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Pedicle Flap On Eyelid, Nose, Ear Or Lip

Utah 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 $4,571 · 10th–90th $832$7,9430%10%10th90th$4,571Professionalmedian $776 · 10th–90th $575$1,2020%10%10th90th$776$50.0$200.0$1.0K$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
$707.95
Median
$4,570.88
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$724.44
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$954.99
Typical High
$1,258.93
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$2,344.23
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$3,548.13
Typical High
$5,495.41
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$954.99
Typical High
$1,288.25
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Select Health
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,071.52
Typical High
$1,698.24
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$977.24
Typical High
$1,905.46
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$4,466.84
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$758.58
Typical High
$1,148.15