Ambulance Service Revenue Benchmark

Average Ambulance Service Revenue per Year 2022 Economic Census

The 2022 Economic Census counts every in-scope ambulance service with paid employees, ground and air, generally leaving out government-owned municipal services, and publishes their combined annual receipts. Dividing that total by the number of services gives the average annual revenue per employer establishment shown below.

≈$3,572,000 /year

Average annual gross revenue per employer establishment

How this is calculated: about $20.3 billion in combined annual receipts divided by 5,689 employer establishments works out to an average annual revenue of $3,572,000 per employer establishment.

Scope: Ambulance Services, NAICS 621910. The category covers ambulance services providing transportation with medical care, by ground or air, for emergencies and scheduled transfers. Special needs transportation without medical care and hospitals are counted in separate categories. Classified separately in group 6219: 621991 Blood and Organ Banks; 621999 All Other Miscellaneous Ambulatory Health Care Services. Nothing outside that code is counted on this page.

Source US Census Bureau, 2022 Economic Census, Summary Statistics (ECNBASIC): ESTAB, RCPTOT and PAYANN by NAICS · Vintage 2022 Economic Census · Calculation BusinessNES · Accessed September 2026

Employer Establishments at Year Five Varies by cohort

Other ambulatory health care services, NAICS 6219, the 2018 starting count compared with the count of five-year-old establishments in 2023.

Across the 2014 to 2018 cohorts, five-year results ranged from 55.3 to 68.2 percent. This benchmark covers Other ambulatory health care services, NAICS 6219, as a whole, and this category accounts for 5,689 of the 16,493 employer establishments in it. A count by age is not a survival rate, because the figures compare two headcounts rather than follow one set of businesses.

Payroll as a Share of Revenue Official data

Payroll divided by receipts, both as published for the same year.

Payroll share of receipts, Ambulance Services, United States, 2022 Economic Census.

Approximately 42.0 percent of every revenue dollar goes to annual payroll, a high share because paramedics and emergency medical technicians must be on duty around the clock whether or not a call comes in.

Payroll here excludes benefits, employer taxes and owner compensation, and it excludes vehicles, medical equipment, fuel, insurance and the cost of billing and collecting from insurers, which together carry the rest of a service's spending.

Business Scale and Ownership Structure Official data

How large the average establishment is, and whether the population is independent operators or multi-site companies.

Scale and ownership, Ambulance Services, United States, 2022 Economic Census.

The average establishment employed about 31.8 people, and the industry averaged 1.9 employer establishments per firm, which confirms that multi-establishment ownership exists in the published population without showing how establishments are distributed across firms. As an illustration, that headcount could be crews for several ambulances across shifts, dispatch and billing staff.

These are arithmetic industry averages. They state the size of the average establishment and show that multi-establishment ownership exists. They do not show the distribution of business sizes and they do not measure market concentration.

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Data Source Notice

This product uses the Census Bureau Data API but is not endorsed or certified by the Census Bureau.

Figures above are from the 2022 Economic Census reference year, released by the Census Bureau in 2024 and 2025; markets have moved since.

Questions Worth Asking BusinessNES analysis

Ambulance Service: what response contracts, reimbursement and round-the-clock staffing do to the average.

Before you rely on this benchmark

• Emergency response or scheduled transfers? Emergency contracts with communities require staffed units waiting for calls, while interfacility transfers and scheduled transports can be planned and billed more predictably. The mix decides staffing, cost per trip and how revenue arrives.
• Who pays for the trips? Medicare, Medicaid, commercial insurers and patients reimburse the same trip at very different rates, and some calls end without a transport that can be billed at all. Payer mix, collection rates and call volume all materially affect revenue.
• What does readiness cost? A crew and an ambulance must be ready whether the shift brings ten calls or none, so the cost of readiness is fixed while revenue depends on transports. That gap is the central economic fact of the trade.
• Which services does the benchmark cover? The Economic Census benchmark covers in-scope employer establishments in this category and generally excludes government-owned municipal ambulance services, so the average describes private and hospital-affiliated services rather than fire department or county ambulance operations.
• Which rules govern the service? Licensing of services and crews, vehicle standards, protocols and billing rules come from states, local authorities and federal payers, and they vary by jurisdiction. Compliance is a permanent cost outside a receipts figure.
• How stable is the workforce? Paramedic and technician shortages, long shifts and wage competition from hospitals make staffing a constant challenge, and overtime shows up in the payroll share. Recruitment and retention decide whether units can be kept in service.