MRI Shoulder Cost in Wisconsin
Mri joint upr extrem w/o dye
$449Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre 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
Wisconsin Medicare physician rate (2026)
-4.2% vs nationalSingle statewide locality.
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.
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 Wisconsin
Check your ZIP code for your part of Wisconsin, whether Milwaukee, Madison, Green Bay and the Fox Valley, La Crosse, Eau Claire, or the rural Northwoods.
What mri shoulder costs at hospitals near you
Everything above is a national average. The hospital you pick in Wisconsin 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.
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 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 Wisconsin
Where Wisconsin ranks for this CPT
MRI Shoulder and how Wisconsin is priced
Wisconsin's Medicare pricing runs through a single statewide locality with indices near the national average, so Milwaukee, Madison, and the Northwoods share the same approved amounts. The unified locality sits atop one of the more regionally organized care systems in the country, with strong integrated groups serving defined territories. No metro premium exists in the fee schedule, so Milwaukee's higher practice costs are averaged into the statewide factors. The published rates here travel unchanged across all seventy-two counties.
Milwaukee and Madison hold the state's academic medicine and largest systems, while integrated clinics in Marshfield, La Crosse, and the Fox Valley have long histories of serving rural Wisconsin through hub-and-spoke networks. The far north is lake and forest country where specialty care means a long drive south, and some western residents use Twin Cities or Rochester, Minnesota providers. Wisconsin's tradition of clinic-based integrated care tends to keep billing relatively coordinated.
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 Wisconsin
MRI Shoulder in other states
MRI Shoulder in Wisconsin: questions
Wisconsin is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 73221 is $196.37 in an office and $196.37 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Wisconsin 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 Wisconsin. Medigap may cover that 20%. This is not the hospital facility fee.
No. $196.37 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. Wisconsin ranks #20 of 51 states on the physician line (4% below the national office rate of $205.08).