Premalignant skin-lesion destructions per 1,000 fee-for-service beneficiaries · by state · 2024
Medicare premalignant skin-lesion destructions per 1,000 fee-for-service beneficiaries, by state, 2024 — counting patients, not billed lines. Full method below.
How the map moved
Between 2019 and 2024 the rate rose in 50 state markets and fell in 1, while the national rate went from 129 to 162 per 1,000 — some state markets moving far more than others.
Each line is a state: its rate per 1,000 fee-for-service beneficiaries in 2019 on the left, 2024 on the right. Rates count fee-for-service beneficiaries booked to the billing state and are not scaled to total Medicare (Medicare Advantage penetration varies by state).
Florida destroyed a premalignant skin lesion on about 287 of every 1,000 fee-for-service beneficiaries — the highest of any state. Alaska, about 57, the lowest. The national rate was about 162.
The spread runs about 5.0 times, top to bottom. Destroying an actinic keratosis — a rough, sun-damaged patch that can precede a skin cancer — is among the most common things a dermatologist bills Medicare for.
What sits behind the pattern is a separate question. Lifetime sun exposure, the age and skin type of each state's Medicare population, the supply of dermatologists, and how aggressively lesions are treated could all plausibly matter.
This figure measures the variation, not its cause. The procedure is delivered in the office, so volume books to roughly where care happens.
A volume record, not a verdict on need, quality, or appropriate care — a higher rate means more procedures per patient, not better or worse care.
What this is
A count of how many fee-for-service Medicare patients had a premalignant skin lesion destroyed, per 1,000, by state, 2024.
What it is not
Not billed claim lines, not a count of lesions, not a complete patient count, not where patients live, not a share of all Medicare enrollees, and not all-payer.
› How this is counted
Patients per 1,000 fee-for-service Medicare beneficiaries, by state, 2024 — one per beneficiary on the first-lesion code, not billed lines, which run higher when a patient is treated across more than one visit. Additional lesions bill a separate code; a visit destroying 15 or more lesions bills a different code and is excluded — a conservative choice that understates high-volume states. Books to the billing state, which for an office procedure is where it happens. A fee-for-service rate, not a share of all Medicare enrollees — MA penetration varies by state — so not scaled to total Medicare; a per-1,000 rate is assumption-free. Cells under 11 beneficiaries withheld by CMS. Source: Medicare Part B.
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