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NPI 1700831401 · West Mifflin, PA · Air Ambulance
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Center For Emergency Medicine Of Western Pennsylvania is a air ambulance provider located in West Mifflin, Pennsylvania. This profile covers 6 Medicare and 6 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 | Center For Emergency Medicine Of Western Pennsylvania |
| Address | 10 Allegheny County Airport |
| City | West Mifflin |
| State | PA |
| ZIP | 15122 |
| Taxonomy | Air Ambulance |
| NPI Enumerated | May 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $47.8M |
| Medicare | $7.9M |
CENTER FOR EMERGENCY MEDICINE OF WESTERN PENNSYLVANIA operates predominantly as a rotary-wing air-ambulance provider: its top revenue-driving codes are A0431 and A0436, which represent conventional one-way rotary-wing transports and rotary-wing mileage respectively, with A0434 (specialty care transport) a much smaller contributor. The presence of large claim volumes on A0431 and A0436 across both payers indicates primary operations focused on air transport rather than ground or non-emergency ambulance services.
Revenue is highly concentrated in a very small set of services for both payers: the top 3 Medicare codes by revenue account for 98.8% of this provider's total Medicare revenue, and the top 3 Medicaid codes by revenue account for 99.4% of this provider's total Medicaid revenue. This concentration means the business line is narrowly focused on a few high-value transport codes rather than a broad mix of ambulance services.
Payer mix is skewed strongly toward Medicaid in scale: total Medicare revenue on file is $7.9M while total Medicaid revenue is $47.8M, so Medicaid is the dominant source of reported fee-for-service revenue. That imbalance indicates the provider’s operations and financial exposure are substantially more tied to state Medicaid reimbursement policies and volumes than to Medicare.
Nationally for Medicare, the provider is a major participant on its core rotary-wing codes: A0431 accounts for $6.1M (77.2% of this provider's total Medicare revenue) and ranks #4 of 348 providers nationally (99th percentile; notably above typical national volume for this code), while A0436 accounts for $1.6M (20.6% of Medicare revenue) and ranks #8 of 348 (98th percentile). Those high ranks and percentiles position the provider among the top national billers for rotary-wing transport under Medicare, reflecting above-typical national volume for those services.
Within Pennsylvania Medicaid the provider is effectively dominant for rotary-wing services: A0431 generates $37.9M (79.3% of this provider's total Medicaid revenue) and A0436 generates $8.4M (17.6% of Medicaid revenue), and both codes rank #1 of 9 providers in-state (100th percentile; notably above typical state volume for these codes). A0434 is also a meaningful secondary Medicaid line at $1.2M and ranks #2 of 14 in-state (92th percentile), indicating statewide leadership not only in basic air transport but also in specialty care transports.
Observed payment and claim patterns show notable differences between payers on similar codes: Medicare reports A0431 at 1.6K claims with $3905 avg paid/claim while Medicaid reports A0431 at 13.1K claims with $2897 avg paid/claim, and Medicare shows A0436 at 60K claims with $27 avg paid/claim versus Medicaid A0436 at 11.8K claims with $716 avg paid/claim. These payer-specific claim counts and average-pay levels suggest materially different billing or unitization practices between Medicare and Medicaid for mileage and transport services and should be considered when comparing revenue drivers across payers.
The provider has an established operational history, with an NPI enumeration date of 2006-05-23 (~20 years ago), consistent with sustained regional presence. Combined with the concentrated code mix and high in-state rankings, this tenure supports a picture of a specialized, long-standing rotary-wing ambulance operator with entrenched Medicaid volume.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 1,560 | $3,910 | $6.1M |
| A0436 | Rotary wing air mileage, per statute mile | 60,040 | $30 | $1.6M |
| A0434 | Specialty care transport (sct) | 130 | $660 | $82.9K |
| A0425 | Ground mileage, per statute mile | 9,040 | $10 | $63.3K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 50 | $390 | $19.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 40 | $240 | $9.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 13,070 | $2,900 | $37.9M |
| A0436 | Rotary wing air mileage, per statute mile | 11,750 | $720 | $8.4M |
| A0434 | Specialty care transport (sct) | 3,520 | $340 | $1.2M |
| A0425 | Ground mileage, per statute mile | 2,560 | $50 | $132.9K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 630 | $140 | $89.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 170 | $290 | $49.2K |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 1 | 10 | 280 | $2,940 | $5.9M |
| A0434 | Specialty care transport (sct) | 2 | 10 | 350 | $20 | $2M |
| A0436 | Rotary wing air mileage, per statute mile | 1 | 10 | 240 | $690 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 152 | 290 | 710 | $300 | $631.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 27 | 60 | 120 | $270 | $160.6K |
| A0425 | Ground mileage, per statute mile | 73 | 440 | 400 | $30 | $76K |
Other providers in the same ZIP code as Center For Emergency Medicine Of Western Pennsylvania, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Christopher Seebruck | PA | Ophthalmology Physician | $2.9M | $442.2K |
| Brian Jewart | PA | Ophthalmology Physician | $2.2M | $266.4K |
| Associates Surgery Centers, LLC | PA | Ambulatory Surgical Clinic/Center | $652.8K | $563.4K |
| Lynette Judy | PA | Nurse Practitioner | $461.1K | $0 |
| Debbie Divenanzo | PA | Anesthesiology Physician | $18.2K | $23.6K |
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