Medicare Physician Fee Schedule · Q3 2026 release

CPT 73721 in St. Louis, MO 05302-01

Lower-extremity joint mri without contrast in ZIPs including 63101, 63108, and 63105

73721 2026 C ·

05302-01 A Active

Non-facility Facility

Allowed amount

$196.87

in a doctor’s own office or clinic

96.3% of the $204.41 national baseline

Medicare payment: $157.50
Patient / secondary: $39.37
Expected total to provider: $196.87

Patient / secondary and expected total to provider assume the Part B annual deductible is already met. If it isn't, the patient owes more than the amount shown here.

Locality-adjusted Physician Fee Schedule pricing

Formula

(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor

RVU × GPCI components of this amount
Component	RVU	× GPCI	= Adjusted
Work	1.32	× 1.000	1.3200
Practice expense	4.71	× 0.952	4.4839
Malpractice	0.09	× 1.002	0.0902
Sum of adjusted RVUs			5.8941
× 33.4009 conversion factor			$196.87

Citations

Physician relative value file (PPRRVU) PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 8,216)

hcpcs (col 1)

73721

status_code (col 4)

A

work_rvu (col 6)

1.32

pe_rvu_nonfacility (col 7)

4.71

pe_rvu_facility (col 9)

4.71

mp_rvu (col 11)

0.09
Geographic practice cost indices (GPCI) GPCI2026.csv in rvu26c-updated-06-30-2026.zip (row 69)

work_gpci (col 5)

1

pe_gpci (col 6)

0.952

mp_gpci (col 7)

1.002
Physician relative value file (PPRRVU) PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 11)

conversion_factor (col 26)

33.4009

How much does Medicare allow for CPT 73721 in St. Louis, MO? Copy link

The Medicare allowed amount is $196.87 in the office (non-facility) and facility settings, under the Q3 2026 Physician Fee Schedule. That is 3.7% below the national baseline. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied — not necessarily what a specific claim pays.

What Medicare locality is St. Louis, MO in? Copy link

CMS payment locality Metropolitan St. Louis (05302-01). Every location in it is priced identically.

Why St. Louis, MO differs from the national amount Copy link

St. Louis, MO (this locality)

$196.87

National PFS baseline (GPCI 1.000)

$204.41

The national figure is a baseline, not an amount any provider is paid. This locality's geographic practice cost indices scale each RVU component before the conversion factor is applied, which puts St. Louis, MO at 3.7% below the national baseline.

Work GPCI

1.000

Practice expense GPCI

0.952

Malpractice GPCI

1.002

2026 conversion factor

$33.4009

Formula and inputs Copy link

The office (non-facility) amount for 73721 in St. Louis, MO: each component's RVU times its GPCI, summed, then multiplied by the conversion factor.

RVU and GPCI components of the St. Louis, MO allowed amount for 73721
Component	RVU	× GPCI	= Adjusted RVU
Work	1.32	1.000	1.3200
Practice expense	4.71	0.952	4.4839
Malpractice	0.09	1.002	0.0902
Sum of adjusted RVUs			5.8941
× $33.4009 2026 conversion factor			$196.87

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in St. Louis, MO. The allowed amount is not the program payment — the rows below separate them. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for 73721 in St. Louis, MO
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full.	$196.87
Non-participating allowed amount 95% of the participating amount.	$187.03
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount.	$215.08
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met.	$157.50
Beneficiary coinsurance The remaining 20%.	$39.37
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share.	$3.15
Medicare pays after sequestration Program payment net of the sequestration reduction.	$154.35

Contracted rate: % of Medicare in St. Louis, MO Copy link

Commercial contracts are usually written as a percentage of the Medicare fee schedule. Which Medicare amount they mean is the part that gets misread: a contract benchmarked to the fee schedule prices off this locality's allowed amount — $196.87 in the office (non-facility) setting — not the $204.41 national baseline.

Opens the calculator already set to St. Louis, MO and the office (non-facility) setting. It also compares what a payer actually paid against the expected amount. See how to find your contract's actual percentage.

ZIP codes this St. Louis, MO rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 131 ZIP codes to this payment locality. 73721 prices identically in every one of them. 7 of them span more than one locality and need ZIP+4 for an exact match.

