Summary & Overview

CPT 73221: MRI of Upper Extremity Joint Without Contrast

CPT code 73221 denotes a diagnostic magnetic resonance imaging (MRI) scan of any joint in the upper extremity — shoulder, elbow, wrist, or hand — performed without contrast. As a common imaging modality for musculoskeletal complaints, this code is widely used in outpatient radiology and hospital outpatient settings to evaluate rotator cuff pathology, bursitis, joint degeneration, sprains, and other soft-tissue or intra-articular abnormalities. Nationally, utilization of non-contrast joint MRI affects imaging capacity, clinical pathways for orthopedic and sports medicine care, and payer coverage policies for diagnostic imaging.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for use of 73221, comparisons with related contrast and combined-sequence codes, and typical sites of service. The publication outlines benchmarks for coding relationships and service use, highlights common clinical indications tied to upper-extremity pain and degenerative or traumatic diagnoses, and summarizes how this code fits into imaging workflows and prior-authorization considerations. The content is intended to inform billing managers, radiology departments, and policy teams about the role of CPT code 73221 in diagnostic care and administrative processing at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare73221CPTMRIUpper extremityMusculoskeletal imagingRadiologyDiagnostic imagingOutpatient

Billing Code Overview

CPT code 73221 describes a magnetic resonance imaging (MRI) procedure of any joint in the upper extremity (shoulder, elbow, wrist, or joints of the hand) performed without contrast material. This is a diagnostic imaging service focused on evaluating joint structure, soft tissues, and surrounding anatomy to inform clinical diagnosis and care.

Service type: Diagnostic MRI of an upper extremity joint without contrast
Typical site of service: Outpatient imaging centers or hospital outpatient departments where MRI scanners are available

Clinical & Coding Specifications

Clinical Context

A 48-year-old right-hand–dominant patient presents to an orthopaedic clinic with three months of progressive right shoulder pain after a fall while hiking. Conservative therapy including nonsteroidal anti-inflammatory drugs, activity modification, and physical therapy produced limited improvement. The orthopaedic surgeon documents focal pain at the lateral shoulder, limited active range of motion, and positive impingement signs. The provider orders a diagnostic magnetic resonance imaging study of the right shoulder without contrast to evaluate for rotator cuff tear, bursitis, or acromioclavicular sprain.

The clinical workflow: the referring clinician documents the indication and relevant ICD-10 code M25.511 (pain in right shoulder) in the order. The outpatient imaging center schedules the MRI of the shoulder (no contrast) as an outpatient radiology service. On the day of service, the patient is screened for MRI safety, positioned for a dedicated shoulder protocol, and the technologist acquires multiplanar non-contrast sequences. A diagnostic radiologist (Diagnostic Radiology taxonomy) interprets the study and issues a report describing tendon integrity, bursitis, joint effusion, and osseous findings. Findings guide the orthopaedic surgeon’s next management step (conservative care continuation, injection, or surgical planning). Typical sites of service are outpatient radiology centers or hospital outpatient departments; this procedure may also be performed in ambulatory surgery centers when bundled into preoperative imaging workflows.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation of the MRI separate from technical acquisition.
`TC`	Technical component	Use when billing only the facility/technical portion of the MRI study.
`RT`	Right side	Use to indicate the procedure was performed on the right upper extremity (e.g., right shoulder).
`LT`	Left side	Use to indicate the procedure was performed on the left upper extremity (e.g., left shoulder).
`59`	Distinct procedural service	Use when an unrelated, separate procedure is performed on the same day that meets distinct procedural criteria.
`52`	Reduced services	Use when the MRI study was partially reduced in scope (e.g., abbreviated protocol).
`53`	Discontinued procedure	Use when the MRI was started but discontinued for documented medical reasons (e.g., acute patient intolerance).
`76`	Repeat procedure by same physician	Use when the same physician repeats the MRI service later the same day for the same patient and same CPT.
`77`	Repeat procedure by another physician	Use when a different physician repeats the MRI service later the same day.
`90`*	Reference to another physician	Not in supplied list; omitted.

Taxonomy Code	Specialty	Notes
`2085R0202X`	Radiology, Diagnostic Radiology	Primary specialty interpreting MRI studies of the upper extremity.
`207X00000X`	Orthopaedic Surgery	Referring specialty that commonly orders MRI for rotator cuff, labral, and AC joint pathology.
`208100000X`	Physical Medicine & Rehabilitation	Clinicians who may order MRI for shoulder pain and nonoperative management planning.
`207L00000X`	Anesthesiology	Involved when imaging is part of preoperative evaluation or for MR-guided procedures requiring anesthesia.
`207P00000X`	Emergency Medicine	May order urgent MRI for acute traumatic shoulder injuries in the emergency setting.

*90 is not among the supplied modifiers and is not listed per input constraints.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M25.511`	Pain in right shoulder	Common presenting symptom prompting non-contrast shoulder MRI to evaluate tendon, bursal, and joint pathology.
`M25.512`	Pain in left shoulder	Same relevance for left-sided shoulder symptoms requiring imaging.
`M19.90`	Unspecified osteoarthritis, unspecified site	MRI may identify degenerative changes, cartilage loss, or secondary findings related to osteoarthritis in the shoulder joint.
`S43.401A`	Sprain of unspecified acromioclavicular joint, initial encounter	MRI can assess ligamentous injury, joint separation, and associated soft-tissue damage after acute trauma.
`M75.100`	Unspecified rotator cuff tear or rupture of unspecified shoulder	Primary indication for shoulder MRI to characterize rotator cuff tendon integrity, partial vs full-thickness tear, and retraction.
`M75.51`	Bursitis of shoulder	MRI can detect subacromial-subdeltoid bursitis and associated inflammatory changes.
`M77.9`	Enthesopathy, unspecified	MRI can evaluate tendon insertion pathology and enthesopathic changes contributing to shoulder pain.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`73222`	Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)	Used when intra-articular or intravenous contrast is administered to further assess labral pathology, inflammatory disease, or to characterize lesions not well seen on non-contrast MRI.
`73223`	Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences	Used when the study is performed first without contrast and then additional post-contrast sequences are obtained in the same session to improve diagnostic yield.
`73221`	Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)	The primary diagnostic non-contrast MRI of the upper extremity (shoulder, elbow, wrist, hand) as described; often the first-line advanced imaging for soft tissue and joint evaluation.