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Pedicle Flap On Eyelid, Nose, Ear Or Lip

South Dakota 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 $1,122 · 10th–90th $724$4,3650%10%10th90th$1,122Professionalmedian $977 · 10th–90th $617$1,8620%10%10th90th$977$1.0K$2.0K$5.0K

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
Facility
Modifier
Global
Typical Low
$660.69
Median
$3,548.13
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$676.08
Typical High
$1,071.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,862.09
Typical High
$2,290.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,071.52
Typical High
$1,995.26
Medica
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,584.89
Typical High
$5,888.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,548.82
Typical High
$1,819.70
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$1,659.59
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,258.93
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,288.25
Typical High
$2,089.30
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,288.25
Typical High
$1,819.70