Understanding Dermatology Data on DocTransparency

What Dermatologists Do

Dermatologists diagnose and treat conditions of the skin, hair, and nails. Medical dermatology covers conditions like psoriasis, eczema, acne, rosacea, and skin cancer detection. Surgical dermatologists perform procedures to remove skin cancers and other lesions. Cosmetic dermatology — Botox, fillers, laser treatments, and chemical peels — is typically not covered by insurance and therefore does not appear in Medicare data.

This distinction matters: a dermatologist with a heavy cosmetic practice may look low-volume in Medicare data while running a very active practice overall.

Common Procedures in Medicare Data

• Skin biopsies — Sampling tissue to diagnose suspicious lesions, one of the most common dermatology procedures billed to Medicare
• Destruction of lesions — Cryotherapy, electrosurgery, or laser destruction of benign or pre-cancerous growths
• Excisions — Surgical removal of skin cancers or other lesions
• Mohs surgery — Tissue-sparing cancer surgery performed in stages; high procedure count per case
• Phototherapy — Light-based treatment for psoriasis or eczema
• Office visits — Including skin cancer surveillance exams

What Normal Volume Looks Like

Biopsy and destruction counts can be high for active dermatologists — hundreds to over a thousand per year for a busy practice. Mohs surgeons in particular accumulate high procedure counts because each cancer removal involves multiple stages billed separately.

Pharma and Device Payments

Dermatology sees moderate industry payments overall. Pharmaceutical companies marketing biologic drugs for psoriasis and atopic dermatitis — medications with very high list prices — are the most significant payment source. A dermatologist who prescribes biologics frequently and receives consulting or speaking fees from the manufacturer of those drugs is worth noting.

Questions to Ask Your Dermatologist

• Is this procedure medical or cosmetic, and will insurance cover it?
• Do you have financial relationships with the companies whose biologic medications you prescribe?
• How many biopsies do you perform per year, and what is your biopsy-to-malignancy rate?