CPT 73221: MRI of Upper Extremity Joint, Without Contrast
Medicare pays $142 and commercial payers pay $542 on average nationally for this procedure.
CPT code 73221 describes a diagnostic magnetic resonance imaging (MRI) study of any joint of the upper extremity (shoulder, elbow, wrist, or hand) performed without contrast material; service type is diagnostic MRI and the typical site of service is an outpatient radiology or imaging center (also performed in hospital outpatient departments or ambulatory surgical centers as appropriate).
For related coverage guidance, see recent payer policy updates: Fixed Wing Air Ambulance Transport, Air Ambulance, Ambulance Services (for New Mexico Only).
Customize your policy alerts
Sign up for cpt 73221 policy alerts
Get alerted when payer policies referencing 73221 are released or updated.
Monitor payer policy activity
National Reimbursement Benchmarks
Medicare’s mean payment of $142.30 for CPT 73221 sits well below BUCA’s average commercial mean of $542.10, indicating a substantial gap between public and commercial reimbursement levels. This gap of $399.80 highlights the differential between a government fee schedule and negotiated commercial rates; BUCA’s mean is roughly 3.8 times Medicare’s mean, reflecting typical commercial uplifts for this code.
Dispersion measured as the interquartile range (P75 minus P25) varies notably across payers. Blue Cross Blue Shield shows the widest IQR at $289.50 (P75 $880.70 minus P25 $609.20), while Aetna’s IQR is $171.50 and Cigna’s is $227.20. UnitedHealth Group has an IQR of $238.50. BUCA’s IQR is $255.50 and Medicare’s IQR is $132.00. Thus Blue Cross Blue Shield presents the greatest middle-range variability and Medicare the tightest interquartile spread.