Defining Mohs micrographic surgery workforce: A cross-sectional analysis of Centers for Medicare and Medicaid Services Current Procedural Terminology Code 17311 billing from 2015 to 2020 - 21/11/25

Doi : 10.1016/j.jaad.2025.10.039

Ji Won Ahn, MD ^a, Sherry H. Yu, MD ^b, Jeffrey F. Scott, MD ^c, Yimeng Shang, MS ^d, Madison N. Kist, MD ^e, Aaron Steen, MD ^f, Hao Feng, MD ^g, Howard Rogers, MD ^h, Lan Kong, PhD ^d, John G. Albertini, MD ^i,^{^{†
Deceased.}}, Charlene Lam, MD, MPH ^e,^⁎
^a Department of Mohs Surgery, The Permanente Medical Group, Walnut Creek, California
^b Optima Dermatology, Macedonia, Ohio
^c Clinical Skin Center, Fairfax Virginia
^d Department of Public Health Sciences, Division of Biostatistics and Bioinformatics, Penn State College of Medicine, Hershey, Pennsylvania
^e Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania
^f Dermatology Physicians of Connecticut, Hamden, Connecticut
^g Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut
^h Advanced Dermatology, Norwich, Connecticut
ⁱ The Skin Surgery Center, Winston-Salem, North Carolina

^∗Correspondence to: Charlene Lam, MD, MPH, Department of Dermatology, Penn State Hershey Medical Center, 500 University Dr, HU14, Hershey, PA 17033.Department of DermatologyPenn State Hershey Medical Center500 University DrHU14HersheyPA17033

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 21 November 2025

Abstract

Background

The adequacy of the future Mohs micrographic surgery workforce is unclear following the establishment of the Micrographic Surgery and Dermatologic Oncology board certification.

Objective

This study assesses the future projection of the number of Mohs surgeons and their geographical distribution.

Methods

Cross-sectional analyses of the Centers for Medicare and Medicaid Services and the Census Bureau databases.

Results

There was an average increase in the number of Mohs surgeons by 135 per year from 2015 to 2019, and the attrition rate of Mohs surgeons was 59.4 per year. There was an average of 92 Micrographic Surgery and Dermatologic Oncology fellows annually. The distributions of the number of Mohs surgeons and the number of services were moderately correlated with the geographical distribution of the population. There was only a weakly positive correlation between the change in population by county and the change in the number of Mohs surgeons from 2015 to 2019.

Limitations

The Centers for Medicare and Medicaid Services database only includes Original Medicare patients.

Conclusion

With the current number of Micrographic Surgery and Dermatologic Oncology fellowships and attrition rate of surgeons, the number of Mohs surgeons will continue to increase. The migration patterns of Mohs surgeons are more sensitive to the overall population distribution than to the change in population.

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Key words : Centers for Medicare and Medicaid Services, geographical distribution, Mohs micrographic surgery workforce

Abbreviations used : MMS, MSDO, NPI