DermEstimator vs. Excel

DermEstimator vs. Excel Spreadsheets

Most practices still estimate patient costs from a saved spreadsheet. Here's what that's actually costing you.

Feature Excel Spreadsheet DermEstimator
2026 MPFS fee schedule Must update manually each year Auto-updated for 2026
Multiple procedure rule (MPPR) Must apply manually or ignore Automatic — built in
Mohs add-on codes (17312, 17314) Manual calculation, error-prone Auto-calculated
All 109 Medicare localities Must maintain separate sheets Single dropdown
NSA Good Faith Estimate Not possible One-click generation
Custom payer rates Separate spreadsheet needed Stored per payer
Training required Moderate — must know formulas None — 60-second estimates
Audit trail / history None Saved estimates log
Cost Free (but your time isn't) $30/mo (Solo) · $50/mo (Practice)

The hidden cost of spreadsheet estimating

Manual update risk. The Medicare Physician Fee Schedule changes every January. In practice, most spreadsheets run six, twelve, even eighteen months behind on fee updates — sometimes longer. That means patients are quoted numbers drawn from outdated allowed amounts, and practices are either over-collecting or under-collecting relative to what insurance will actually pay. Every estimate built on stale data is a version of the same error, repeated daily.

MPPR errors lead to over-collection. The multiple procedure rule requires a 50% reduction on the allowed amount for secondary procedures performed on the same day. This rule is routinely missed in spreadsheet-based estimates — not because staff don't know the rule, but because applying it correctly across Mohs add-on codes and their exemptions requires billing expertise that most front desk staff simply don't have. The result is a quoted patient responsibility that's higher than what the patient will actually owe, which damages trust and creates collection friction downstream.

NSA compliance gap. The No Surprises Act's Good Faith Estimate requirement applies to self-pay and uninsured patients requesting scheduled services. A compliant GFE requires specific CPT codes, expected charges, provider NPI information, and prescribed delivery and retention documentation. None of that is achievable from a spreadsheet without a separate manual process — creating exactly the kind of undocumented, ad-hoc workflow that auditors flag. DermEstimator generates a complete, NSA-compliant GFE directly from the estimate with a single click, with no re-entry required.

Frequently asked questions

Is DermEstimator just an updated fee schedule spreadsheet?

No. DermEstimator is a web app that runs calculations in real time against the 2026 MPFS, applies MPPR automatically, and generates NSA-compliant GFEs with a single click. No formulas, no manual updates, no version control issues.

How often is the Medicare fee schedule updated?

CMS releases new MPFS rates every January. DermEstimator's database is updated for 2026 and will be maintained going forward.

Can I import my custom payer rates?

Yes. DermEstimator supports custom payer plan creation with your contracted rates, stored per payer so front desk staff always use the right rates.

What does the NSA require for Good Faith Estimates?

The No Surprises Act requires practices to provide a written GFE upon request for uninsured or self-pay patients. The estimate must include specific CPT codes, expected charges, and provider information. DermEstimator generates this automatically.

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Related pages
Pricing · Features · How It Works · Good Faith Estimate Template for Dermatology