Cost analysis for CPT A0433 — Advanced life support, level 2 (als 2)
Average Medicare Payment
$573.52
2023 data
Total Payments (2023)
$40.2M
Services (2023)
69.8K
Price Change (2014–2023)
+22.1%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $469.89 | $47.1M | 100.2K | — |
| 2015 | $477.94 | $46.3M | 96.8K | +1.7% |
| 2016 | $476.41 | $47.0M | 98.7K | -0.3% |
| 2017 | $480.11 | $47.0M | 97.6K | +0.8% |
| 2018 | $486.06 | $46.2M | 94.8K | +1.2% |
| 2019 | $497.86 | $46.6M | 93.5K | +2.4% |
| 2020 | $507.22 | $43.5M | 85.5K | +1.9% |
| 2021 | $511.28 | $42.1M | 82.0K | +0.8% |
| 2022 | $529.59 | $40.1M | 75.5K | +3.6% |
| 2023 | $573.52 | $40.2M | 69.8K | +8.3% |
The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $711.57 vs WV at $517.13.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $711.57 | $106.0K | 149 | 6 |
| DC | $664.08 | $124.8K | 188 | 1 |
| CA | $662.87 | $3.6M | 5.4K | 76 |
| WY | $659.17 | $77.1K | 117 | 4 |
| NJ | $646.06 | $419.9K | 650 | 3 |
| UT | $642.95 | $538.1K | 837 | 15 |
| SD | $642.37 | $122.1K | 190 | 7 |
| HI | $641.33 | $173.2K | 270 | 3 |
| MT | $628.33 | $86.7K | 138 | 4 |
| NY | $627.24 | $1.3M | 2.1K | 50 |
| MA | $623.60 | $813.2K | 1.3K | 45 |
| CT | $617.95 | $310.8K | 503 | 21 |
| CO | $616.83 | $495.9K | 804 | 22 |
| MN | $614.28 | $578.7K | 942 | 17 |
| WA | $608.20 | $976.8K | 1.6K | 49 |
| OR | $599.30 | $707.8K | 1.2K | 31 |
| ND | $597.66 | $133.9K | 224 | 4 |
| NH | $596.35 | $98.4K | 165 | 10 |
| MD | $594.15 | $705.3K | 1.2K | 20 |
| NV | $590.46 | $565.7K | 958 | 13 |
| AZ | $588.02 | $797.9K | 1.4K | 27 |
| WI | $586.58 | $606.5K | 1.0K | 42 |
| VA | $585.66 | $1.3M | 2.2K | 64 |
| VT | $578.77 | $61.9K | 107 | 7 |
| IL | $576.19 | $1.0M | 1.8K | 77 |
| TX | $573.42 | $4.5M | 7.8K | 160 |
| PA | $570.15 | $917.4K | 1.6K | 60 |
| PR | $567.10 | $81.1K | 143 | 3 |
| FL | $559.13 | $4.3M | 7.8K | 90 |
| NE | $556.12 | $529.4K | 952 | 13 |
| NM | $555.07 | $223.1K | 402 | 9 |
| MI | $554.43 | $718.0K | 1.3K | 40 |
| AR | $554.13 | $474.9K | 857 | 26 |
| MO | $549.88 | $765.4K | 1.4K | 53 |
| NC | $548.68 | $2.3M | 4.2K | 76 |
| KS | $548.66 | $470.8K | 858 | 21 |
| OK | $546.91 | $811.6K | 1.5K | 28 |
| ID | $544.70 | $298.0K | 547 | 14 |
| IA | $543.63 | $339.2K | 624 | 28 |
| GA | $543.53 | $1.4M | 2.5K | 55 |
| IN | $542.38 | $731.7K | 1.3K | 54 |
| OH | $542.01 | $766.4K | 1.4K | 58 |
| SC | $536.77 | $818.6K | 1.5K | 28 |
| LA | $534.67 | $632.0K | 1.2K | 15 |
| TN | $534.42 | $1.5M | 2.8K | 58 |
| AL | $527.93 | $592.9K | 1.1K | 35 |
| KY | $526.29 | $690.5K | 1.3K | 54 |
| MS | $525.11 | $447.4K | 852 | 17 |
| WV | $517.13 | $166.5K | 322 | 14 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| New York City Health And Hospitals Corporation | Ambulance Service Provider | NY | $437.4K | 657 | $665.71 |
| Mt. Shasta Ambulance Service Inc | Ambulance Service Provider | CA | $389.0K | 522 | $745.26 |
| Acadian Ambulance Service, Inc. | Ambulance Service Provider | LA | $381.1K | 721 | $528.55 |
| Robert Wood Johnson Health Network Inc | Ambulance Service Provider | NJ | $303.9K | 473 | $642.59 |
| Board Of County Commissioners Palm Beach County | Ambulance Service Provider | FL | $291.7K | 503 | $579.88 |
| Midwest Medical Transport Company Llc | Ambulance Service Provider | NE | $291.4K | 534 | $545.73 |
| County Of Wake | Ambulance Service Provider | NC | $260.6K | 476 | $547.48 |
| City Of Los Angeles | Ambulance Service Provider | CA | $254.8K | 390 | $653.43 |
| Metropolitan Area Ems Authority | Ambulance Service Provider | TX | $242.4K | 419 | $578.42 |
| Falck Mobile Health Corp | Ambulance Service Provider | CA | $241.0K | 373 | $646.20 |
| City Of Chicago | Ambulance Service Provider | IL | $224.3K | 379 | $591.76 |
| County Of Dade Board Of County Commissioners | Ambulance Service Provider | FL | $213.1K | 362 | $588.58 |
| Polk County Board Of County Commissioners | Ambulance Service Provider | FL | $206.3K | 377 | $547.31 |
| Emergency Medical Services Authority | Ambulance Service Provider | OK | $191.3K | 357 | $535.75 |
| Acadian Ambulance Service Of Texas Llc | Ambulance Service Provider | TX | $183.4K | 325 | $564.15 |
| Etmc Ems | Ambulance Service Provider | TX | $176.9K | 318 | $556.21 |
| County Of Pinellas Board Of County Commissioners | Ambulance Service Provider | FL | $176.7K | 319 | $553.78 |
| County Of Sevier | Ambulance Service Provider | UT | $172.0K | 254 | $676.99 |
| County Of Lake Office Clerk Board County Commissioners | Ambulance Service Provider | FL | $171.1K | 317 | $539.66 |
| Montgomery County Hospital District | Ambulance Service Provider | TX | $157.8K | 284 | $555.77 |
Based on the data, CPT A0433 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.
Costs have increased 22.1% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
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.