CPT code 73221: Joint MRI, upper extremity, no contrast2026 Medicare rate & RVUs in Massachusetts

Reports MRI imaging of an upper-extremity joint without contrast, commonly used to assess shoulder, elbow, or wrist problems.

CMS RVU26DEffective Oct 1, 20262 payment localities528.4K Medicare services in 2024

Medicare pays $213.55–$237.21 for 73221 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. Which amount applies depends on the service address.

$213.55–$237.21Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Massachusetts
  2. What 73221 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 73221 covers

This service uses magnetic resonance imaging to evaluate an upper-extremity joint without contrast material. Common targets include the shoulder, elbow, and wrist; clinicians may request the study for suspected rotator cuff or labral injury, internal joint derangement, or unexplained joint pain. An imaging technologist acquires the images, and a radiologist or other qualified physician interprets them in an outpatient imaging center or hospital department.

Select this code when the study is directed at a joint rather than a nonjoint region of the arm, and when contrast is not used. The order and report should identify the joint and clinical reason for imaging, and the record should support the performed protocol. The global service includes the technical work and interpretation; modifier 26 reports interpretation only, and modifier TC reports the technical portion only. CMS applies the diagnostic imaging multiple procedure reduction to both components. For bilateral imaging, each side is paid separately at 100%.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 73221 pays more and less in Massachusetts

73221 office and facility rates by payment locality
Payment localityOfficeFacility
Metropolitan Boston, MA$237.21Unavailable
Rest of Massachusetts$213.55Unavailable

How the 73221 rate is calculated

Each of 73221’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 73221

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.32

1.32 RVUs× 1.000 GPCI

Practice expense4.73

4.73 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

6.1400

Conversion factor

$33.4009

Medicare rate

$205.08

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 73221

The CMS indicators that decide how 73221 is paid alongside other services.

CMS payment indicators · 73221

Joint MRI, upper extremity, no contrast

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures4Diagnostic imaging reduction applies to the technical component (and professional component) of additional services.
Bilateral (modifier 50)3Each side paid at 100% (no 150% cap).
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

73221 without 26 · national office

$205.08

Joint MRI, upper extremity, no contrast

73221-26 · Professional component

$63.13

Pays only the interpretation and report.

When to use modifier 26

73221 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 73221

    Joint MRI, upper extremity, no contrast1.32 wRVU

    $205.08

  • 73218

    Extremity MRI, non-joint, without contrast1.32 wRVU

    $303.28+$98.20

  • 73222

    Joint MRI, upper extremity, with contrast1.58 wRVU

    $312.63+$107.55

  • 73223

    Joint MRI, without and with contrast2.1 wRVU

    $383.11+$178.03

How to choose

73218Extremity MRINon-joint, without contrast
This code is for MRI focused on a joint. Code 73218 applies when the target is an upper-extremity region rather than a joint.
73222Joint MRIUpper extremity, with contrast
Both describe MRI of an upper-extremity joint, but 73222 is used when contrast is administered.
73223Joint MRIWithout and with contrast
Use 73223 for joint imaging performed both without and with contrast; use this code for imaging without contrast.

73221 billing questions

How does this differ from MRI of the upper extremity?

Use this code when imaging is directed at an upper-extremity joint, such as the shoulder, elbow, or wrist. Code 73218 describes MRI of an upper-extremity area rather than a joint.

When should contrast MRI codes be used instead?

Use 73222 when contrast is used, or 73223 when the study is performed both without and with contrast. This code is for a study performed without contrast.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the interpretation, while modifier TC identifies the equipment and staff portion; billing without either modifier represents the global service.

How is bilateral joint imaging reported?

Report each side distinctly when both upper-extremity joints are imaged. CMS pays each side separately at 100%.

What happens when multiple imaging procedures are performed?

CMS's diagnostic imaging multiple procedure reduction applies to both the technical and professional components. The reduction can therefore affect either a global claim or separately billed components.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 73221PPRRVU2026_Oct_nonQPP.csv, line 8,174 (RVU26D)

Open CMS sourceHow we calculate rates

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