A0427
Ambulance, ALS emergency transport Level 1
Ambulance, ALS emergency transport Level 1 is the #20 most-billed Medicaid procedure code, with $7.67B in payments across 33.5M claims from 2018–2024. The national median cost per claim is $164.22.
Total Paid
$7.67B
0.70% of all spending
Total Claims
33.5M
Providers
6K
Avg Cost/Claim
$229
National Cost Distribution
How much do providers bill per claim for A0427? Based on 6K providers billing this code nationally.
Median
$164.22
Average
$212.98
Std Dev
$243.36
Max
$4,872.62
Percentile Distribution (Cost per Claim)
50% of providers bill between $104.51 and $233.08 per claim for this code.
90% bill between $72.72 and $324.78.
Top 1% bill above $1,257.40.
About This Procedure
HCPCS code A0427 (Ambulance, ALS emergency transport Level 1) was billed by 6K providers across 33.5M claims, totaling $7.67B in Medicaid payments from 2018–2024. This code was used for 27.7M unique beneficiaries.
Investigation Context
ALS emergency ambulance transport (A0427) has a national median of about $163/trip. We found Chicago billing $1,611/trip — nearly 10x the national average.
Fraud Risk Context
Ambulance transport codes are a known fraud vector — the OIG has documented schemes involving unnecessary transports and kickbacks.
Source: HHS OIG Reports
Risk Assessment
Billing Statistics
Median Cost/Claim
$164.22
Providers Billing
6K
National Spending
$7.67B
Avg/Median Ratio
1.30×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for A0427
| # | Provider | Total Paid |
|---|---|---|
| 1 | City Of Chicago Chicago, IL · Ambulance | $868.4M |
| 2 | Acadian Ambulance Service Inc. Lafayette, LA · Ambulance Air Transport | $166.0M |
| 3 | New York City Health And Hospitals Corporation Brooklyn, NY · Ambulance, Land Transport | $89.0M |
| 4 | Allina Health System Saint Paul, MN · Ambulance | $83.4M |
| 5 | City Of Los Angeles Los Angeles, CA · Ambulance | $76.1M |
| 6 | Falck Mobile Health Corp Orange, CA · Ambulance, Land Transport | $73.4M |
| 7 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $67.7M |
| 8 | Government Of The District Of Columbia Office Of Tax And Revenue Washington, DC · Ambulance Land Transport | $66.6M |
| 9 | City Of Phoenix Arizona Phoenix, AZ · Emergency Medical Technician Paramedic | $66.5M |
| 10 | City & County Of San Francisco San Francisco, CA · Ambulance | $60.8M |
| 11 | American Medical Response Of Maricopa, Llc Mesa, AZ · Ambulance, Land Transport | $56.2M |
| 12 | City Of Las Vegas Las Vegas, NV · Ambulance | $52.1M |
| 13 | 1093790974 | $52.0M |
| 14 | 1447200167 | $51.1M |
| 15 | Maricopa Ambulance, Llc Phoenix, AZ · Ambulance, Land Transport | $50.3M |
| 16 | American Medical Response Of Connecticut Incorporated New Haven, CT · Ambulance, Land Transport | $49.0M |
| 17 | 1538195912 | $48.0M |
| 18 | 1518075449 | $37.3M |
| 19 | 1194833939 | $37.0M |
| 20 | 1457378150 | $36.7M |
Showing top 20 of 6K providers billing this code