A0427 HCPCS code: Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)
A0427 is the HCPCS Level II code for ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency). In 2024 Medicare paid an average of $412.46 per service for A0427 across 3,697,421 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on outpatient hospital claims. Medicare volume fell 6% from 2022 to 2024 (3,915,876 to 3,697,421 services). In 2024, about 8,360 clinicians billed Medicare for A0427 for 2,429,989 beneficiaries; California, Florida, Texas accounted for 30% of services.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 52 |
| BETOS category | O1A — Ambulance |
| Added | 2001-01-01 |
| Last action effective | 2001-01-01 |
Who bills A0427 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 8,360 |
| Medicare beneficiaries | 2,429,989 |
| States with claims | 54 |
| Share of services in top 3 states (California, Florida, Texas) | 30% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A0427, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,915,876 | 2,597,072 | $469.32 | $369.38 |
| 2023 | 3,776,526 | 2,493,958 | $508.30 | $401.05 |
| 2024 | 3,697,421 | 2,429,989 | $522.51 | $412.46 |
States with the most A0427 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 449,836 | $468.89 |
| Florida | 352,527 | $400.52 |
| Texas | 289,166 | $405.24 |
| Illinois | 184,186 | $406.94 |
| North Carolina | 136,724 | $389.38 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Clinical: Data |
| practitioner claims | 2 | Clinical: Data |
What changed for A0427
- 2001-01-01: A0427 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A0427?
A0427 is the HCPCS Level II code for ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency). Short descriptor: "Als1-emergency".
How much does Medicare pay for A0427?
In 2024, the average Medicare payment was $412.46 per service (average allowed $522.51).
Does Medicare cover A0427?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A0427 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related A04 codes
- A0420 — Ambulance waiting time (als or bls), one half (1/2) hour increments
- A0422 — Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation
- A0424 — Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)
- A0425 — Ground mileage, per statute mile
- A0426 — Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)
- A0428 — Ambulance service, basic life support, non-emergency transport, (bls)
- A0429 — Ambulance service, basic life support, emergency transport (bls-emergency)
- A0430 — Ambulance service, conventional air services, transport, one way (fixed wing)
- A0431 — Ambulance service, conventional air services, transport, one way (rotary wing)
- A0432 — Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers
- A0433 — Advanced life support, level 2 (als 2)
- A0434 — Specialty care transport (sct)
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Next steps
- Run a reimbursement report for a device billed under A0427
- Watch A0427 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A0427
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.