Objective: In the DRG/DIP medical insurance payment system, traditional Chinese medicine (TCM) often faces relatively low payment standards and difficulties in reflecting its value. This study explores a way to realize “same payment” based on “same disease and same efficacy” between TCM and western medicine, using radial fracture treatment as an example to develop a case-based payment standard. Methods: Based on clinical practice in hospitals of Foshan City, Guangdong Province, an evaluation framework covering both safety and effectiveness was established. By integrating DRG payment big data with expert opinions, the equivalence of treatment outcomes between TCM and western medicine for radial fractures was verified. Based on these results, reasonable cost levels were estimated and a corresponding payment standard was formulated. Results: The evaluation showed comparable efficacy between TCM and western medicine in radial fracture treatment. The proposed price based on the study is higher than the average TCM cost but lower than the western medicine cost, ensuring hospital motivation while maintaining the price advantage of TCM. Conclusion: Based on the principle of “same disease and same efficacy”, this study explores implementation pathways of “same payment” for TCM and western medicine. The findings indicate that the proposed scheme balances patient affordability, hospital revenue, and medical insurance expenditure, which offers important reference for medical insurance payment reform and the coordinated development of TCM and western medicine.