Planning a fracture plate or hardware removal bill in South Korea
Removing a plate, screw, pin, or intramedullary nail after fracture treatment does not have one nationwide retail price.
The bone involved, number and depth of implants, incision, anesthesia, admission, associated procedures, and follow-up care can all change the bill.
Even at the same anatomical site, buried or broken screws and a plan covering more than one bone may produce a different operative record and billing combination.
This planner therefore starts provider and follow-up prices at KRW 0 instead of inventing an average.
Enter the hospital’s covered gross charge before copay, separately disclosed non-covered patient charge, and additional patient-paid medical items.
Whether removal is medically appropriate, when it should occur, and which code applies must come from the treating clinician, final operative record, and provider billing process rather than this budget result.
Collect these three records first
- A consultation note stating the planned operation, anatomical site, and plate, screw, pin, or nail expected to be removed
- An itemized provider estimate separating covered gross charges, the applicable patient-share rate, non-covered items, and other patient payments
- An insurer-confirmed expected payment and a household plan for leave from work, transport, and caregiver costs
2026 HIRA internal fixation hardware removal identifiers
The Health Insurance Review and Assessment Service, or HIRA, lists internal fixation hardware removal under procedure group `Ja 60-2` in the 2026 KDRG Classification Book Version 4.7.
These identifiers are consultation and billing-verification anchors, not codes that a patient should assign from anatomy alone.
2026 HIRA internal fixation hardware removal identifiers by site and method| Code | Official Korean classification in English | Quote question |
|---|
| N0972 | Pelvis or femur internal fixation hardware removal | Nail or plate, implant count, admission, and mobility equipment |
| N0973 | Humerus or scapula internal fixation hardware removal | Implant depth, anesthesia, imaging, and arm-use restrictions |
| N0977 | One forearm or lower-leg bone | Radius versus ulna, or tibia versus fibula |
| N0974 | Both radius and ulna, or both tibia and fibula | One combined hospital estimate rather than a simple multiplier |
| N0975 | Clavicle, patella, carpal bone, or tarsal bone | Day surgery versus admission, dressing, and support equipment |
| N0976 | Metacarpal, metatarsal, or phalanx | Number of bones and whether the quote is per digit or per operation |
| N0978 | Simple pin or nail removal with fascial incision | Incision, closure, anesthesia, imaging, and dressing |
| N0979 | Simple pin or nail removal without fascial incision | Treatment room versus operating room and included aftercare |
A classification code is not a nationwide price
Inclusion in the KDRG book confirms that the procedure exists in the Korean health-insurance classification framework.
It does not mean every line for surgery, anesthesia, imaging, admission, meals, medication, room choice, wound care, or another procedure has the same benefit status or patient share.
Do not double a one-bone estimate when two bones or multiple sites are involved; enter the provider’s combined itemized estimate once.
What makes up the total household cost?
Covered gross charge and patient share
Enter the covered amount before the patient-share percentage is applied.
The planner uses 20% as the ordinary inpatient starting rate, but meals, outpatient lines, selective benefits, full-self-pay covered items, and special statuses can follow different rules.
Non-covered procedure or material
Enter only the amount the provider has disclosed as a non-covered patient charge.
Confirm the item name, price unit, included services, and estimate date under the provider disclosure boundary in Medical Service Act Article 45.
Additional medical spending
Add patient-paid testing, anesthesia, meals, room upgrades, medication, dressings, or support equipment that is not already in the covered or non-covered surgery inputs.
Ask the provider what the main estimate already includes so the same item is not counted twice.
Follow-up and non-medical recovery spending
Plan wound checks, suture removal, imaging, consultation, and medication as visits multiplied by patient spending per visit.
Keep travel, caregiver spending, and income interruption separate because they are not medical-expense tax-credit inputs in this model.
How the ordinary inpatient 20% planning rate works
Article 19 of the National Health Insurance Act Enforcement Decree delegates patient-share rates and amounts to Annex 2.
Under the ordinary inpatient rule in Annex 2, this calculator starts with a 20% patient share for a covered gross amount confirmed to use that rate.
If the covered gross estimate is KRW 2,000,000 and the entire input is confirmed at 20%, the covered patient-share plan is KRW 400,000.
Covered gross quoteKRW 2,000,000Before applying the patient share
Planning patient share20%Ordinary inpatient starting point
Covered patient paymentKRW 400,000KRW 2,000,000 × 20%
This example does not authorize applying 20% to every line on the bill.
