Contact Information
- Website - Division of Worker's Compensation
- Email - Bureau of Claims Management
71000 - 71555
| CPT Code | Region | Zip Codes | Formula Amount |
|---|---|---|---|
| 71010 | NE | 541\542\543\545\549 | $125.67 |
| 71010 | NW | 540\544\546\547\548 | $171.67 |
| 71010 | SE | 530\531\532\533\534 | $122.65 |
| 71010 | SW | 535\537\538\539 | $114.78 |
| 71020 | NE | 541\542\543\545\549 | $134.51 |
| 71020 | NW | 540\544\546\547\548 | $172.32 |
| 71020 | SE | 530\531\532\533\534 | $164.24 |
| 71020 | SW | 535\537\538\539 | $129.79 |
| 71021 | NE | 541\542\543\545\549 | $202.22 |
| 71021 | NW | 540\544\546\547\548 | $183.39 |
| 71021 | SE | 530\531\532\533\534 | $246.02 |
| 71021 | SW | 535\537\538\539 | $186.35 |
| 71022 | NE | 541\542\543\545\549 | $338.88 |
| 71022 | NW | 540\544\546\547\548 | $370.06 |
| 71022 | SE | 530\531\532\533\534 | $358.81 |
| 71023 | NW | 540\544\546\547\548 | $251.40 |
| 71023 | SE | 530\531\532\533\534 | $283.04 |
| 71023 | SW | 535\537\538\539 | $270.74 |
| 71030 | NW | 540\544\546\547\548 | $266.02 |
| 71030 | SE | 530\531\532\533\534 | $302.45 |
| 71030 | SW | 535\537\538\539 | $182.60 |
| 71034 | NW | 540\544\546\547\548 | $386.17 |
| 71034 | SE | 530\531\532\533\534 | $419.26 |
| 71034 | SW | 535\537\538\539 | $170.59 |
| 71035 | NE | 541\542\543\545\549 | $127.18 |
| 71035 | NW | 540\544\546\547\548 | $136.75 |
| 71035 | SE | 530\531\532\533\534 | $140.35 |
| 71035 | SW | 535\537\538\539 | $202.56 |
| 71036 | SW | 535\537\538\539 | $355.66 |
| 71100 | NE | 541\542\543\545\549 | $168.28 |
| 71100 | NW | 540\544\546\547\548 | $237.60 |
| 71100 | SE | 530\531\532\533\534 | $273.41 |
| 71100 | SW | 535\537\538\539 | $193.27 |
| 71101 | NE | 541\542\543\545\549 | $161.51 |
| 71101 | NW | 540\544\546\547\548 | $221.91 |
| 71101 | SE | 530\531\532\533\534 | $256.61 |
| 71101 | SW | 535\537\538\539 | $216.38 |
| 71110 | NE | 541\542\543\545\549 | $351.83 |
| 71110 | NW | 540\544\546\547\548 | $318.81 |
| 71110 | SE | 530\531\532\533\534 | $302.04 |
| 71110 | SW | 535\537\538\539 | $222.79 |
| 71111 | NE | 541\542\543\545\549 | $250.13 |
| 71111 | NW | 540\544\546\547\548 | $235.52 |
| 71111 | SE | 530\531\532\533\534 | $306.31 |
| 71111 | SW | 535\537\538\539 | $247.77 |
| 71120 | NE | 541\542\543\545\549 | $166.52 |
| 71120 | NW | 540\544\546\547\548 | $185.68 |
| 71120 | SE | 530\531\532\533\534 | $240.92 |
| 71120 | SW | 535\537\538\539 | $197.90 |
| 71130 | NE | 541\542\543\545\549 | $158.03 |
| 71130 | NW | 540\544\546\547\548 | $157.97 |
| 71130 | SE | 530\531\532\533\534 | $238.20 |
| 71130 | SW | 535\537\538\539 | $161.57 |
| 71250 | NE | 541\542\543\545\549 | $995.22 |
| 71250 | NW | 540\544\546\547\548 | $925.75 |
| 71250 | SE | 530\531\532\533\534 | $1,177.44 |
| 71250 | SW | 535\537\538\539 | $853.10 |
| 71260 | NE | 541\542\543\545\549 | $1,079.35 |
| 71260 | NW | 540\544\546\547\548 | $1,091.40 |
| 71260 | SE | 530\531\532\533\534 | $1,154.20 |
| 71260 | SW | 535\537\538\539 | $995.43 |
| 71270 | NE | 541\542\543\545\549 | $1,132.81 |
| 71270 | NW | 540\544\546\547\548 | $1,125.01 |
| 71270 | SE | 530\531\532\533\534 | $1,400.77 |
| 71270 | SW | 535\537\538\539 | $1,098.81 |
| 71275 | NE | 541\542\543\545\549 | $1,504.65 |
| 71275 | SE | 530\531\532\533\534 | $1,905.32 |
| 71275 | SW | 535\537\538\539 | $945.31 |
| 71550 | NE | 541\542\543\545\549 | $1,896.93 |
| 71550 | NW | 540\544\546\547\548 | $1,674.06 |
| 71550 | SE | 530\531\532\533\534 | $2,273.26 |
| 71550 | SW | 535\537\538\539 | $1,688.50 |
| 71551 | NE | 541\542\543\545\549 | $1,592.33 |
| 71551 | SE | 530\531\532\533\534 | $2,417.80 |
| 71551 | SW | 535\537\538\539 | $1,576.11 |
| 71552 | NE | 541\542\543\545\549 | $2,105.14 |
| 71552 | SE | 530\531\532\533\534 | $2,475.62 |
| 71552 | SW | 535\537\538\539 | $1,535.84 |
| 71555 | NE | 541\542\543\545\549 | $1,857.03 |
| 71555 | NW | 540\544\546\547\548 | $1,492.67 |
| 71555 | SE | 530\531\532\533\534 | $2,032.94 |
| 71555 | SW | 535\537\538\539 | $1,677.64 |