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Pedicle Flap On Eyelid, Nose, Ear Or Lip

Montana rates for HCPCS 15576

Creates a flap of skin and underlying tissue that stays attached at one end so it keeps its own blood supply, and moves it to cover a defect on the eyelid, nose, ear, lip or inside the mouth. Keeping the attachment lets the moved tissue survive while it grows into its new bed. A later operation to divide the attachment is sometimes needed.

Rates data updated July 2026.

Facilitymedian $1,349 · 10th–90th $1,047$1,6600%20%40%10th90th$1,349Professionalmedian $813 · 10th–90th $617$1,4450%10%20%10th90th$813$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$741.31
Typical High
$1,318.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,047.13
Typical High
$1,318.26
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,348.96
Typical High
$1,445.44
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,348.96
Typical High
$1,445.44
Providence
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$794.33
Typical High
$1,479.11
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$1,023.29
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
United
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,202.26
Typical High
$1,445.44