Summary & Overview
CPT 73220: MRI Upper Extremity (Non-Joint), With and Without Contrast
CPT code 73220 represents a diagnostic magnetic resonance imaging (MRI) procedure of the upper extremity performed for locations other than the joint, with sequences obtained both before and after intravenous contrast administration. This study supports evaluation of soft-tissue structures, neurovascular bundles, tumors, infectious or inflammatory processes, and preoperative planning where non-contrast and contrast-enhanced imaging provide complementary findings. Nationally, MRI utilization for extremity pathology contributes to imaging-driven diagnostic workflows and stewardship conversations about appropriate use and contrast administration.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find operational and billing context for CPT code 73220, including the clinical scope of the service, typical sites of service, and common billing modifiers (listed separately). The publication also outlines relevant benchmarks and policy considerations affecting reimbursement and prior authorization practices, where available.
This summary is intended to orient billing staff, radiology managers, and policy analysts to the clinical purpose of CPT code 73220, expected care settings, and the types of documentation and workflow elements that typically accompany contrast and non-contrast upper extremity MRI studies. Data not available in the input will be noted in detailed sections.
Billing Code Overview
CPT code 73220 describes a diagnostic magnetic resonance imaging (MRI) of the upper extremity, non-joint location, performed first without contrast and then repeated after intravenous contrast administration. The procedure captures detailed soft-tissue and vascular information by acquiring both non-contrast and contrast-enhanced sequences.
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Service type: Diagnostic MRI with and without contrast
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Typical site of service: Outpatient imaging centers or hospital outpatient departments
Clinical & Coding Specifications
Clinical Context
A 52-year-old right-hand–dominant patient presents to an outpatient imaging center with persistent forearm and wrist pain after a fall onto an outstretched hand six weeks prior. Conservative care (rest, splinting, NSAIDs, and physical therapy) provided limited relief. The referring orthopedic hand specialist orders magnetic resonance imaging of the upper extremity for a non‑joint location (soft tissue and bone assessment of the distal radius, wrist soft tissues and forearm compartments) to evaluate for occult fracture, tendon injury, or soft-tissue mass. The ambulatory MRI technologist obtains the study in a dedicated extremity coil. The radiologist performs the exam first without intravenous contrast to evaluate marrow edema, tendon integrity, and fluid collections, then administers gadolinium-based contrast and acquires post-contrast sequences to assess for enhancing soft-tissue mass, infection/abscess, or synovial disease. The radiology report documents indication, technique (unenhanced and contrast-enhanced sequences), findings, and impression. Typical documentation includes vascular access and contrast agent, patient consent (if required by facility policy), and any immediate contrast reactions. The typical site of service is an outpatient imaging center or hospital outpatient department; the service is diagnostic and does not include image-guided injection or arthrography.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician's professional component separate from technical component billing (paired with ). |