ED visit

A recent ED visit, where the MD provided pain control (IV) and splinting of Tibial transverse fracture w/o reduction of fracture for transfer to covered facility resulted in the following codes:
99285-57 ED, high severity-decision for sx
27760-54 Closed Tx of Tibial Fx w/o manipulation-surg proc only
99053 Tx of patient after hours, btwn 10p-8a

The physician did nothing but splint a spiral fx of the Tib and provide IV pain control. Documentaion does not support a 99285. With just the splinting, does the physician warrant using the code for Fx mgmnt? The patient was transferred via BLS ambulance to next facility, where he ultimately had major surg on the leg, to include an IM rod placement in the tibia, along with a handful of drywall screws (at least that's what it feels like).

Now the question(s):
if the phys didn't perform the svc of fx reduction (subsequent xrays showed a displaced, transverse fx of the tibial shaft), and only splinted the ankle for the BLS transfer, can he use the code 27760-54? Can he use only the E&M or Surg code?
Is it allowed to use an "after hours code" (99053) in an ER setting, where they are open 24/7? I actually have too many questions about this to post at once, so let's start with these. Any help would be appreciated.