CPT73221

MRI Shoulder Cost in New Jersey

Mri joint upr extrem w/o dye

$449Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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New Jersey Medicare physician rate (2026)

+10.9% vs national

Average of 2 localities. Office range $221.67–$233.34.

New Jersey (Hospital)
$227.51
Facility physician fee
Private plan est.
$296–$455
~130–200% of Medicare
Cash / self-pay est.
$182–$341
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery centre, total
$337
$205 physician + $131 facility
Physician fee alone
$205
Only 46% of the hospital total

Choosing a surgery centre over a hospital saves about $112 on the Medicare allowed amount for mri shoulder. Ask whether your procedure can be done at an ambulatory surgery centre.

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. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in New Jersey

Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.

What mri shoulder costs at hospitals near you

Everything above is a national average. The hospital you pick in New Jersey moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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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 centre 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.

National vs New Jersey

National office$205.08
National hospital (physician)$205.08
New Jersey vs national11% above the national office rate of $205.08

Where New Jersey ranks for this CPT

Rank (lowest physician fee first)#47 of 51
Lowest stateArkansas ($181.35)
Highest stateAlaska ($236.05)

CPT 73221 by New Jersey locality

LocalityOffice
northern nj$233.34
rest of new jersey$221.67

PE GPCI ranges from 1.092 to 1.160 in New Jersey. That index is why the same CPT is not one price statewide.

MRI Shoulder and how New Jersey is priced

New Jersey is split into two payment localities: northern New Jersey, which carries higher adjustments befitting its position in the New York metropolitan orbit, and the rest of the state to the south. Both localities price above the national average, but the northern one ranks among the more expensive in the country. The dividing line means a procedure in Bergen County is approved at a higher amount than the same one in Cherry Hill or along the shore. South Jersey's pricing gravity pulls toward Philadelphia even though its locality is its own.

New Jersey may be the ultimate cross-border care state: North Jersey residents flow into Manhattan hospitals, South Jersey residents into Philadelphia's academic centers, and the state's own large systems compete hard in between. Dense population means most residents have multiple hospitals within a short drive, which is real negotiating leverage for a cash-pay patient. The shore counties see seasonal population surges that strain capacity each summer.

This procedure: 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 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.

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 in New Jersey: questions

The 2026 Medicare physician office rate for CPT 73221 averages $227.51 across 2 New Jersey localities, from $221.67 in REST OF NEW JERSEY to $233.34 in NORTHERN NJ. The hospital physician rate averages $227.51. Enter a ZIP for the exact locality.

Yes. CMS splits New Jersey into 2 payment localities. For this CPT the office physician fee spans $11.67 from the lowest to highest locality. Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $46 for the office physician line or $46 for the hospital physician line in New Jersey. Medigap may cover that 20%. This is not the hospital facility fee.

No. $227.51 is only the physician's share. Adding Medicare's facility payment brings the total to about $449 in a hospital outpatient department, or about $337 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. New Jersey ranks #47 of 51 states on the physician line (11% above the national office rate of $205.08).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.