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NPI 1689786717 · Fayetteville, NC · Ambulance
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Cumberland County Hospital System Inc is a ambulance provider located in Fayetteville, North Carolina. 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 | Cumberland County Hospital System Inc |
| Address | 610 Gillespie St |
| City | Fayetteville |
| State | NC |
| ZIP | 28306 |
| Taxonomy | Ambulance |
| NPI Enumerated | August 31, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $19.7M |
| Medicare | $4.3M |
CUMBERLAND COUNTY HOSPITAL SYSTEM INC operates as a ground ambulance provider whose billing mix is overwhelmingly dominated by transport services: the Medicare and Medicaid top codes are ALS and BLS emergency transports, ground mileage, and specialty care transport (examples include A0427, A0429, A0425, A0434). The presence of both advanced life support (ALS) and basic life support (BLS) emergency codes alongside ground mileage suggests an operation that runs high-volume emergency response and interfacility transport on a ground-ambulance platform.
Medicare revenue is highly concentrated in a few codes: the provider’s top three Medicare codes (A0427, A0425, A0429) account for 82.6% of its $4.3M total Medicare revenue. Those three include A0427 ($2.1M; 48.3% of Medicare revenue), A0425 ($769.4K; 18.0%), and A0429 ($699K; 16.3%), indicating that ALS emergency, mileage, and BLS emergency drives most Medicare receipts.
Medicaid revenue is even more concentrated: the top three Medicaid codes (A0427, A0429, A0428) represent 95.9% of the provider’s $19.7M total Medicaid revenue. In particular, A0427 generates $12.6M (63.6% of Medicaid revenue) and A0429 generates $5.8M (29.4%), with A0428 contributing $562.2K (2.8%), showing Medicaid payments are overwhelmingly for emergency ALS/BLS transports and some non-emergency BLS.
The provider is effectively Medicaid-dominant in scale: lifetime Medicaid revenue ($19.7M) substantially exceeds lifetime Medicare revenue ($4.3M), so overall operations and cash flow appear driven by Medicaid transport volumes. This payer mix implies dependence on state Medicaid rates and case volumes for financial performance rather than Medicare alone.
CUMBERLAND’s Medicare billing footprint is unusually large nationally for several transport codes: A0427 ranks #112 of 6841 providers (98th percentile; extreme outlier), A0425 ranks #122 of 8934 (99th percentile; extreme outlier), and A0429 ranks #166 of 7808 (98th percentile; notably above typical national volume). Those high national ranks for ALS emergency and ground mileage position the provider as an extreme outlier relative to most Medicare ambulance billers, consistent with atypically high national-scale activity on those CPT/HCPCS codes.
This provider is also a leading in-state Medicaid biller for the same transport services: A0427 ranks #4 of 168 providers in-state (98th percentile; extreme outlier) and A0429 ranks #3 of 144 (99th percentile; extreme outlier), with A0425 at #4 of 222 (99th percentile; notably above typical state volume). Those state ranks indicate CUMBERLAND is among the top Medicaid ambulance suppliers in North Carolina for emergency ALS and BLS transports and for mileage.
The NPI was enumerated on 2006-08-31 (~20 years ago), indicating long tenure in the market, and billing volumes reflect sustained high utilization: Medicare A0425 shows 109.9K claims and Medicaid A0427 shows 81.5K claims across the lifetime dataset. Average paid/claim differences are notable—A0427 is paid $378 avg/claim in Medicare versus $154 avg/claim in Medicaid—highlighting material payer rate differentials for the same transport 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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 5,480 | $380 | $2.1M |
| A0425 | Ground mileage, per statute mile | 109,910 | $10 | $769.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,210 | $320 | $699K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,500 | $200 | $492.3K |
| A0433 | Advanced life support, level 2 (als 2) | 170 | $550 | $94.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 350 | $240 | $85.3K |
| A0434 | Specialty care transport (sct) | 110 | $650 | $74.6K |
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 81,530 | $150 | $12.6M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 43,360 | $130 | $5.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 17,040 | $30 | $562.2K |
| A0425 | Ground mileage, per statute mile | 60,050 | $10 | $300.3K |
| A0433 | Advanced life support, level 2 (als 2) | 1,760 | $170 | $298.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4,540 | $50 | $208.7K |
| A0434 | Specialty care transport (sct) | 180 | $20 | $3.1K |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 150 | $10 | $880 |
| A0998 | Ambulance response and treatment, no transport | 130 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina 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) | 4 | 170 | 2,470 | $140 | $1.2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3 | 140 | 2,410 | $110 | $686.8K |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 2,577 | 2,850 | 10,910 | $10 | $330.3K |
| A0433 | Advanced life support, level 2 (als 2) | 4 | 30 | 280 | $140 | $100K |
| A0425 | Ground mileage, per statute mile | 4 | 220 | 3,930 | $10 | $86.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 8 | 110 | 1,530 | $20 | $74.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 3 | 50 | 250 | $50 | $51.4K |
| A0434 | Specialty care transport (sct) | 4 | 10 | 180 | $30 | $5K |
| A0998 | Ambulance response and treatment, no transport | 16 | 30 | 150 | $10 | $3.6K |
Other providers in the same ZIP code as Cumberland County Hospital System Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Therapy Playground, Inc | NC | Speech-Language Pathologist | $0 | $10.5M |
| Digestive Health Endoscopy Center, LLC | NC | Endoscopy Clinic/Center | $404.7K | $231.9K |
| Patrice Brown-parker | NC | Gerontology Nurse Practitioner | $221K | $0 |
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