How much does Medicare pay for CPT 15576?

Medicare allowed an average of $658.37 per service and paid $520.22 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1781.19, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 15576?

Creation of flap graft to eyelids, nose, ears, lips, or mouth. It was billed 2,243 times to 1,704 Medicare beneficiaries by 68 providers in 2024.

Does 15576 pay differently in an office than a hospital?

Yes. The allowed amount averaged $806.36 in an office setting and $479.96 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 15576 most?

Ophthalmology, with 395 services from 5 clinicians. Next are Dentist, Plastic and Reconstructive Surgery, Oral Surgery (Dentist only).

CPT 15576

Creation of flap graft to eyelids, nose, ears, lips, or mouth

$658.37Medicare-allowed amount per service, averaged across 2,243 services

Providers submitted

$1781.19

Asking price, not received

Medicare allowed

$658.37

The fee schedule figure

Medicare paid

$520.22

Balance is patient coinsurance

Providers submitted an average of $1781.19 for this code and Medicare allowed $658.37 — 2.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $520.22 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $806.36
Hospital / facility: $479.96

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,226 services were billed in an office setting and 1,017 in a facility.

Services: 2,243
Beneficiaries: 1,704
Providers billing it: 68
Total allowed: $1,476,724

What Medicare pays for CPT 15576

Across 2,243 services billed by 68 providers to 1,704 beneficiaries, Medicare allowed an average of $658.37 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 15576

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	395	246	$382.47	5
Dentist	343	125	$903.52	2
Plastic and Reconstructive Surgery	342	332	$515.73	18
Oral Surgery (Dentist only)	304	179	$905.22	2
Ambulatory Surgical Center	301	279	$685.07	14
Dermatology	261	259	$745.42	15
Micrographic Dermatologic Surgery	165	162	$667.44	6
Otolaryngology	115	106	$418.51	5
Pathology	17	16	$303.22	1

15576 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	620	$783.78	$533.76	10
Florida	325	$416.57	$328.68	7
New Jersey	284	$899.96	$609.71	2
Utah	116	$385.10	$314.07	2
California	102	$725.53	$532.25	6
North Carolina	89	$746.33	$625.13	3
Oklahoma	70	$538.30	$446.24	3
Missouri	68	$612.32	$505.73	4
Washington	64	$432.30	$317.31	2
Arkansas	60	$627.03	$473.23	4
Virginia	51	$711.33	$584.16	3
Kansas	50	$609.33	$512.91	3
South Carolina	49	$722.85	$570.73	1
Texas	46	$394.24	$311.39	3
Delaware	46	$438.22	$336.55	2
Illinois	43	$778.43	$579.41	3
Ohio	27	$656.85	$408.08	2
Louisiana	20	$751.67	$603.48	1
Wisconsin	20	$595.71	$480.23	1
Pennsylvania	19	$572.82	$368.67	1
Oregon	19	$342.63	$252.97	1
South Dakota	17	$611.02	$479.08	1
Michigan	15	$737.32	$612.36	1
Nebraska	12	$455.25	$404.94	1
Arizona	11	$652.57	$477.60	1

Related codes

15574Creation of flap graft to forehead$519.99

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.