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NPI 1013127026 · Gaffney, SC · Land Ambulance
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Ambu-star, Inc. is a land ambulance provider located in Gaffney, South Carolina. This profile covers 5 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Ambu-star, Inc. |
| Address | 154 Webber Rd |
| City | Gaffney |
| State | SC |
| ZIP | 29341 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | May 22, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.6M |
| Medicaid | $24K |
AMBU-STAR, INC. is a land-ambulance operator whose Medicare billing is overwhelmingly concentrated in basic life-support non-emergency transport and mileage: A0428 (BLS non-emergency) and A0425 (ground mileage) together drive the bulk of Medicare revenue, with the provider’s precomputed top 3 Medicare codes accounting for 99.5% of total Medicare revenue and A0428 alone representing 76.1% of Medicare receipts. The claim volume and per‑claim averages reported (A0428: 12.2K claims, $162 avg paid/claim; A0425: 96.5K claims, $6 avg paid/claim) indicate high-volume, routine ground-transport operations rather than primarily emergency advanced-care services.
The provider’s Medicare competitive standing is extremely concentrated at the national level: A0428 ranks #37 of 2772 providers nationally (99th percentile) and is labeled an extreme outlier, signaling nationally exceptional volume for BLS non-emergency transports. A0425 also ranks well above peers at #165 of 8934 (98th percentile) and is described as notably above typical national volume, while A0429 (BLS emergency) is routine in national terms (rank #4094 of 7808, 47th percentile).
By contrast, AMBU-STAR’s Medicaid billing is small in scale compared with Medicare: total Medicaid revenue is $24K versus $2.6M in Medicare, making it effectively Medicare‑dominant in revenue mix. Medicaid billing is still concentrated—precomputed top 3 Medicaid codes represent 88.4% of Medicaid revenue—but those Medicaid code ranks are modest to low within the state, suggesting a limited competitive footprint in Medicaid markets.
Medicaid code mix mirrors the Medicare operational profile but at much lower scale: the top Medicaid codes are A0425 (49.2% of Medicaid revenue; 371 claims, $32 avg paid/claim, $11.9K), A0428 (25.3% of Medicaid revenue; 63 claims, $97 avg paid/claim, $6.1K), and A0429 (13.9% of Medicaid revenue; 25 claims, $134 avg paid/claim, $3.4K). These figures imply the provider performs a majority of its Medicaid work as mileage and BLS transports rather than higher‑level ALS services.
State-level competitive standing on Medicaid is modest to weak: A0425 ranks #98 of 108 providers in-state (9th percentile) and A0428 ranks #43 of 51 (14th percentile), while A0429 and A0427 rank near the bottom in-state (5th and 2th percentiles respectively), indicating AMBU-STAR is not a leading Medicaid ambulance provider in South Carolina.
Operational risk and business implications are clear: the provider’s revenue is highly concentrated in a very small set of codes (99.5% of Medicare revenue from the top 3 Medicare codes and 88.4% of Medicaid revenue from its top 3), which creates sensitivity to reimbursement changes or policy shifts affecting A0428 and A0425. The minimal revenue from ALS codes (e.g., A0426 and A0427 small shares) suggests limited advanced-life-support service lines and a business model focused on BLS and mileage-based transports.
AMBU-STAR has an established tenure: its NPI was enumerated on 2007-05-22 (~19 years ago), indicating long-term participation in Medicare/Medicaid billing that supports the development of the high-volume BLS and mileage billing pattern observed across payers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 12,220 | $160 | $2M |
| A0425 | Ground mileage, per statute mile | 96,530 | $10 | $579.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 90 | $310 | $28.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 40 | $240 | $8.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 10 | $380 | $5.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 370 | $30 | $11.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 60 | $100 | $6.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 30 | $130 | $3.4K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 20 | $170 | $2.8K |
How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Carolina median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 81 | 90 | 1,720 | $90 | $577.3K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 88 | 90 | 1,720 | $110 | $525.8K |
| A0425 | Ground mileage, per statute mile | 98 | 110 | 3,520 | $20 | $193.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 43 | 50 | 830 | $10 | $31.6K |
Other providers in the same ZIP code as Ambu-star, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Meeting Milestones Early Intervention Services, LLC | SC | Early Intervention Provider Agency | $0 | $6.6M |
| Cherokee Medical Center | SC | Rural Health Clinic/Center | $0 | $4.5M |
| Access Therapies, Inc | SC | Speech-Language Pathologist | $0 | $2.9M |
| Cherokee County School District | SC | Local Education Agency (LEA) | $0 | $2M |
| Cherokee Community Care, LLC | SC | Rural Health Clinic/Center | $0 | $2M |
| Steven Murray | SC | Physical Therapist | $0 | $1.6M |
| American Transmed, Inc | SC | Land Ambulance | $462.9K | $212.1K |
| Alfred Ezman | SC | Internal Medicine Physician | $157.6K | $0 |
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