CPT 73721Radiology

Mri jnt of lwr extre w/o dye

CPT code 73721 is used when a patient receives an MRI scan of a lower extremity joint (such as knee, ankle, or hip) without using contrast dye. This imaging helps doctors diagnose injuries, arthritis, ligament tears, and other joint problems in the legs.

Showing rates for

National Average

Base Medicare rate

$200.22

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.35

PE RVU (NF)

4.75

MP RVU

0.09

Total RVU

6.19

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Always verify prior authorization before scheduling; most commercial payers require pre-authorization for MRI studies
Impact: Prevents denials that cost the full $200.22 reimbursement and require time-consuming appeals; pre-auth denial rates exceed 15% for lower extremity MRIs
Document specific joint imaged (hip, knee, ankle) in operative note and claim; do not use generic 'lower extremity' language
Impact: Reduces audit risk and prevents downcoding; vague documentation increases claim review probability by 25-30%
For bilateral studies, bill 73721 twice with RT and LT modifiers rather than using modifier 50
Impact: Many payers process bilateral imaging as separate line items; modifier 50 may reduce reimbursement to 150% instead of 200% of allowable
Confirm contrast usage before coding; if contrast was administered, use 73722 or 73723 instead of 73721
Impact: Incorrect contrast coding triggers automatic denials and reimbursement delays; contrast codes reimburse at different rates
Bundle professional and technical components when your facility owns equipment and provides interpretation
Impact: Billing global code 73721 without modifiers yields full $200.22; splitting unnecessarily creates administrative burden without revenue benefit
Link to specific ICD-10 codes demonstrating medical necessity such as M23.2 (meniscus derangement), M25.56 (knee pain), S83.5 (knee sprain)
Impact: Generic or unspecified diagnosis codes increase denial rates by 40%; specific diagnosis codes demonstrate medical necessity and expedite payment

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 73721?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 73721 in 2025?

The 2025 Medicare national average reimbursement for CPT 73721 is $200.22 for both facility and non-facility settings. This rate is based on 6.19 total RVUs (1.35 work RVU, 4.75 practice expense RVU, 0.09 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Does CPT 73721 require prior authorization from insurance?

Most commercial insurance plans and Medicare Advantage plans require prior authorization for CPT 73721. Original Medicare does not require prior authorization but does require medical necessity documentation. Always verify payer-specific requirements before scheduling the MRI to avoid denial of the $200.22 reimbursement.

What is the difference between CPT 73721 and 73722?

CPT 73721 is for MRI of lower extremity joint WITHOUT contrast dye, while 73722 is for the same procedure WITH contrast dye administered intravenously. The codes have different reimbursement rates and require different documentation regarding contrast administration and patient consent.

Can I bill CPT 73721 for both knees on the same day?

Yes, you can bill CPT 73721 twice for bilateral knee MRIs performed the same day. Bill the code on two separate lines with RT (right) modifier on one line and LT (left) modifier on the other. Include separate medical necessity documentation for each knee when clinical indications differ.

What diagnosis codes support medical necessity for CPT 73721?

Common supporting ICD-10 codes include M23.2 (meniscus derangement), M25.56 (knee pain), S83.5 (knee sprain), M17.0 (knee osteoarthritis), M76.8 (lower limb tendinopathy), and M71.46 (knee effusion). The diagnosis must correlate with the specific joint being imaged and justify advanced imaging over standard X-rays.

How do I bill 73721 if only reading the images, not performing the scan?

If you are only providing the professional interpretation (reading), bill CPT 73721 with modifier 26 (professional component). This typically reimburses approximately 40% of the total fee, or about $80.09, while the facility performing the technical component bills 73721-TC for the remaining 60%.

What are the RVU values for CPT code 73721 in 2025?

CPT 73721 has a total of 6.19 RVUs in 2025, broken down as: 1.35 work RVUs, 4.75 practice expense RVUs (both facility and non-facility), and 0.09 malpractice RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.