Summary & Overview

CPT 73218: MRI Upper Extremity (Non‑Joint), Without Contrast

CPT code 73218 represents a non‑contrast magnetic resonance imaging (MRI) study of the upper extremity when the imaging focus is on an anatomical location other than a joint. This diagnostic procedure is widely used to evaluate soft tissue, tendons, muscles, nerves, and bone pathology in the arm, forearm, wrist, and hand when intra‑articular assessment with contrast is not required. Nationally, MRI codes like 73218 are important for imaging utilization, care pathways for musculoskeletal complaints, and billing consistency across outpatient imaging centers and hospital radiology departments. Key payers commonly involved in coverage and reimbursement for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers of this publication will find a concise clinical context for the procedure, typical sites of service where it is performed, and an overview of payer coverage patterns and common billing modifiers used with the code. The report also covers benchmarking and policy considerations relevant to imaging utilization, documentation expectations that support medical necessity, and operational implications for radiology practices and hospital billing teams. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare73218CPTMRIUpper extremityDiagnostic imagingRadiologyNon-contrastOutpatient imaging

Billing Code Overview

CPT code 73218 describes a magnetic resonance imaging (MRI) of the upper extremity, performed for an anatomical location other than a joint, without contrast. The procedure is diagnostic in nature and produces cross‑sectional images of soft tissues, bones, and related structures in the upper limb outside of joint spaces.

Service type: Diagnostic imaging — MRI of the upper extremity (non‑joint), without contrast
Typical site of service: Outpatient imaging centers or hospital radiology departments

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 42-year-old right-hand–dominant male presents to the outpatient imaging center with several weeks of persistent forearm pain and swelling after a fall while mountain biking. The referring orthopedic surgeon documents focal tenderness over the proximal radius and concern for a suspected soft-tissue mass or occult fracture not visible on plain radiographs. The provider orders a non-contrast magnetic resonance imaging study of the right upper extremity (excluding the elbow joint proper) to evaluate soft tissues, tendons, muscle, and cortical bone detail.

The clinical workflow: the patient checks in at the imaging front desk, completes screening for MRI safety (implants, pacemakers, pregnancy), and changes into gowning as required. The MRI technologist reviews the order and safety checklist, positions the arm in a dedicated coil, and acquires non-contrast sequences per protocol. After image acquisition, the technologist submits images to PACS. A radiologist with musculoskeletal expertise reviews and interprets the study, issues a final report to the referring provider, and documents any incidental findings or recommendations for further imaging if contrast or targeted joint MRI is indicated.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation portion separately from technical component.
`TC`	Technical component	Use when billing only the technical equipment/staff portion separately from professional component.
`LT`	Left side	Use when the study is specifically of the left upper extremity.
`RT`	Right side	Use when the study is specifically of the right upper extremity.
`59`	Distinct procedural service	Use when a distinct, separate non-overlapping procedure is performed the same day (different anatomic area or standalone study).
`52`	Reduced services	Use when the MRI was partially completed or limited due to patient factors or equipment constraints.
`53`	Discontinued procedure	Use when the exam was started but terminated for safety, intolerance, or medical reasons before completion.
`76`	Repeat procedure by same provider	Use when the same provider repeats the MRI the same day due to technical failure or unacceptable prior images.
`77`	Repeat procedure by different provider	Use when a different provider repeats the MRI the same day for technical reasons.
`22`	Increased procedural services	Use when the procedure requires substantially greater effort or time (complex positioning, extensive sequences) than typical.
`23`	Unusual anesthesia	Use when substantial, medically necessary anesthesia (not sedation) is provided for the MRI due to patient condition.
`50`	Bilateral procedure	Use when bilateral upper extremity studies are performed and payer requires a bilateral modifier.
`63`	Procedure performed on infants less than 4 kg	Data not available in the input.
`QK`	Medical direction of two or more qualified individuals	Use when the physician directs multiple qualified individuals in administration of anesthesia tied to MRI.

Taxonomy Code	Specialty	Notes
`207L00000X`	Radiology	Radiologists perform interpretation of musculoskeletal MRI studies.
`207K00000X`	Diagnostic Radiology	Diagnostic radiologists commonly perform and interpret upper extremity MRI exams.
`207X00000X`	Interventional Radiology	Interventional radiologists may perform image-guided procedures related to findings but less commonly perform standard MRI interpretation.
`207VP0002X`	Orthopedic Surgery	Orthopedic surgeons commonly order and manage findings from upper extremity MRI exams.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M79.6`	Pain in limb, hand/foot	Common presenting symptom prompting non-contrast MRI of the upper extremity to evaluate soft tissues and occult pathology.
`S52.2X9A`	Fracture of radius, unspecified, initial encounter for closed fracture	Occult or healing fractures of forearm bones may be assessed with MRI when radiographs are inconclusive.
`M75.1`	Rotator cuff tear or rupture, not specified as traumatic	Although shoulder joint is excluded by this code, adjacent soft-tissue pathologies in the upper extremity may require targeted imaging; included when clinically relevant to regional pain patterns.
`M77.9`	Enthesopathy, unspecified	Tendon insertions and soft-tissue causes of pain are well evaluated on non-contrast MRI.
`G56.01`	Carpal tunnel syndrome, right upper limb	MRI may be obtained to assess secondary causes or structural contributors when electrodiagnostic testing is inconclusive.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`73221`	MRI, upper extremity; with contrast	Performed when intravenous contrast is required to characterize masses, infection, or vascularized lesions after an initial non-contrast study.
`73218`	MRI, upper extremity, other than joint, without contrast	This is the primary diagnostic code describing a non-contrast MRI of the upper extremity excluding joint-specific codes.
`73030`	Radiologic examination, acute, with minimum 2 views, forearm	Plain radiographs often precede MRI to evaluate for obvious fractures and guide need for advanced imaging.
`76942`	Ultrasound guidance for aspiration/biopsy	May be used if MRI identifies a fluid collection or mass that requires image-guided aspiration or biopsy as a next step.
`73220`	MRI, upper extremity; without contrast, followed by contrast and further sequences	May be used if the exam is escalated intra-procedurally to include contrast after initial non-contrast sequences.