Our primary dataset is built directly from the official Centers for Medicare & Medicaid Services (CMS) CY 2026 Ambulance Fee Schedule (AFS). This federally maintained database details the exact maximum allowable amounts the government will reimburse participating providers for ground and air ambulance transports across the United States.
The Power of the CMS Baseline
Private ambulance companies and municipal fire departments legally have the freedom to set their own "Sticker Prices," which are often astronomically inflated to serve as starting points for negotiations with private insurance companies. Because these sticker prices vary wildly from county to county and provider to provider, there is no reliable national average for retail transport bills.
However, the CMS fee schedule offers a concrete, federally-audited baseline. It represents what the government has objectively calculated that a transport should cost in any given locality to fairly compensate providers for their equipment, fuel, and highly-trained medical staff, while protecting patients from surprise billing.
How CMS Factors in Location
A transport in downtown Manhattan costs differently to run than a transport in rural Montana. To account for this, the CMS dataset applies specific locality modifiers to its national base rates:
- Urban Zones: Base rates are adjusted using the specific Geographic Practice Cost Index (GPCI) for that metropolitan area, factoring in elements like local rent and wage standards.
- Rural Zones: Providers operating in rural areas receive a bonus modifier. This helps subsidize emergency networks that experience lower call volumes but must maintain 24/7 readiness over vast service areas.
- Super-Rural Zones: The CMS identifies areas in the lowest 25th percentile of population density as 'Super-Rural'. Transports originating in these remote areas receive an additional 22.6% bonus multiplier to prevent the total collapse of local emergency infrastructure.