MRI Knee price: Medicare anchor and facility lever
Anchor for MRI Knee - CPT 73721
$200.97
Professional (26) $63.82 plus technical (TC) $137.14.
Hospital OPPS facility anchor, this code billed alone: $243.77 (APC 5523, Level 3 Imaging without Contrast; national unadjusted, before wage-index adjustment).
Composite APC 8007: $537.85 (multi-study only, national unadjusted).
A knee MRI is billed under the lower-extremity joint code, CPT 73721, which also covers the ankle and hip. The joint named on the order should match the joint on the bill. With contrast the code becomes 73722, and that change has a larger effect on the hospital facility amount than for any other MRI on this site.
CPT code
73721
Magnetic resonance imaging, any joint of lower extremity; without contrast material
CPT 73721 covers a lower-extremity joint (knee, ankle, or hip) without contrast. Without and with contrast is 73723. The joint named on the order should match the joint scanned.
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 73721 (this page) | $200.97 | $200.97 | not a surgical global | $243.77 (APC 5523) | $48.76 |
| 73722 | $308.44 | $308.44 | not a surgical global | $800.90 (APC 5573) | $160.18 |
Billed alone in a hospital, 73721 maps to CY2026 APC 5523 at $243.77, with a minimum unadjusted copayment of $48.76. The contrast version, 73722, maps to APC 5573 at $800.90, more than three times the without-contrast facility amount, while its global anchor rises from $200.97 to $308.44.
If the order involves contrast given in a way that requires a separate procedure before the scan, that procedure has its own code and price. Ask the facility to list every line it expects to bill, not only the MRI.
For a Medicare patient, the hospital line for 73721 alone carries a minimum unadjusted copayment of $48.76, and the radiologist's coinsurance is figured on the professional component of $63.82. For the contrast code 73722 the hospital minimum copayment rises to $160.18, which reflects the higher APC that code is assigned.
CMS Addendum B lists 73721 with status indicator Q3. Billed alone it is paid through single-service APC 5523; only when another qualifying MRI study is on the same claim can the hospital be paid the MRI without contrast composite, APC 8007, instead.
Inside and outside the 73721 anchor
Covered by the anchor
- Scanner time and image acquisition for one joint
- Radiologist interpretation and written report (professional component, modifier 26)
- Standard image storage and transmission to the ordering clinician
Billed outside it
- Contrast material when a with-contrast code is billed instead
- Sedation or anesthesia, when used
- The ordering visit and follow-up visit
- Imaging of the other knee billed under a second claim line
Why prices vary for CPT 73721
Joint MRI without contrast sits in the same payment pattern as other MRI codes: hospital OPPS facility payment plus a separate professional fee, versus one global Physician Fee Schedule amount at an imaging center. The technical component is the larger share of the global anchor, so who owns the scanner drives the cash quote more than the reading fee does.
Price the same CPT code at an imaging center and at the hospital outpatient department. Ask for one all-in cash price in each setting, with interpretation included.
Questions specific to Knee MRI
- Does the order name the correct joint and side for 73721?
- Is contrast planned, which would change the code to 73722 or the without-and-with code?
- If any procedure is needed to give contrast, is it a separate line on the quote?
- Is the price one global amount or a facility fee plus a reading?
MRI Knee: billing questions
Is a knee MRI coded differently from an ankle or hip MRI?
No. CPT 73721 covers any lower-extremity joint without contrast, so the anchor is the same. The order and the bill should name the same joint and side.
Why is the hospital amount for a contrast knee MRI so much higher?
In CY2026 the contrast code 73722 maps to APC 5573, a higher hospital APC than the one used for 73721. The global fee schedule anchor rises too, but by a smaller proportion.
Are other procedures on the same day part of the MRI price?
No. The MRI anchor covers CPT 73721 only. Any separate procedure on the same day has its own code and anchor. Ask the facility to list every line it expects to bill.
How much of a knee MRI anchor is the radiologist's reading?
Of the CY2026 Michigan Locality 01 global anchor of $200.97 for 73721, the professional component is $63.82. The larger technical share is what a hospital bills as its facility payment, which is why setting moves the price more than the reader does.