Billing code 73221: Joint MRIMedicare rate & RVUs in Illinois
Reports MRI imaging of an upper-extremity joint without contrast, commonly used to assess shoulder, elbow, or wrist problems.
Medicare pays $193.03–$211.98 for 73221 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
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 Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$193.03 to $211.98
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $210.07 | Unavailable |
| East St. Louis | $195.49 | Unavailable |
| Rest Of Illinois | $193.03 | Unavailable |
| Suburban Chicago | $211.98 | Unavailable |
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
Swap in your local Medicare rate.
Work 1.32Practice expense 4.73Malpractice 0.09
All indexes start 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 3 | Each side paid at 100% (no 150% cap). |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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
73221-26 · Professional component
$63.13
Pays only the interpretation and report.
73221 compared with similar codes
Compare codes
73221 vs 73218 vs 73222 vs 73223: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 73218Extremity MRI
- 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 MRI
- Both describe MRI of an upper-extremity joint, but 73222 is used when contrast is administered.
- 73223Joint MRI
- 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
Fee sheets
Put 73221 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →