Contact Information
- Website - Division of Worker's Compensation
- Email - Bureau of Claims Management
73000 - 73725
| CPT Code | Region | Zip Codes | Formula Amount |
|---|---|---|---|
| 73000 | NE | 541\542\543\545\549 | $165.16 |
| 73000 | NW | 540\544\546\547\548 | $190.47 |
| 73000 | SE | 530\531\532\533\534 | $229.42 |
| 73000 | SW | 535\537\538\539 | $168.96 |
| 73010 | NE | 541\542\543\545\549 | $177.35 |
| 73010 | NW | 540\544\546\547\548 | $194.38 |
| 73010 | SE | 530\531\532\533\534 | $230.45 |
| 73010 | SW | 535\537\538\539 | $207.80 |
| 73020 | NE | 541\542\543\545\549 | $100.33 |
| 73020 | NW | 540\544\546\547\548 | $137.73 |
| 73020 | SE | 530\531\532\533\534 | $158.80 |
| 73020 | SW | 535\537\538\539 | $134.72 |
| 73030 | NE | 541\542\543\545\549 | $172.76 |
| 73030 | NW | 540\544\546\547\548 | $231.85 |
| 73030 | SE | 530\531\532\533\534 | $250.26 |
| 73030 | SW | 535\537\538\539 | $191.25 |
| 73040 | NE | 541\542\543\545\549 | $459.11 |
| 73040 | NW | 540\544\546\547\548 | $454.09 |
| 73040 | SE | 530\531\532\533\534 | $565.71 |
| 73040 | SW | 535\537\538\539 | $476.76 |
| 73050 | NE | 541\542\543\545\549 | $190.13 |
| 73050 | NW | 540\544\546\547\548 | $192.50 |
| 73050 | SE | 530\531\532\533\534 | $259.92 |
| 73050 | SW | 535\537\538\539 | $231.24 |
| 73060 | NE | 541\542\543\545\549 | $179.54 |
| 73060 | NW | 540\544\546\547\548 | $191.50 |
| 73060 | SE | 530\531\532\533\534 | $225.88 |
| 73060 | SW | 535\537\538\539 | $178.31 |
| 73070 | NE | 541\542\543\545\549 | $150.17 |
| 73070 | NW | 540\544\546\547\548 | $149.70 |
| 73070 | SE | 530\531\532\533\534 | $186.12 |
| 73070 | SW | 535\537\538\539 | $157.20 |
| 73080 | NE | 541\542\543\545\549 | $199.03 |
| 73080 | NW | 540\544\546\547\548 | $237.02 |
| 73080 | SE | 530\531\532\533\534 | $186.43 |
| 73080 | SW | 535\537\538\539 | $197.10 |
| 73085 | NE | 541\542\543\545\549 | $483.92 |
| 73085 | NW | 540\544\546\547\548 | $450.52 |
| 73085 | SE | 530\531\532\533\534 | $524.46 |
| 73085 | SW | 535\537\538\539 | $440.26 |
| 73090 | NE | 541\542\543\545\549 | $199.54 |
| 73090 | NW | 540\544\546\547\548 | $187.70 |
| 73090 | SE | 530\531\532\533\534 | $197.77 |
| 73090 | SW | 535\537\538\539 | $155.48 |
| 73092 | NE | 541\542\543\545\549 | $162.57 |
| 73092 | NW | 540\544\546\547\548 | $179.20 |
| 73092 | SE | 530\531\532\533\534 | $193.04 |
| 73092 | SW | 535\537\538\539 | $137.87 |
| 73100 | NE | 541\542\543\545\549 | $122.46 |
| 73100 | NW | 540\544\546\547\548 | $150.49 |
| 73100 | SE | 530\531\532\533\534 | $198.35 |
| 73100 | SW | 535\537\538\539 | $135.75 |
| 73110 | NE | 541\542\543\545\549 | $175.91 |
| 73110 | NW | 540\544\546\547\548 | $210.45 |
| 73110 | SE | 530\531\532\533\534 | $199.67 |