Meals, upgraded rooms, outpatient follow-up, selective-benefit charges, full-self-pay covered items, and non-covered charges must remain in the categories shown by the hospital.
Industrial accident insurance, automobile insurance, Medical Aid, and other payer systems require their own settlement instructions rather than this ordinary National Health Insurance planning formula.
Calculation formulas
Medical out-of-pocket amount
covered copay = round(covered gross quote × patient-share rate)
planned NHIS share = covered gross quote − covered copay
follow-up cost = visit count × patient spending per visit
medical out-of-pocket = covered copay + non-covered quote + additional medical cost + follow-up cost
Insurance, tax credit, and final burden
gross cash need = medical out-of-pocket + income interruption + travel and caregiver cost
insurance used = min(insurer-confirmed payment, medical out-of-pocket)
tax threshold = gross salary × 3%
incremental tax credit = increase in eligible base × 15%
net patient burden = gross cash need − insurance used − incremental tax credit
The planned NHIS share is only the arithmetic difference between your covered gross input and patient-share plan; it is not a promise of payment by NHIS.
The low and high budget values apply your selected plus-or-minus variation rate to the net burden.
They are a cash reserve scenario, not a statistical confidence interval or a forecast of provider prices.
Step-by-step use
- Choose the closest site or removal method
Use the card to display a HIRA verification anchor and provider questions. The selection does not diagnose the condition or assign a billing code. - Separate the itemized hospital estimate
Enter the covered gross amount before copay, the rate stated by the provider, the disclosed non-covered charge, and additional patient payments in different fields. - Add follow-up care
Use the planned number of visits and patient spending per visit for wound checks, dressing, suture removal, imaging, consultation, and medication. - Model household cash flow
Enter only a recovery-planning period confirmed with the clinician and employer, net income interruption after paid leave or benefits, and travel or caregiver spending. - Use confirmed reimbursement only
Do not guess an indemnity-insurance percentage. Enter the amount confirmed by the insurer after providing the planned procedure and itemized estimate. - Review every result line
Compare covered, non-covered, follow-up, income, insurance, and tax-credit lines with the provider and insurer records instead of relying only on the final total.
Worked example: KRW 1,385,000 net burden
The following numbers explain the formulas and are not a Korean national average.
Enter a KRW 2,000,000 covered gross quote at 20%, KRW 200,000 non-covered charge, KRW 300,000 additional medical spending, and four follow-up visits at KRW 50,000 each.
Add two weeks of net income interruption at KRW 300,000 per week, KRW 100,000 of travel and caregiver spending, and an insurer-confirmed payment of KRW 400,000.
For the tax illustration, use KRW 20,000,000 gross salary, no other eligible medical expense, and the uncapped statutory group.
Covered copayKRW 400,000KRW 2,000,000 × 20%
Medical out-of-pocketKRW 1,100,000KRW 400,000 covered + KRW 700,000 other medical spending
Gross cash needKRW 1,800,000KRW 1,100,000 medical + KRW 700,000 non-medical recovery
Medical cost after insuranceKRW 700,000KRW 1,100,000 − KRW 400,000
Incremental tax creditKRW 15,000KRW 100,000 increase above the salary threshold × 15%
Net patient burdenKRW 1,385,000KRW 1,800,000 − KRW 400,000 − KRW 15,000
With a 10% variation rate, the cash reserve range is KRW 1,246,500 to KRW 1,523,500.
Replace every example price with the current itemized provider estimate and replace the insurance amount with a contract-specific confirmation.
Indemnity insurance and medical-expense tax credit
Enter an insurer-confirmed payment
Contract generation, covered and non-covered deductibles, admission status, riders, exclusions, and limits vary by policy.
Send the insurer the proposed operation, admission plan, and itemized estimate, then enter only the expected amount it confirms.
The formula caps insurance at medical out-of-pocket spending so it never erases income interruption or other household recovery costs.
Calculate only the incremental tax-credit plan
Income Tax Act Article 59-4 generally applies a 15% credit to eligible medical spending above gross salary × 3%.
This model caps the ordinary-family eligible base at KRW 7,000,000 and excludes the amount reimbursed by insurance.
Actual tax relief depends on the ordering of family medical expenses, simplified tax records, insurance timing, and available calculated tax, so the result is not a guaranteed cash refund.
Practical comparison scenarios
Your first provider estimate
If the hospital gives only one total, ask it to separate the covered gross charge, applicable patient-share rate, non-covered charge, and other patient-paid items.
