CPT 73221: Medicare rates for 2026
73221: MRI of shoulder or other arm joint, no contrast (Imaging). Description is our plain-language summary.
Which number to compare to
Match the reference to the kind of charge. A hospital visit often produces two bills: the hospital's facility charge and the doctor's professional charge.
| Kind of charge | 2026 national amount | Notes |
|---|---|---|
| Hospital outpatient facility charge (APC 5523) | $243.77 | Status Q3: May be paid through a composite APC when billed with related services; otherwise paid separately at this APC rate. Source: CMS OPPS Addendum B, October 2026, national unadjusted. |
| Doctor's charge, in a hospital/facility | $205.08 | Global amount (professional + technical). Doctors billing in a hospital usually bill the -26 professional component below. Source: CMS Physician Fee Schedule CY2026 (RVU26D, Oct 2026), national unadjusted. |
| Doctor's charge, office or clinic (non-facility) | $205.08 | Includes the practice's overhead; no separate facility charge. Source: CMS Physician Fee Schedule CY2026 (RVU26D, Oct 2026), national unadjusted. |
| Professional component only (-26) | $63.13 | The doctor's interpretation, e.g. the radiologist's read. Source: CMS Physician Fee Schedule CY2026 (RVU26D, Oct 2026), national unadjusted. |
| Technical component only (-TC) | $141.95 | Equipment and staff, billed by a non-hospital imaging center or lab. Hospitals use the facility rate instead. Source: CMS Physician Fee Schedule CY2026 (RVU26D, Oct 2026), national unadjusted. |
- All amounts are CY2026 national unadjusted rates (PFS RVU26D October release, conversion factor $33.4009; CLFS 2026 Q4; OPPS Addendum B October 2026). Medicare adjusts them by area, so local amounts differ.
- Rates are per unit. If your line shows more than one unit, multiply.
- Modifiers change the reference: -26 and -TC split imaging/tests; repeat modifiers (76, 77, 91) and distinct-service modifiers (59, XE, XS, XP, XU) mean a repeated line can be legitimate.
What a higher price means
Hospital and doctor list prices are often several times Medicare. That's usually legal, and it isn't proof of a billing error. What you actually owe depends on your insurance, your plan's negotiated rate, or the provider's self-pay price.
Useful next steps if your charge for 73221 looks high:
- If you're insured, compare the bill with your insurer's Explanation of Benefits (EOB). An in-network provider generally can't bill more than the EOB's patient amount.
- Ask for an itemized bill with codes, dates, units and modifiers (free letter).
- If you're uninsured or self-pay, ask for the self-pay price and the hospital's financial assistance policy. If you got a Good Faith Estimate and the bill is $400+ higher, you may be able to use the No Surprises Act dispute process.
Last checked against CMS files October 14, 2026. Not legal, medical, or financial advice.
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