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NPI 1609868090 · Menasha, WI · Land Ambulance
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Gold Cross Ambulance Service Inc is a land ambulance provider located in Menasha, Wisconsin. This profile covers 7 Medicare and 8 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 | Gold Cross Ambulance Service Inc |
| Address | 1055 Wittmann Dr |
| City | Menasha |
| State | WI |
| ZIP | 54952 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | August 22, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.7M |
| Medicare | $1.4M |
GOLD CROSS AMBULANCE SERVICE INC operates as a ground ambulance provider with its revenue heavily driven by emergency transport services: Medicare top codes A0427 (1.7K claims, $659.7K revenue, 45.8% of Medicare revenue) and A0429 (1.4K claims, $456.1K revenue, 31.7% of Medicare revenue) are the largest Medicare line items, and the same emergency codes dominate Medicaid where A0427 (17.4K claims, $2.8M revenue, 49.6% of Medicaid revenue) and A0429 (14.8K claims, $2M revenue, 35.6% of Medicaid revenue) account for most activity. The code mix — ALS and BLS emergency transports plus mileage codes — indicates the operation is primarily an emergency response and patient-transport service rather than a non-transport or predominantly interfacility provider.
Revenue concentration is acute across both payers: the top 3 Medicare codes account for 93.3% of this provider’s Medicare revenue, and the top 3 Medicaid codes account for 92.5% of Medicaid revenue. This concentration means a small set of transport and mileage codes disproportionately drives the business’s billed revenue and any shifts in coverage or reimbursement for those codes would materially affect overall receipts.
Payer mix is skewed toward Medicaid in scale: Total Medicare revenue is $1.4M while Total Medicaid revenue is $5.7M, so Medicaid represents the larger share of reported lifetime billing. The provider is therefore effectively Medicaid-dominant by revenue, with Medicaid billing volumes and dollars substantially exceeding Medicare on file.
Nationally, GOLD CROSS’s Medicare volumes sit in upper percentiles for its core ambulance codes but are described as typical rather than extreme: A0427 ranks #405 of 6841 providers (94th percentile, labeled typical), A0429 ranks #311 of 7808 providers (96th percentile, labeled typical), and A0425 ranks #731 of 8934 providers (92th percentile, labeled typical). In plain terms, the provider has a solid national presence on core Medicare ambulance services but is not a national outlier or market dominator for those lines.
State-level competitive standing in Medicaid is strong for emergency ALS and mileage: A0427 ranks #5 of 166 providers in-state (98th percentile, labeled notably above typical state volume) and A0390 (ALS mileage) ranks #4 of 135 providers in-state (98th percentile, labeled notably above typical state volume). These ranks indicate GOLD CROSS is a major Medicaid participant in Wisconsin for high-acuity emergency transport and associated mileage, with volumes well above most in-state peers for those codes.
There is a clear asymmetry between emergency and non-emergency/specialty work: non-emergency advanced life support (A0426) and basic life support non-emergency (A0428) are small shares of Medicare revenue (A0426 $42.7K, 3.0%; A0428 $26K, 1.8%), and specialty care transport A0434 is very limited (21 claims, $14.1K, 1.0% of Medicare). On Medicaid the non-transport/response code A0998 (2.5K claims, $146.6K, 2.6% of Medicaid revenue) is present but not a primary revenue driver, reinforcing that routine emergency transports dominate the service mix.
Operational signals from mileage codes differ by payer and reinforce a large-field footprint: Medicare ground mileage A0425 accounts for $228.1K (15.8% of Medicare revenue) while Medicaid shows substantial mileage through A0390 (17.2K claims, $412.6K revenue, 7.3% of Medicaid revenue) and A0380 (8.6K claims, $240.6K revenue, 4.2%). The Medicaid mileage ranks (A0390 at #4 in-state, 98th percentile) suggest the provider handles long or frequent transport distances for Medicaid patients within the state.
The provider has long tenure in the national enrollment file, with NPI enumeration on 2005-08-22 (~21 years ago), which supports interpretation of these patterns as established operational characteristics rather than a short-term spike. Coupled with the concentration on a narrow set of ambulance codes, the long tenure suggests a stable, focused ambulance business centered on emergency ALS/BLS transports and associated mileage.
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,710 | $390 | $659.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,410 | $320 | $456.1K |
| A0425 | Ground mileage, per statute mile | 28,510 | $10 | $228.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 170 | $250 | $42.7K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 130 | $210 | $26K |
| A0434 | Specialty care transport (sct) | 20 | $670 | $14.1K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $550 | $13.2K |
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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 17,410 | $160 | $2.8M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 14,790 | $140 | $2M |
| A0390 | Als mileage (per mile) | 17,190 | $20 | $412.6K |
| A0380 | Bls mileage (per mile) | 8,590 | $30 | $240.6K |
| A0998 | Ambulance response and treatment, no transport | 2,480 | $60 | $146.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 400 | $50 | $21.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 190 | $50 | $10.4K |
| A0425 | Ground mileage, per statute mile | 8,360 | $1 | $8.4K |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6 | 150 | 450 | $150 | $480.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 5 | 170 | 690 | $150 | $372.4K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 16 | 30 | 700 | $40 | $231.9K |
| A0380 | Bls mileage (per mile) | 7 | 110 | 290 | $30 | $113.7K |
| A0390 | Als mileage (per mile) | 4 | 140 | 440 | $50 | $103.4K |
| A0998 | Ambulance response and treatment, no transport | 8 | 50 | 180 | $60 | $70.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 13 | 30 | 120 | $60 | $21.9K |
| A0425 | Ground mileage, per statute mile | 12 | 160 | 770 | $10 | $20.6K |
Other providers in the same ZIP code as Gold Cross Ambulance Service Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Preferred Home Health Care, Inc | WI | Home Health Agency | $0 | $4.2M |
| Thedacare, Incorporated | WI | Counselor | $0 | $1.5M |
| Joseph Neilitz | WI | Ophthalmology Physician | $257.8K | $0 |
| Michele Holder | WI | Dermatology Physician | $153.7K | $0 |
| Sorin Herscovici | WI | Endocrinology, Diabetes & Metabolism Physician | $79.7K | $2.8K |
| Cheryl-lynn Pitre | WI | Family Medicine Physician | $82.4K | $0 |
| John Joseph | WI | Pain Medicine (Anesthesiology) Physician | $73.8K | $0 |
| John Briggs | WI | Counseling Psychologist | $8.2K | $29.6K |
| John Beld | WI | Psychiatry Physician | $23.1K | $0 |
| Yong Li | WI | Psychiatry Physician | $17.9K | $70 |
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