Use the selected HIRA anchor and consultation questions to verify the site, implant scope, anesthesia, admission, and included follow-up.
Comparing two hospitals
One total may include anesthesia, room, and follow-up while another excludes them.
Put equivalent categories into equivalent fields, note the quote unit and validity date, and compare the combined household burden rather than the headline surgery amount alone.
Removal from two bones or several sites
N0974 recognizes simultaneous radius-ulna or tibia-fibula removal, but it does not tell the patient to double an N0977 price.
Enter one combined covered and non-covered estimate that reflects the provider’s actual simultaneous-procedure calculation, anesthesia, and admission plan.
Work return is not yet known
Keep recovery weeks at zero until the clinician and employer can discuss restrictions, paid leave, and adjusted duties.
Then compare a confirmed plan with a more conservative household scenario without treating either as a medical prediction.
Clinical decision and safety boundary
Hardware removal is not a decision to make from price alone.
Bone union, current symptoms, implant position, infection or skin concerns, growth, activity, and refracture risk require evaluation by the treating team.
Selecting a simple-removal card does not promise that the operation will be simple, safe, or appropriate.
Seek care before working on the budget when symptoms change
A sudden major increase in pain, redness, warmth, drainage, fever, new numbness or weakness, severe swelling, or a color change deserves prompt medical assessment rather than waiting for a planned cost discussion.
After surgery, follow the provider’s wound and emergency instructions and never use this calculator to delay evaluation of a possible complication.
Frequently asked questions
Is every fracture plate or screw removal covered by Korean National Health Insurance?
HIRA lists N0972 through N0979 for internal fixation hardware removal in the 2026 KDRG book. That confirms procedure classifications, but it does not make every surgery, material, room, meal, or follow-up line share one benefit status. Use the provider itemization.
Does applying 20% produce the final surgery bill?
No. The 20% rate is the ordinary inpatient planning share for the covered gross amount confirmed to use that rate. Meals, room upgrades, outpatient care, selective benefits, full-self-pay covered items, and non-covered charges require separate treatment.
Can the calculator price each plate, screw, or pin automatically?
No. Position, depth, breakage, burial, incision, anesthesia, and simultaneous-procedure billing prevent a safe national unit-price model. Enter the hospital quote for the complete planned operation.
How do I choose between N0978 and N0979?
They distinguish simple removal with a fascial incision from simple removal without one. Do not assign either from the appearance of the skin or an assumption; ask the provider for the planned operation and billing identifier.
Does this estimate Korean indemnity-insurance reimbursement?
It does not infer a policy generation or payment percentage. Enter only an amount confirmed by the insurer after it reviews the planned operation and itemized estimate. The formula uses it only up to medical out-of-pocket spending.
Will the tax-credit estimate be refunded in cash?
Not necessarily. It is the modeled increase from this expense under the gross salary × 3% and 15% structure. Actual tax relief depends on family ordering, reimbursed expenses, tax records, and available calculated tax.
Can this calculator tell me when the plate should be removed?
No. Removal need and timing depend on bone union, symptoms, site, implant characteristics, infection concerns, activity, and other clinical factors assessed by the treating clinician.
Official sources, jurisdiction, and update date
- Health Insurance Review and Assessment Service, KDRG Classification Book Version 4.7, publication G000EV3-2025-174, N0972 through N0979, checked July 29, 2026
- Korean National Law Information OPEN API, National Health Insurance Act Enforcement Decree Article 19, current MST 283469, effective February 19, 2026
- Korean National Law Information OPEN API, Enforcement Decree Annex 2 serial 17976571, patient-share rates and amounts, promulgated February 19, 2026
- Korean National Law Information OPEN API, Medical Service Act Article 45, current MST 285327, effective April 7, 2026
- Korean National Law Information OPEN API, Income Tax Act Article 59-4, current MST 280405, article effective January 1, 2026
This English guide applies South Korean insurance, provider-disclosure, and tax rules as checked on July 29, 2026.
Procedure classifications, laws, benefit rules, insurer contracts, and provider prices can change, so verify the current itemized quote and rules before treatment.
Replace every zero with verified records
Fill the covered, non-covered, additional, and follow-up inputs from the provider estimate, then add insurer-confirmed support and household recovery costs.
Use the breakdown and consultation questions to organize conversations, while leaving clinical decisions, final billing, reimbursement, and tax filing to the responsible professionals and institutions.