| 73110 | SW | 535\537\538\539 | $170.54 |
| 73115 | NE | 541\542\543\545\549 | $473.06 |
| 73115 | NW | 540\544\546\547\548 | $459.95 |
| 73115 | SE | 530\531\532\533\534 | $510.42 |
| 73115 | SW | 535\537\538\539 | $442.11 |
| 73120 | NE | 541\542\543\545\549 | $136.52 |
| 73120 | NW | 540\544\546\547\548 | $171.41 |
| 73120 | SE | 530\531\532\533\534 | $172.95 |
| 73120 | SW | 535\537\538\539 | $141.24 |
| 73130 | NE | 541\542\543\545\549 | $169.51 |
| 73130 | NW | 540\544\546\547\548 | $192.02 |
| 73130 | SE | 530\531\532\533\534 | $217.41 |
| 73130 | SW | 535\537\538\539 | $179.72 |
| 73140 | NE | 541\542\543\545\549 | $107.52 |
| 73140 | NW | 540\544\546\547\548 | $115.25 |
| 73140 | SE | 530\531\532\533\534 | $131.99 |
| 73140 | SW | 535\537\538\539 | $173.32 |
| 73200 | NE | 541\542\543\545\549 | $958.86 |
| 73200 | NW | 540\544\546\547\548 | $1,114.32 |
| 73200 | SE | 530\531\532\533\534 | $1,139.27 |
| 73200 | SW | 535\537\538\539 | $951.43 |
| 73201 | NE | 541\542\543\545\549 | $1,094.23 |
| 73201 | NW | 540\544\546\547\548 | $1,028.99 |
| 73201 | SE | 530\531\532\533\534 | $1,138.62 |
| 73201 | SW | 535\537\538\539 | $860.23 |
| 73202 | NE | 541\542\543\545\549 | $898.05 |
| 73202 | NW | 540\544\546\547\548 | $1,146.13 |
| 73202 | SE | 530\531\532\533\534 | $1,344.67 |
| 73202 | SW | 535\537\538\539 | $1,128.73 |
| 73218 | NE | 541\542\543\545\549 | $1,769.34 |
| 73218 | SE | 530\531\532\533\534 | $2,131.98 |
| 73218 | SW | 535\537\538\539 | $1,868.24 |
| 73219 | NE | 541\542\543\545\549 | $1,583.85 |
| 73219 | SE | 530\531\532\533\534 | $2,318.25 |
| 73219 | SW | 535\537\538\539 | $1,859.34 |
| 73220 | NE | 541\542\543\545\549 | $1,893.77 |
| 73220 | NW | 540\544\546\547\548 | $2,156.61 |
| 73220 | SE | 530\531\532\533\534 | $2,423.22 |
| 73220 | SW | 535\537\538\539 | $1,854.21 |
| 73221 | NE | 541\542\543\545\549 | $1,823.68 |
| 73221 | NW | 540\544\546\547\548 | $2,006.22 |
| 73221 | SE | 530\531\532\533\534 | $2,017.79 |
| 73221 | SW | 535\537\538\539 | $1,476.22 |
| 73222 | NE | 541\542\543\545\549 | $1,590.98 |
| 73222 | SE | 530\531\532\533\534 | $2,057.91 |
| 73222 | SW | 535\537\538\539 | $1,521.43 |
| 73223 | NE | 541\542\543\545\549 | $1,895.51 |
| 73223 | SE | 530\531\532\533\534 | $2,482.56 |
| 73223 | SW | 535\537\538\539 | $1,811.89 |
| 73225 | NE | 541\542\543\545\549 | $1,855.77 |
| 73225 | NW | 540\544\546\547\548 | $1,545.57 |
| 73225 | SE | 530\531\532\533\534 | $1,968.13 |
| 73225 | SW | 535\537\538\539 | $1,483.81 |
| 73500 | NE | 541\542\543\545\549 | $90.82 |
| 73500 | NW | 540\544\546\547\548 | $152.64 |
| 73500 | SE | 530\531\532\533\534 | $129.22 |
| 73500 | SW | 535\537\538\539 | $155.35 |
