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NPI 1932258506 · Gastonia, NC · Land Ambulance
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Gaston County is a land ambulance provider located in Gastonia, North Carolina. This profile covers 7 Medicare and 12 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 | Gaston County |
| Address | 615 N Highland St |
| City | Gastonia |
| State | NC |
| ZIP | 28052 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | January 10, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $10.4M |
| Medicare | $2.4M |
GASTON COUNTY is a land ambulance operator by taxonomy and its claims mix confirms an emergency transport focus: Medicare top codes are A0427 (ALS 1 emergency) and A0429 (BLS emergency) and Medicaid top codes mirror that pattern with A0427 and A0429 dominating state billing. The presence of A0425 (ground mileage) among top Medicare and Medicaid codes further indicates routine point-to-point EMS transport rather than primarily non-transport or ancillary services. This code profile is consistent with an ambulance service that handles a high volume of emergency responses.
Revenue is heavily concentrated in a very small set of codes for both payers: the precomputed top 3 Medicare codes account for 84.1% of the provider’s Medicare revenue, and the top 3 Medicaid codes account for 96.2% of its Medicaid revenue. That concentration indicates that a few transport-related services (ALS and BLS emergency transports plus mileage/ancillary codes) drive nearly all reimbursed activity, exposing the provider’s topline to utilization or rate changes for those specific ambulance services.
In absolute scale the provider generates much more Medicaid revenue than Medicare: Total Medicare revenue is $2.4M versus Total Medicaid revenue of $10.4M. This makes the entity effectively Medicaid-dominant in lifetime revenue terms, so payer negotiations, state policy changes, or Medicaid program design will have outsized impact on its financial performance compared with Medicare.
For Medicare volume the provider’s top code A0427 ($1M revenue, 44.5% of Medicare revenue) ranks in the 96th percentile nationally and A0429 ($577.3K, 24.5%) ranks in the 97th percentile, which the source labels as typical/unremarkable volumes for those percentiles. In Medicaid the same codes are notably above typical state volume: A0427 ($5.7M, 55.0%) ranks #7 of 168 in-state (96th percentile, labeled notably above typical) and A0429 ($3.6M, 34.8%) ranks #5 of 144 (97th percentile, labeled notably above typical). Taken together, the provider is a modest-to-strong regional player for emergency ambulance transports within North Carolina, with Medicare volumes that are high relative to many peers nationally but described as typical for the national distribution.
Code-level payment characteristics show a substantial payer rate differential: average paid/claim for A0427 is $379 on Medicare but $139 on Medicaid as reported, and A0429 averages $317/claim on Medicare versus $115/claim on Medicaid. These per-claim differences, combined with much larger Medicaid claim counts, help explain why Medicaid revenue outpaces Medicare despite lower per-claim payments.
Operational metrics imply high utilization of ambulance mileage and frequent emergency transports: A0425 (ground mileage) appears in the top lists for both payers and represents 15.1% of Medicare revenue and 1.5% of Medicaid revenue, with very large claim counts reported (51.1K Medicare claims and 38.1K Medicaid claims). The mileage and high claim volumes support an operational profile centered on many discrete transports rather than specialty non-transport services.
The provider has long tenure in the NPI registry, enumerated since 2007-01-10 (about 19 years ago). That longevity combined with the high in-state rankings on core emergency transport codes suggests an established county ambulance service with sustained Medicaid-facing activity over time.
A handful of ancillary or less-productive codes have minimal revenue impact despite many claims on Medicaid: 99199 accounts for $672.8K (6.5% of Medicaid revenue) with a large claim count, while several disposable-supply codes (A0398, A0382, A0394) show claims but report $0 revenue in the Medicaid extract. These patterns point to administrative or coding line-items that produce little payer revenue relative to core transport codes and may reflect payer non-coverage or bundling of supply items into transport payments.
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) | 2,770 | $380 | $1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,820 | $320 | $577.3K |
| A0425 | Ground mileage, per statute mile | 51,050 | $10 | $357.4K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,360 | $200 | $271.2K |
| A0433 | Advanced life support, level 2 (als 2) | 90 | $550 | $49K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 140 | $240 | $32.9K |
| A0434 | Specialty care transport (sct) | 40 | $660 | $22.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.
View: State1 / 2
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 41,200 | $140 | $5.7M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 31,480 | $120 | $3.6M |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 134,550 | $10 | $672.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 8,140 | $30 | $203.6K |
| A0425 | Ground mileage, per statute mile | 38,090 | $1 | $152.4K |
| A0433 | Advanced life support, level 2 (als 2) | 230 | $150 | $34.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 90 | $40 | $3.6K |
| A0998 | Ambulance response and treatment, no transport | 150 | $20 | $2.3K |
| A0382 | Bls routine disposable supplies | 130 | $0 | $0 |
| A0394 | Als specialized service disposable supplies; iv drug therapy | 30 | $0 | $0 |
Showing 1–10 of 12
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
12 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) | 7 | 170 | 2,470 | $140 | $1.2M |
| A0999 | Unlisted ambulance service | 3 | 10 | 150 | $690 | $695.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5 | 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. | 251 | 2,850 | 10,910 | $10 | $330.3K |
| A0433 | Advanced life support, level 2 (als 2) | 17 | 30 | 280 | $140 | $100K |
| A0425 | Ground mileage, per statute mile | 9 | 220 | 3,930 | $10 | $86.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 18 | 110 | 1,530 | $20 | $74.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 33 | 50 | 250 | $50 | $51.4K |
| A0998 | Ambulance response and treatment, no transport | 15 | 30 | 150 | $10 | $3.6K |
| A0398 | Als routine disposable supplies | 5 | 10 | 190 | $1 | $100 |
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Other providers in the same ZIP code as Gaston County, ranked by combined Medicare and Medicaid revenue.
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