MRI Shoulder Cost
Mri joint upr extrem w/o dye
$307Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, an MRI shoulder costs up to about $307 in total at a hospital outpatient department, counting both the physician and the facility. Outside a hospital, one global fee of about $205 covers the whole test, and a ZIP code adjusts every figure to your area.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
National Medicare physician rate (2026)
What the whole procedure costs
The office rate above is what an imaging center, lab or office is paid for the whole test. In a hospital, the facility bills its own fee and the physician bills only the reading. These are 2026 national Medicare amounts.
Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. For a test like this the physician in a hospital bills only the reading (the professional component); outside a hospital one global fee covers the whole test, shown in the office rate above. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Get the rate for your ZIP
CMS adjusts this CPT by locality. A five-digit ZIP is enough: no account, no insurance card.
What MRI shoulder costs at hospitals near you
Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 90001.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. For this code the office and hospital physician lines differ by $141.95.
How CMS prices CPT 73221
Work is about 21% of the office total RVU; practice expense is about 77%. Localities with a high PE GPCI move this code more when practice expense is a large share.
Office vs hospital for this code
Office (non-facility) physician rate: $205.08. Hospital (facility) physician rate: $63.13.
Medicare patients typically owe 20% of the allowed amount after the Part B deductible, about $41 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.
Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.
MRI Shoulder cost by state
2026 Medicare non-hospital rate for CPT 73221, averaged across each state's localities. Open a state for its locality table and full cost breakdown.
What Is MRI Shoulder?
A shoulder MRI without contrast (the upper extremity joint MRI code) images the rotator cuff tendons, labrum, and cartilage that X-rays cannot see, making it the key test for suspected rotator cuff tears and persistent shoulder pain. You lie still with the arm positioned at your side inside the scanner for 20 to 40 minutes. It is painless, though holding a sore shoulder motionless is the hardest part for many patients.
What Affects the Cost
- –Freestanding imaging centers price this scan dramatically below hospital outpatient departments.
- –Suspected labral tears sometimes require an MR arthrogram instead, where dye is injected directly into the joint first, adding an injection procedure and a different code.
- –Insurers frequently require completed X-rays and weeks of conservative care before approving, so those upstream costs are part of the pathway.
- –A positive finding often leads to orthopedic consultation, injections, or arthroscopic surgery, each a new spending episode.
- –The radiologist's reading fee is a separate component of the total.
How It Is Billed
CPT 73221 covers a non-contrast MRI of any upper extremity joint, and for the shoulder it is billed once per side; imaging both shoulders means two full studies. An MR arthrogram involves a separately billed joint injection under imaging guidance plus a with-contrast MRI code, a meaningfully more expensive package. Hospitals split technical and professional fees; independent centers usually quote one global price.
Insurance & Coverage Notes
Commercial prior authorization is standard, and approvals typically require recent X-rays plus documented conservative treatment such as physical therapy or an injection trial, unless there is an acute traumatic tear. Medicare covers it without authorization at standard Part B cost sharing. If surgery is already likely, coordinate the MRI authorization and surgical consultation within the same network to avoid repeat imaging demands from a new surgeon.
Questions to Ask Before Booking
- 1.Does my insurer require X-rays and therapy first, and does my record show them?
- 2.Do you suspect a labral tear needing an arthrogram, and how much more does that cost?
- 3.What is the price at a freestanding center versus the hospital?
- 4.Will the surgeon you might refer me to accept this facility's images, or would I face a rescan?
- 5.Is the radiologist fee included in the quote?
MRI Shoulder (CPT 73221): questions
Under 2026 Medicare rates, an MRI shoulder costs up to about $307 in total at a hospital outpatient department, counting both the physician and the facility. Outside a hospital, one global fee of about $205 covers the whole test, and a ZIP code adjusts every figure to your area.
Outside a hospital, one global fee pays for the equipment, the staff and the doctor's reading, so the office or imaging center rate for CPT 73221 is $205.08. In a hospital the physician bills only the reading, about $63.13, and the hospital is paid for the rest on its own claim.
A shoulder MRI without contrast (the upper extremity joint MRI code) images the rotator cuff tendons, labrum, and cartilage that X-rays cannot see, making it the key test for suspected rotator cuff tears and persistent shoulder pain. You lie still with the arm positioned at your side inside the scanner for 20 to 40 minutes. It is painless, though holding a sore shoulder motionless is the hardest part for many patients. CMS bills it as “Mri joint upr extrem w/o dye.”
It depends on the setting. At an independent imaging center, lab or office, $205.08 is Medicare's full national rate, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $63.13) and the hospital is paid separately, which takes the total to about $307. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.
For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.