How much does Medicare pay for HCPCS A0431?

Medicare allowed an average of $5614.16 per service and paid $4467.22 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $40,112, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code A0431?

Ambulance service, conventional air services, transport, one way (rotary wing). It was billed 65,548 times to 63,643 Medicare beneficiaries by 347 providers in 2024.

Which specialty bills A0431 most?

Ambulance Service Provider, with 65,548 services from 347 clinicians.

HCPCS A0431

Ambulance service, conventional air services, transport, one way (rotary wing)

$5614.16Medicare-allowed amount per service, averaged across 65,548 services

Providers submitted

$40,112

Asking price, not received

Medicare allowed

$5614.16

The fee schedule figure

Medicare paid

$4467.22

Balance is patient coinsurance

Providers submitted an average of $40,112 for this code and Medicare allowed $5614.16 — 7.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $4467.22 (80%); the rest is the patient’s coinsurance and deductible.

Services: 65,548
Beneficiaries: 63,643
Providers billing it: 347
Total allowed: $367,996,960

What Medicare pays for HCPCS A0431

Across 65,548 services billed by 347 providers to 63,643 beneficiaries, Medicare allowed an average of $5614.16 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills A0431

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulance Service Provider	65,548	63,643	$5614.16	347

A0431 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Alabama	12,993	$5437.35	$4357.30	11
Texas	4,320	$5637.70	$4361.89	43
Oregon	3,764	$6046.72	$4360.99	3
Missouri	3,174	$5716.96	$4364.68	15
Tennessee	2,690	$5684.57	$4363.79	31
California	2,673	$6011.13	$4364.17	3
Illinois	2,471	$5667.20	$4362.20	16
Arkansas	2,216	$5641.36	$4367.84	11
Nevada	2,054	$6039.37	$4354.10	4
Oklahoma	2,029	$5912.16	$4367.35	21
Colorado	1,942	$6060.13	$4363.28	10
Kentucky	1,836	$5711.58	$4364.32	20
Arizona	1,675	$5463.29	$4352.99	8
Ohio	1,674	$5314.24	$4360.37	7
Pennsylvania	1,580	$5075.66	$4361.28	1
Mississippi	1,472	$5703.04	$4363.86	15
Virginia	1,433	$5294.10	$4360.38	10
Georgia	1,284	$5484.47	$4362.92	18
Florida	1,264	$4954.94	$4358.36	14
Louisiana	1,149	$5263.49	$4366.39	7
North Carolina	1,086	$5481.26	$4360.22	7
Minnesota	1,063	$5969.47	$4355.39	3
New Mexico	1,027	$6043.23	$4361.72	7
Massachusetts	1,015	$5138.30	$4360.94	1
West Virginia	844	$5227.26	$4354.32	4
Indiana	833	$5576.41	$4366.90	7
Kansas	761	$5707.88	$4372.89	7
Maryland	754	$4546.69	$4365.78	3
Washington	659	$5982.39	$4356.37	1
South Carolina	558	$5482.79	$4365.20	9
Wisconsin	385	$5562.06	$4365.63	3
Alaska	363	$6565.33	$4361.21	2
Utah	349	$5731.18	$4360.41	1
Maine	338	$5825.84	$4361.11	1
Wyoming	334	$6099.36	$4365.97	4
Iowa	294	$5455.23	$4363.45	3
Nebraska	284	$6069.81	$4361.77	2
New York	282	$5359.56	$4378.09	3
Michigan	264	$5601.74	$4377.31	6
New Jersey	243	$4481.18	$4379.48	2
Hawaii	65	$6632.27	$4380.97	2
Connecticut	54	$4603.06	$4364.18	1

Related codes

A0425Ground mileage$9.46
A0436Rotary wing air mileage$38.43
A0427Ambulance service$522.48
A0428Ambulance service$261.47
A0435Fixed wing air mileage$14.65
A0429Ambulance service$446.93
A0426Ambulance service$327.62
A0433Advanced life support$752.44
A0434Specialty care transport (sct)$919.21
A0430Ambulance service$5195.78

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.