MRI of a shoulder, elbow, or wrist joint done first without contrast and then repeated after IV contrast is given, usually for infection, tumor, or postoperative questions.
- Medicare
- $383.11
- Work RVU
- 2.1
- Global, days
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Order with a clinical reason that supports a pre- and post-contrast study
- Contrast agent, dose, and route
- Both phases described in the interpretation
- Joint and laterality imaged
- Prior authorization number matching 73223
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
73223 covers an upper extremity joint MRI with two sequences: one set without contrast, then a second set after IV gadolinium. It is the right code when both phases are documented. If only post-contrast images were taken, bill 73222. If no contrast was given, bill 73221.
For most rotator cuff, labral, and ligament questions, ortho surgeons order a non-contrast MRI or an MR arthrogram, not 73223. This code shows up for suspected septic arthritis or osteomyelitis, a mass near the joint, or a revision case where the surgeon wants to see enhancement around hardware or scar.
MR arthrograms get coded differently than many people expect. Contrast injected into the joint is coded with the arthrography injection code (for example, 23350 for the shoulder) plus the MRI code. CPT treats intra-articular contrast as a with-contrast study, so it is usually reported as 73222, not 73223. Report 73223 only when IV contrast is also given and both phases are read. Commercial payers will ask for a clinical reason that fits the dual-phase study.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (2.1) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.47) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 2.1 |
| Practice expense RVU | 9.22 |
| Malpractice RVU | 0.15 |
| Total RVU | 11.47 |
| Medicare national rate | $383.11 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $383.11 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 73223 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Authorization obtained for 73221 or 73222 but 73223 billed
- Only one phase documented in the report
- MR arthrogram coded as 73223 without IV contrast
- Diagnosis does not justify contrast (for example, routine rotator cuff tear workup)
- Missing laterality or 26/TC modifier
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is a shoulder MR arthrogram 73222 or 73223?
02What is the difference between 73221, 73222, and 73223?
03Why do payers deny 73223 for rotator cuff tears?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes capture the clinical concern that calls for contrast, such as suspected infection or a mass, which is what supports a dual-phase joint MRI with the payer.
See how Mira captures CPT 73223 documentation