CPT73221

MRI Shoulder Cost in North Carolina

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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North Carolina Medicare physician rate (2026)

-5.7% vs national

Single statewide locality.

North Carolina (Hospital)
$193.41
Facility physician fee
Private plan est.
$251–$387
~130–200% of Medicare
Cash / self-pay est.
$155–$290
~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 North Carolina

Check your ZIP code for your region of North Carolina, whether Charlotte, Raleigh-Durham and the Triangle, the Triad, Asheville and the mountains, or Wilmington and the coastal east.

What mri shoulder costs at hospitals near you

Everything above is a national average. The hospital you pick in North Carolina 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 North Carolina

National office$205.08
National hospital (physician)$205.08
North Carolina vs national6% below the national office rate of $205.08

Where North Carolina ranks for this CPT

Rank (lowest physician fee first)#18 of 51
Lowest stateArkansas ($181.35)
Highest stateAlaska ($236.05)

MRI Shoulder and how North Carolina is priced

North Carolina's Medicare physician pricing comes from one statewide locality with indices just under the national average, so Charlotte, the Research Triangle, and the rural east and mountain west all share the same approved amounts. For a state with several fast-growing metros, the single-locality approach keeps the fee schedule simple even as local economies diverge. Nothing in the geographic adjustments distinguishes a Raleigh procedure from one in Boone or Greenville. As elsewhere, the office-versus-hospital setting decision moves prices more than geography within the state does.

North Carolina is unusually rich in academic medicine, with multiple nationally known university medical centers clustered in the Triangle and Winston-Salem, plus a major hospital system anchored in Charlotte that has grown across the Southeast. The rural east and the mountain counties are much thinner markets, and hospital consolidation has been reshaping who owns local care. Patients near the borders sometimes use Virginia or South Carolina providers.

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 North Carolina: questions

North Carolina is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 73221 is $193.41 in an office and $193.41 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. North Carolina uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $39 for the office physician line or $39 for the hospital physician line in North Carolina. Medigap may cover that 20%. This is not the hospital facility fee.

No. $193.41 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. North Carolina ranks #18 of 51 states on the physician line (6% below 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.