63001 63005 63006 63010 63011 63012 63016 63017 63019 63020 63021 63022 63023 63024 63025 63026 63028 63030 63031 63032 63033 63034 63038 63040 63042 63043 63044 63045 63047 63048 63049 63050 63051 63052 63053 63057 63065 63066 63070 63074 63088 63099 63101 63102 63103 63104 63105 63106 63107 63108 63109 63110 63111 63112 63113 63114 63115 63116 63117 63118 63119 63120 63121 63122 63123 63124 63125 63126 63127 63128 63129 63130 63131 63132 63133 63134 63135 63136 63137 63138 63139 63140 63141 63143 63144 63145 63146 63147 63150 63151 63153 63155 63156 63157 63158 63160 63163 63164 63166 63167

31 more ZIP codes map to this locality. The St. Louis, MO locality page lists the full set.

Checking a different ZIP code?

Resolves the ZIP to its payment locality, so you can confirm whether this amount applies.

73721 in nearby payment localities Copy link

Payment localities in the same region as St. Louis, MO, nearest first. Each amount is that locality's own GPCI-adjusted office (non-facility) figure for 73721. Proximity doesn't imply similar pricing — neighbouring localities often differ.

73721 allowed amount in payment localities near St. Louis, MO
Metro	Allowed amount	vs. St. Louis, MO
Metro East, IL	$194.88	-1.0%
Kansas City, MO	$194.75	-1.1%
Indianapolis, IN	$191.38	-2.8%
Chicago, IL	$209.40	+6.4%
Louisville, KY	$186.70	-5.2%
Nashville, TN	$188.71	-4.1%

Every payment locality nationwide is on the CPT 73721 rate map.

Other codes priced in St. Louis, MO Copy link

Office (non-facility) allowed amounts in this same payment locality, Q3 2026.

Other curated codes and their allowed amounts in St. Louis, MO
Code	Service	St. Louis, MO	vs. national
72148	Lumbar Spine MRI Without Contrast	$184.99	-3.5%
70553	Brain MRI With and Without Contrast	$305.60	-3.6%
70551	Brain MRI Without Contrast	$188.49	-3.5%
72141	Cervical Spine MRI Without Contrast	$184.04	-3.5%
73221	Upper-Extremity Joint MRI Without Contrast	$197.50	-3.7%
74183	Abdominal MRI With and Without Contrast	$323.60	-3.7%
72146	MRI	$183.72	-3.5%
72197	Pelvic MRI With and Without Contrast	$322.01	-3.7%
77049	MRI	$327.24	-3.7%
73222	MRI	$300.34	-3.9%
70552	MRI	$258.96	-3.7%
73722	MRI	$302.57	-3.9%

Common questions Copy link

Which ZIP codes does the St. Louis, MO rate for 73721 cover?

The CMS ZIP-to-locality crosswalk maps 131 ZIP codes to this payment locality, and every one of them prices 73721 identically. Examples include 63001, 63005, 63006, 63010, 63011, 63012. 7 of them span more than one payment locality, so those need ZIP+4 for an exact match.

Why is the 73721 rate in St. Louis, MO different from the national amount?

The national figure is a GPCI 1.000 baseline, not an amount any provider is paid. This locality's geographic practice cost indices — work 1.000, practice expense 0.952, malpractice 1.002 — scale each RVU component before the conversion factor is applied, which is why St. Louis, MO allows less than the $204.41 baseline.

What is the non-participating amount and limiting charge for 73721 in St. Louis, MO?

A non-participating provider is paid $187.03 — 95% of the $196.87 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $215.08, which is 115% of the non-participating amount.

How much of the St. Louis, MO 73721 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($157.50) once the annual Part B deductible is met, and the beneficiary owes 20% ($39.37). Sequestration reduces Medicare's share by about 2% ($3.15), leaving $154.35. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q3 2026 release : this code's RVUs from the relative value file, multiplied by payment locality 05302-01's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2026 release . Releases are immutable: an amount retrieved for a past quarter always reflects that PFS release. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 8,216)

Geographic practice cost indices (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 69)

ZIP code to carrier locality crosswalk (Q3 2026) · zip-code-carrier-locality-file-updated-05-13-2026.zip (ZIP5_JUL2026.txt)

Working a claim with an earlier date of service? The calculator prices 73721 in St. Louis, MO against the release that governed that date. Past releases need a free account; today's rate does not.

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