| 73510 | NE | 541\542\543\545\549 | $238.97 |
| 73510 | NW | 540\544\546\547\548 | $199.98 |
| 73510 | SE | 530\531\532\533\534 | $196.55 |
| 73510 | SW | 535\537\538\539 | $217.87 |
| 73520 | NE | 541\542\543\545\549 | $274.52 |
| 73520 | NW | 540\544\546\547\548 | $277.86 |
| 73520 | SE | 530\531\532\533\534 | $311.79 |
| 73520 | SW | 535\537\538\539 | $224.24 |
| 73525 | NE | 541\542\543\545\549 | $459.95 |
| 73525 | NW | 540\544\546\547\548 | $467.69 |
| 73525 | SE | 530\531\532\533\534 | $573.52 |
| 73525 | SW | 535\537\538\539 | $521.36 |
| 73530 | NE | 541\542\543\545\549 | $444.25 |
| 73530 | NW | 540\544\546\547\548 | $452.91 |
| 73530 | SE | 530\531\532\533\534 | $512.80 |
| 73530 | SW | 535\537\538\539 | $207.86 |
| 73540 | NE | 541\542\543\545\549 | $135.34 |
| 73540 | NW | 540\544\546\547\548 | $168.40 |
| 73540 | SE | 530\531\532\533\534 | $224.74 |
| 73540 | SW | 535\537\538\539 | $138.23 |
| 73542 | SW | 535\537\538\539 | $287.33 |
| 73550 | NE | 541\542\543\545\549 | $270.20 |
| 73550 | NW | 540\544\546\547\548 | $203.14 |
| 73550 | SE | 530\531\532\533\534 | $269.44 |
| 73550 | SW | 535\537\538\539 | $175.54 |
| 73560 | NE | 541\542\543\545\549 | $160.28 |
| 73560 | NW | 540\544\546\547\548 | $173.72 |
| 73560 | SE | 530\531\532\533\534 | $180.30 |
| 73560 | SW | 535\537\538\539 | $213.37 |
| 73562 | NE | 541\542\543\545\549 | $211.87 |
| 73562 | NW | 540\544\546\547\548 | $186.37 |
| 73562 | SE | 530\531\532\533\534 | $248.73 |
| 73562 | SW | 535\537\538\539 | $239.58 |
| 73564 | NE | 541\542\543\545\549 | $180.76 |
| 73564 | NW | 540\544\546\547\548 | $229.18 |
| 73564 | SE | 530\531\532\533\534 | $291.14 |
| 73564 | SW | 535\537\538\539 | $290.92 |
| 73565 | NE | 541\542\543\545\549 | $165.89 |
| 73565 | NW | 540\544\546\547\548 | $104.97 |
| 73565 | SE | 530\531\532\533\534 | $143.46 |
| 73565 | SW | 535\537\538\539 | $163.10 |
| 73580 | NE | 541\542\543\545\549 | $377.35 |
| 73580 | NW | 540\544\546\547\548 | $438.93 |
| 73580 | SE | 530\531\532\533\534 | $480.11 |
| 73580 | SW | 535\537\538\539 | $442.76 |
| 73590 | NE | 541\542\543\545\549 | $185.62 |
| 73590 | NW | 540\544\546\547\548 | $195.08 |
| 73590 | SE | 530\531\532\533\534 | $225.12 |
| 73590 | SW | 535\537\538\539 | $167.50 |
| 73592 | NE | 541\542\543\545\549 | $158.95 |
| 73592 | NW | 540\544\546\547\548 | $170.16 |
| 73592 | SE | 530\531\532\533\534 | $224.80 |
| 73592 | SW | 535\537\538\539 | $148.25 |
| 73600 | NE | 541\542\543\545\549 | $135.71 |
| 73600 | NW | 540\544\546\547\548 | $155.90 |
| 73600 | SE | 530\531\532\533\534 | $143.86 |
| 73600 | SW | 535\537\538\539 | $133.02 |
| 73610 | NE | 541\542\543\545\549 | $168.44 |
| 73610 | NW | 540\544\546\547\548 | $173.54 |
