Lower leg (tibia/fibula) fracture repair - non-surgical with manipulation
What goes into a price?
Negotiated prices across insurers
Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.
Procedures included in this package
This list includes the services and fees bundled into the Lower leg (tibia/fibula) fracture repair - non-surgical with manipulation Standard Service Package (SSP MS031). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS J3490 | Facility Fee | Pharmaceuticals without Categories |
| HCPCS 76000 | Facility Fee | Real-time, Dynamic Imaging of Body Area, Up to 1hr Expertise |
| HCPCS 73600 | Facility Fee | X-ray of ankle, 2 views |
| HCPCS J7030 | Facility Fee | Intravenous infusion of 1000cc of normal saline |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS J2250 | Facility Fee | Intramuscular injection of 1mg midazolam hydrochloride |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J0690 | Facility Fee | Intramuscular injection cefazolin sodium, 500mg |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS 27825 | Facility Fee | Closed Tibial Fracture Treatment with Traction and/or Manipulation |
| Revenue Code 710 | Facility Fee | Recovery Room - General |
| HCPCS 27825 | Professional Fee | Closed Tibial Fracture Treatment with Traction and/or Manipulation |
| HCPCS J2001 | Facility Fee | Injection of 10mg Lidocaine Hcl via IV Infusion |