Cost analysis for CPT A0427 — Ambulance service, advanced life support, emergency transport, level 1 (als1-emergency)
Average Medicare Payment
$403.07
2023 data
Total Payments (2023)
$1.5B
Services (2023)
3.8M
Price Change (2014–2023)
+22.1%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $330.09 | $1.6B | 5.0M | — |
| 2015 | $335.67 | $1.7B | 5.0M | +1.7% |
| 2016 | $334.11 | $1.6B | 5.0M | -0.5% |
| 2017 | $336.61 | $1.7B | 5.1M | +0.7% |
| 2018 | $340.95 | $1.7B | 4.9M | +1.3% |
| 2019 | $348.97 | $1.7B | 4.8M | +2.4% |
| 2020 | $356.00 | $1.5B | 4.1M | +2.0% |
| 2021 | $359.16 | $1.4B | 4.0M | +0.9% |
| 2022 | $372.29 | $1.4B | 3.9M | +3.7% |
| 2023 | $403.07 | $1.5B | 3.8M | +8.3% |
The most expensive state pays 3.3x more than the cheapest for this procedure. AK averages $473.69 vs GU at $142.66.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $473.69 | $4.4M | 9.4K | 26 |
| DC | $456.72 | $2.2M | 4.8K | 2 |
| CA | $451.82 | $205.5M | 454.7K | 206 |
| WY | $449.25 | $2.0M | 4.3K | 14 |
| NJ | $446.24 | $5.7M | 12.8K | 10 |
| HI | $444.68 | $4.7M | 10.6K | 3 |
| ND | $442.27 | $3.7M | 8.5K | 47 |
| MT | $441.71 | $4.2M | 9.4K | 53 |
| SD | $440.80 | $4.7M | 10.6K | 45 |
| CT | $429.21 | $18.1M | 42.2K | 126 |
| CO | $427.68 | $19.0M | 44.3K | 124 |
| MA | $427.41 | $55.6M | 130.0K | 258 |
| MD | $426.04 | $31.8M | 74.7K | 101 |
| NY | $419.88 | $53.7M | 127.8K | 414 |
| WA | $417.79 | $22.4M | 53.7K | 117 |
| MN | $415.88 | $18.0M | 43.2K | 60 |
| OR | $415.26 | $24.1M | 58.1K | 98 |
| RI | $413.17 | $6.8M | 16.5K | 48 |
| NH | $411.88 | $8.8M | 21.4K | 107 |
| AZ | $411.18 | $32.3M | 78.7K | 99 |
| VA | $408.63 | $36.7M | 89.8K | 210 |
| DE | $408.38 | $42.1K | 103 | 1 |
| NV | $406.95 | $16.9M | 41.6K | 33 |
| UT | $399.85 | $6.8M | 17.0K | 71 |
| IL | $398.55 | $77.3M | 194.0K | 438 |
| VT | $397.06 | $5.0M | 12.7K | 61 |
| NM | $396.58 | $8.8M | 22.2K | 52 |
| TX | $395.97 | $115.0M | 290.4K | 432 |
| ME | $394.88 | $7.7M | 19.5K | 133 |
| PA | $392.33 | $54.0M | 137.7K | 457 |
| WI | $390.55 | $22.3M | 57.2K | 218 |
| KS | $390.36 | $15.8M | 40.5K | 100 |
| FL | $389.34 | $135.6M | 348.2K | 157 |
| ID | $388.52 | $5.8M | 15.0K | 42 |
| MI | $387.01 | $43.2M | 111.7K | 199 |
| NE | $386.47 | $8.1M | 21.1K | 44 |
| IA | $384.80 | $12.0M | 31.3K | 143 |
| MO | $383.70 | $27.8M | 72.6K | 174 |
| PR | $382.94 | $313.2K | 818 | 19 |
| GA | $379.58 | $44.4M | 116.8K | 144 |
| NC | $378.36 | $55.0M | 145.5K | 144 |
| OK | $378.15 | $24.1M | 63.8K | 84 |
| OH | $375.05 | $52.0M | 138.6K | 716 |
| IN | $374.98 | $21.4M | 57.1K | 160 |
| SC | $373.23 | $24.7M | 66.2K | 66 |
| LA | $371.10 | $25.8M | 69.6K | 37 |
| TN | $371.10 | $37.2M | 100.2K | 98 |
| AR | $370.69 | $19.9M | 53.8K | 55 |
| AL | $368.94 | $23.7M | 64.2K | 113 |
| MS | $366.04 | $21.5M | 58.8K | 25 |
| KY | $364.28 | $26.0M | 71.4K | 157 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Falck Mobile Health Corp | Ambulance Service Provider | CA | $18.1M | 40.4K | $447.06 |
| Acadian Ambulance Service, Inc. | Ambulance Service Provider | LA | $15.4M | 42.1K | $366.47 |
| City Of Los Angeles | Ambulance Service Provider | CA | $12.8M | 28.3K | $453.19 |
| County Of Pinellas Board Of County Commissioners | Ambulance Service Provider | FL | $10.5M | 27.3K | $384.36 |
| City Of Chicago | Ambulance Service Provider | IL | $9.4M | 23.0K | $408.35 |
| Rural-Metro Of California Inc | Ambulance Service Provider | CA | $8.7M | 16.9K | $516.21 |
| Board Of County Commissioners Palm Beach County | Ambulance Service Provider | FL | $8.2M | 20.5K | $401.24 |
| Kwph Enterprises Inc | Ambulance Service Provider | CA | $7.4M | 17.8K | $416.53 |
| Falck Northern California Corp. | Ambulance Service Provider | CA | $6.9M | 13.8K | $501.73 |
| New York City Health And Hospitals Corporation | Ambulance Service Provider | NY | $6.5M | 14.2K | $458.12 |
| Emergency Medical Services Authority | Ambulance Service Provider | OK | $6.0M | 16.4K | $369.07 |
| Contra Costa County | Ambulance Service Provider | CA | $6.0M | 11.9K | $505.69 |
| Allina Health System | Ambulance Service Provider | MN | $5.9M | 14.5K | $405.70 |
| City & County Of San Francisco | Ambulance Service Provider | CA | $5.6M | 11.2K | $501.28 |
| American Medical Response Ambulance Service, Inc. | Ambulance Service Provider | CA | $5.6M | 13.2K | $423.37 |
| Baltimore County Maryland Office Of Finance | Ambulance Service Provider | MD | $5.5M | 12.9K | $426.82 |
| American Medical Response Of Inland Empire | Ambulance Service Provider | CA | $5.5M | 13.0K | $422.14 |
| Maricopa Ambulance, Llc | Ambulance Service Provider | AZ | $5.4M | 13.8K | $390.38 |
| Director Of Finance-County Of Fairfax Va | Ambulance Service Provider | VA | $5.3M | 11.4K | $459.29 |
| County Of Wake | Ambulance Service Provider | NC | $4.9M | 12.8K | $378.47 |
The data suggests significant pricing inconsistencies for CPT A0427. With a 3.3x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have risen 22.1% since 2014, outpacing inflation and raising questions about whether reimbursement rates reflect actual costs.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.