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Pedicle Flap On Eyelid, Nose, Ear Or Lip

Washington 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 $1,738 · 10th–90th $1,000$12,8820%10%10th90th$1,738Professionalmedian $1,072 · 10th–90th $646$1,9500%10%10th90th$1,072$50.0$200.0$1.0K$5.0K$20.0K

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
$1,047.13
Median
$2,041.74
Typical High
$17,782.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$912.01
Typical High
$1,778.28
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$5,623.41
Typical High
$10,000.00
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,258.93
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$1,122.02
Typical High
$2,344.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,230.27
Typical High
$2,187.76
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,513.56
Typical High
$2,951.21
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,479.11
Typical High
$2,041.74
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$295.12
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$1,548.82
Typical High
$1,584.89
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,071.52
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,230.27
Typical High
$1,949.84
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$5,495.41
Typical High
$10,000.00
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,258.93
Typical High
$1,862.09
United
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$6,456.54
Typical High
$11,748.98
United
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,096.48
Typical High
$2,089.30
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$912.01
Typical High
$1,174.90