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NPI 1134298599 · Rio Rancho, NM · Ambulance
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City Of Rio Rancho is a ambulance provider located in Rio Rancho, New Mexico. This profile covers 4 Medicare and 5 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 | City Of Rio Rancho |
| Address | 3200 Civic Center Cir Ne |
| City | Rio Rancho |
| State | NM |
| ZIP | 87144 |
| Taxonomy | Ambulance |
| NPI Enumerated | November 7, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4M |
| Medicare | $555.1K |
Payer mix is heavily weighted to Medicaid: the provider reports $4M in lifetime Medicaid revenue versus $555.1K in lifetime Medicare revenue, making Medicaid the dominant source of billed dollars for this Ambulance taxonomy entity. This indicates the organization operates primarily in markets or patient populations covered by Medicaid rather than Medicare.
Medicare revenue concentration is extremely focused: the top three Medicare codes (A0427, A0429, A0425) account for 98.8% of total Medicare revenue, with A0427 at 49.6% of Medicare dollars, A0429 at 38.4%, and A0425 at 10.8%. Each of these codes is characterized in the national data as "typical, unremarkable volume for this code," and the provider sits in the mid-to-high national percentiles for those codes (A0427 85th, A0429 89th, A0425 75th), which points to a revenue profile concentrated in standard emergency transport services rather than a diversified Medicare portfolio.
Medicaid revenue concentration is similarly concentrated: the top three Medicaid codes (A0429, A0427, A0998) account for 96.1% of Medicaid revenue, with A0429 contributing $2M (49.5%) and A0427 $1.7M (42.5%), and A0998 $167.4K (4.2%). In-state competitive standing for these Medicaid codes is relatively strong: A0429 and A0427 both rank #9 in their respective in-state peer sets (85th percentile) and A0998 ranks #4 of 27 (88th percentile), each labeled as "typical, unremarkable volume for this code," which together indicate a top-tier in-state presence on emergency transport and response services.
Competitive standing differs by payer: nationally the provider’s Medicare activity for primary ambulance codes sits in mid-to-high percentiles (e.g., A0429 89th, A0427 85th) but is described as typical rather than dominant, so the provider is a modest national participant for Medicare ambulance billing. By contrast, the provider appears to be a significant in-state competitor for Medicaid emergency transport and response services, with top-10 in-state ranks on its two largest Medicaid codes and an 85th–88th percentile placement that signals relative market prominence locally.
Operational detail — mileage and claim counts: mileage (A0425) shows high claim counts on both payers (8.6K Medicare claims and 6.3K Medicaid claims) but a low average paid/claim ($7) and relatively small share of revenue (Medicare A0425 at $60K, 10.8% of Medicare revenue; Medicaid A0425 at $44.4K, 1.1% of Medicaid revenue). This pattern indicates mileage units are a frequent billing component that contributes modestly to overall dollars, consistent with many short transports or routine mileage billing rather than large per-claim payment drivers.
Tenure and continuity: the provider’s NPI was enumerated on 2006-11-07 (~20 years ago), demonstrating long-standing enrollment and suggesting operational continuity over multiple Medicare and Medicaid reimbursement cycles. That tenure supports interpretation of the observed code mix as an established service pattern rather than a recent shift.
Minor lines and statistical notes: some codes appear as smaller contributors to revenue or show low ranking positions — for example, Medicare A0433 (ALS 2) contributes $6.5K and is characterized as "typical, unremarkable volume for this code" with a 6th-percentile standing in its national peer set, while Medicaid A0999 (unlisted ambulance service) produces $109.7K and ranks #5 of 8 in-state (43th percentile). These entries are secondary to the provider’s primary emergency transport and response footprint and reflect limited revenue diversification beyond core ALS/BLS services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 740 | $370 | $276.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 690 | $310 | $214K |
| A0425 | Ground mileage, per statute mile | 8,570 | $10 | $60K |
| A0433 | Advanced life support, level 2 (als 2) | 10 | $540 | $6.5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7,960 | $250 | $2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6,700 | $250 | $1.7M |
| A0998 | Ambulance response and treatment, no transport | 2,390 | $70 | $167.4K |
| A0999 | Unlisted ambulance service | 850 | $130 | $109.7K |
| A0425 | Ground mileage, per statute mile | 6,340 | $10 | $44.4K |
How this provider's Medicaid billing volume and revenue compare to other New Mexico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Mexico median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 9 | 50 | 1,320 | $270 | $2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 9 | 60 | 1,850 | $260 | $1.2M |
| A0425 | Ground mileage, per statute mile | 13 | 70 | 2,010 | $50 | $332.1K |
| A0999 | Unlisted ambulance service | 5 | 10 | 1,160 | $70 | $280.1K |
| A0998 | Ambulance response and treatment, no transport | 4 | 30 | 470 | $40 | $77.6K |
Other providers in the same ZIP code as City Of Rio Rancho, ranked by combined Medicare and Medicaid revenue.
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