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NPI 1457901506 · Big Lake, MN · Ambulance
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Centracare Health System is a ambulance provider located in Big Lake, Minnesota. This profile covers 7 Medicare and 9 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 | Centracare Health System |
| Address | 121 Lake St N |
| City | Big Lake |
| State | MN |
| ZIP | 55309 |
| Taxonomy | Ambulance |
| NPI Enumerated | September 19, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $12.8M |
| Medicare | $1.6M |
CENTRACARE HEALTH SYSTEM in BIG LAKE, MN is filed under an Ambulance taxonomy with an NPI enumerated 2019-09-19 (~7 years ago). The claims mix is dominated by ambulance transport and mileage codes (A0425, A0427, A0429 and related BLS/ALS transport codes), indicating the operation functions primarily as a patient-transport service offering both emergency and non-emergency responses rather than an in-hospital clinical service line. The presence of both emergency ALS/BLS codes and high ground-mileage activity points to a fleet-based transport model where mileage reimbursement and emergency response are revenue drivers.
This provider reports $1.6M in total Medicare revenue and $12.8M in total Medicaid revenue, so Medicaid represents the much larger share of lifetime revenue on file. That payer mix indicates CENTRACARE is effectively Medicaid-heavy in scale, with Medicaid billing activity that substantially exceeds Medicare billing activity in absolute dollars.
Revenue concentration is high on a small number of codes for each payer: the top three Medicare codes account for 79.4% of Medicare revenue, and the top three Medicaid codes account for 83.2% of Medicaid revenue. These precomputed shares imply the business is highly dependent on a narrow set of transport and mileage CPT/HCPCS codes for the bulk of its reimbursement.
Medicare billing is concentrated around ground mileage and emergency transport: A0425 accounts for $621.5K (37.4% of Medicare revenue) and ranks #226 of 8934 providers nationally (97th percentile; notably above typical national volume for this code). A0427 ($418.3K, 25.2%) and A0429 ($279.2K, 16.8%) round out the top Medicare drivers; both rank in the high national percentiles (89th and 91th) and represent typical, unremarkable volume patterns for ALS and BLS emergency transports at scale.
On the Medicaid side the same codes dominate dollars: A0425 is $4.9M (38.1% of Medicaid revenue) and ranks #7 of 107 in-state (94th percentile), A0429 is $3.7M (28.6%) and ranks #7 of 78 (92th percentile), and A0427 is $2.1M (16.4%) and ranks #14 of 60 (78th percentile). These in-state ranks show CENTRACARE as a major regional provider for ground mileage and emergency basic life support transports, accounting for a sizable share of Medicaid ambulance dollars in Minnesota.
Unit-payment reporting differs markedly between payers for the same code: Medicare shows A0425 at $8 avg paid/claim while Medicaid shows A0425 at $231 avg paid/claim, and similar patterns appear for transport codes where Medicaid avg paid/claim figures are substantially higher than Medicare averages for the same codes as reported. This divergence highlights that reimbursement per claim varies dramatically by payer and should be considered when modeling per-transport economics or negotiating rates.
Competitive standing is mixed by market: nationally CENTRACARE ranks in the upper percentiles for several Medicare codes (e.g., 97th percentile for A0425), indicating above-typical volume on a national scale for ground mileage, while within Minnesota the provider is clearly a leading Medicaid participant for the same mileage and emergency transport codes (top-10 in-state ranks for A0425 and A0429). For less dominant codes, percentile ranks fall, implying the provider is a specialist in core transport services rather than a broad-spectrum ambulance competitor across every advanced-service code.
Smaller code activity exists but contributes little to total revenue: Medicare shows modest revenue for A0433 and A0434 (combined low single-digit percentages of Medicare revenue), and Medicaid lists small amounts for A0999, A0998 and A9270. A0433 is notably low in-state for Medicaid (14th percentile), and unlisted/response-only codes are minimal, reinforcing that CENTRACARE’s business is concentrated on mileage and standard BLS/ALS transports rather than specialty or high-acuity interfacility transports.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 77,690 | $10 | $621.5K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 990 | $420 | $418.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 780 | $360 | $279.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 660 | $230 | $149.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 470 | $280 | $130.2K |
| A0433 | Advanced life support, level 2 (als 2) | 60 | $630 | $36.1K |
| A0434 | Specialty care transport (sct) | 40 | $730 | $25.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 21,170 | $230 | $4.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 8,040 | $460 | $3.7M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3,730 | $570 | $2.1M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4,860 | $340 | $1.6M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,020 | $420 | $429.4K |
| A0433 | Advanced life support, level 2 (als 2) | 90 | $720 | $61.7K |
| A0999 | Unlisted ambulance service | 660 | $20 | $15.8K |
| A0998 | Ambulance response and treatment, no transport | 20 | $340 | $5.4K |
| A9270 | Non-covered item or service | 160 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Minnesota median
9 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) | 14 | 60 | 780 | $470 | $5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7 | 80 | 410 | $430 | $2.3M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4 | 30 | 420 | $220 | $1.1M |
| A0425 | Ground mileage, per statute mile | 7 | 110 | 870 | $80 | $971K |
| A0433 | Advanced life support, level 2 (als 2) | 7 | 10 | 560 | $790 | $714.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 6 | 20 | 130 | $290 | $438.3K |
| A0998 | Ambulance response and treatment, no transport | 11 | 10 | 140 | $230 | $59K |
| A9270 | Non-covered item or service | 32 | 60 | 210 | $10 | $15.4K |
| A0999 | Unlisted ambulance service | 4 | 10 | 360 | $20 | $10.4K |
Other providers in the same ZIP code as Centracare Health System, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Rajbir Sarpal | MN | Anesthesiology Physician | $19.5K | $0 |
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