
Frequently asked questions
How do West Virginia dermatology rates compare with the rest of the country?
West Virginia ranks 24th of 50 states with an index of 101; 27 of 44 codes are above the national median.
Which dermatology code has the biggest premium in West Virginia?
CPT 11104 (Punch bx skin single lesion), at 132% 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 West Virginia dermatology contracts
Compare your rates with these medians.