How Much Does an MRI Shoulder Cost in New York?
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 (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in New York averages $227, from $196 in Rest of New York to $240 in Nyc Suburbs/Long Island.
- ✓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
New York Medicare physician rate (2026)
+10.5% vs nationalAverage of 5 localities. Office range $196.29–$240.34.
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.
Your ZIP in New York
New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.
What MRI shoulder costs at hospitals near you
Everything above is a national average. The hospital you pick in New York 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 12007.
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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 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. In New York the office and hospital physician lines for this CPT differ by $158.53.
National vs New York
Where New York ranks for this CPT
CPT 73221 by New York locality
| Locality | Office |
|---|---|
| nyc suburbs/long island | $240.34 |
| queens | $237.99 |
| manhattan | $235.26 |
| poughkpsie/n nyc suburbs | $222.71 |
| rest of new york | $196.29 |
PE GPCI ranges from 0.950 to 1.189 in New York. That index is why the same CPT is not one price statewide.
MRI Shoulder and how New York is priced
New York has one of the most complex locality maps in the country, with around five payment areas: Manhattan is its own locality, Queens is separately priced, the NYC suburbs and Long Island form another high-cost locality, the Poughkeepsie area has its own, and the rest of the state, including Buffalo, Rochester, Syracuse, and Albany, shares a distinctly lower-priced upstate locality. The spread between Manhattan and upstate adjustments is among the widest within any state. A knee MRI or office visit is approved at meaningfully different amounts in Manhattan, Mineola, and Rochester. Upstate New York prices closer to the Midwest than to the five boroughs.
New York City is a global medical capital with world-famous academic medical centers competing within blocks of each other, while upstate cities each center on their own regional academic hubs. Long Island and the lower Hudson Valley support dense suburban hospital markets of their own. The upstate-downstate divide runs through everything in New York health care, including what providers charge and what patients can access locally.
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?
Other featured procedures in New York
MRI Shoulder in other states
MRI Shoulder in New York: 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 (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in New York averages $227, from $196 in Rest of New York to $240 in Nyc Suburbs/Long Island. Enter a ZIP for the exact New York locality.
Yes. CMS splits New York into 5 payment localities. For this CPT the office physician fee spans $44.05 from the lowest to highest locality. New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $45 for the office physician line or $14 for the hospital physician line in New York. Medigap may cover that 20%. This is not the hospital facility fee.
It depends on where the test is done. At an independent imaging center, lab or office, $226.52 is Medicare's full rate in New York, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $67.99) and the hospital is paid separately, which brings the national total to up to about $307. New York ranks #46 of 51 states on the non-hospital rate (10% above the national office rate of $205.08).