| 73610 | SE | 530\531\532\533\534 | $207.58 |
| 73610 | SW | 535\537\538\539 | $170.14 |
| 73615 | NE | 541\542\543\545\549 | $483.39 |
| 73615 | NW | 540\544\546\547\548 | $451.79 |
| 73615 | SE | 530\531\532\533\534 | $562.53 |
| 73615 | SW | 535\537\538\539 | $438.02 |
| 73620 | NE | 541\542\543\545\549 | $132.58 |
| 73620 | NW | 540\544\546\547\548 | $155.31 |
| 73620 | SE | 530\531\532\533\534 | $174.73 |
| 73620 | SW | 535\537\538\539 | $143.10 |
| 73630 | NE | 541\542\543\545\549 | $194.62 |
| 73630 | NW | 540\544\546\547\548 | $200.49 |
| 73630 | SE | 530\531\532\533\534 | $226.76 |
| 73630 | SW | 535\537\538\539 | $174.29 |
| 73650 | NE | 541\542\543\545\549 | $164.09 |
| 73650 | NW | 540\544\546\547\548 | $223.70 |
| 73650 | SE | 530\531\532\533\534 | $246.58 |
| 73650 | SW | 535\537\538\539 | $171.30 |
| 73660 | NE | 541\542\543\545\549 | $96.19 |
| 73660 | NW | 540\544\546\547\548 | $125.34 |
| 73660 | SE | 530\531\532\533\534 | $127.28 |
| 73660 | SW | 535\537\538\539 | $126.31 |
| 73700 | NE | 541\542\543\545\549 | $889.68 |
| 73700 | NW | 540\544\546\547\548 | $837.95 |
| 73700 | SE | 530\531\532\533\534 | $1,316.69 |
| 73700 | SW | 535\537\538\539 | $767.82 |
| 73701 | NE | 541\542\543\545\549 | $1,098.26 |
| 73701 | NW | 540\544\546\547\548 | $1,222.94 |
| 73701 | SE | 530\531\532\533\534 | $1,229.66 |
| 73701 | SW | 535\537\538\539 | $892.37 |
| 73702 | NE | 541\542\543\545\549 | $1,245.68 |
| 73702 | NW | 540\544\546\547\548 | $1,099.83 |
| 73702 | SE | 530\531\532\533\534 | $1,403.20 |
| 73702 | SW | 535\537\538\539 | $1,038.31 |
| 73718 | NE | 541\542\543\545\549 | $1,770.22 |
| 73718 | SE | 530\531\532\533\534 | $1,965.16 |
| 73718 | SW | 535\537\538\539 | $1,197.03 |
| 73719 | NE | 541\542\543\545\549 | $1,587.80 |
| 73719 | SE | 530\531\532\533\534 | $1,910.42 |
| 73719 | SW | 535\537\538\539 | $1,354.95 |
| 73720 | NE | 541\542\543\545\549 | $1,899.35 |
| 73720 | NW | 540\544\546\547\548 | $2,307.41 |
| 73720 | SE | 530\531\532\533\534 | $2,400.14 |
| 73720 | SW | 535\537\538\539 | $1,668.89 |
| 73721 | NE | 541\542\543\545\549 | $1,931.81 |
| 73721 | NW | 540\544\546\547\548 | $1,768.47 |
| 73721 | SE | 530\531\532\533\534 | $2,160.90 |
| 73721 | SW | 535\537\538\539 | $1,195.80 |
| 73722 | NE | 541\542\543\545\549 | $1,587.24 |
| 73722 | SE | 530\531\532\533\534 | $1,174.94 |
| 73722 | SW | 535\537\538\539 | $1,351.83 |
| 73723 | NE | 541\542\543\545\549 | $1,898.04 |
| 73723 | SE | 530\531\532\533\534 | $2,546.59 |
| 73723 | SW | 535\537\538\539 | $1,666.97 |
| 73725 | NE | 541\542\543\545\549 | $1,851.77 |
| 73725 | NW | 540\544\546\547\548 | $1,501.52 |
| 73725 | SE | 530\531\532\533\534 | $2,052.56 |
| 73725 | SW | 535\537\538\539 | $1,540.94 |