Medical Billing & Coding Salary by State & Work Setting (2026)

This guide equips you with current data, state-by-state breakdowns, and the employer nuances to keep top of mind. 

The National Baseline for Medical Billing and Coding 

The Bureau of Labor Statistics (BLS) puts the national median for medical records specialists – the category that covers medical billers and coders – at $50,250 per year, or roughly $24.16 an hour. The average annual figure sits slightly higher at $53,690. The average is pulled upward by credentialed specialists, experienced coders in high-paying states, and professionals working for insurers rather than small physician groups. 

With roughly 14,900 medical billing and coding openings expected annually, this isn't a niche corner of healthcare administration. 

Professionals holding two certifications average $71,130 per year, and those with three or more certifications climb to $76,035, according to the American Academy of Professional Coders’ (AAPC's) salary survey data. That's a meaningful jump from the median – and it doesn't require a four-year degree to get there. 

Why Your Zip Code Might Be Worth $30,000 

The geographic spread in this field is wider than most people expect. Washington State leads the country, with medical billers and coders earning nearly $30,000 more annually than their counterparts in Mississippi, according to BLS data. Washington, D.C. clocks in at a median of $62,810 per year – among the highest metro figures nationwide. 

The coastal and upper-Midwest corridor consistently outpaces the Southeast: 

• Washington State: Among the top three highest-paying states nationally. 
• Rhode Island: Consistently strong performer due to dense healthcare infrastructure. 
• California: Median salaries exceeding $80,000 in some metro markets. 
• New York: High cost-of-living adjustment pushes wages up significantly. 
• Alabama, Arkansas, and Mississippi: Among the lowest median salaries, though purchasing power in these states partially offsets the gap. 

A lower-wage state isn't always a bad deal. A $44,000 salary in rural Arkansas may stretch further than $58,000 in the San Francisco Bay Area once housing, transportation, and taxes are factored in. The AAPC has noted that medical billers and coders in most states still earn above their state's median annual income. 

Urban versus rural gaps are also notable. Metropolitan positions almost universally pay more than rural ones, but rural postings carry less competition. This can benefit early-career professionals who need to build their portfolio quickly. 

Watch Our Video on How to Advance Your Medical Coder Career 

Employer Type: The ‘X’ Factor 

Not all employers pay equally, and the difference between settings is sharper than the state-level data suggests. 

• Hospitals are the largest single employer of billing and coding professionals, accounting for roughly 29% of the 186,400 jobs in the field. But larger doesn't automatically mean higher-paying. 
• BLS data shows insurance companies consistently rank as the highest-paying employers for medical billing and coding specialists. The work tends to be more specialized, the claim volumes higher, and the technical demands greater –which pushes compensation up accordingly. 
• Health systems (networks of three to ten hospitals) pay up to 14% more than solo physicians or small physician groups, per AAPC data. If you're evaluating two offers and one is from a three-hospital system versus a solo practice, the system offer is likely the better starting point. 
• Physician offices and clinics sit in the middle of the pay range. The trade-off is often a calmer pace, more direct provider interaction, and in some cases, better work-life balance. 
• Remote billing vendors occupy their own bracket. Third-party medical billing companies – the outsourced vendors that handle revenue cycle management for dozens of practices simultaneously – can offer competitive pay precisely because they run at scale. A specialist working for one of these firms processes claim volume that would take a small clinic team to match, which justifies higher per-employee investment. 

"Any healthcare setting with anything administratively related to the revenue cycle is an opportunity to work as a medical biller or coder.”

– Nancy Szwydek, MPH, RN, RHIA, CRAT, CMAC, Assistant Dean for Accreditation at Purdue University Global

Medical Billing Remote Work and What It Does to Salary Ranges 

ZipRecruiter data puts the average remote medical coder salary at around $46,638 annually – slightly below the national median, but with significant upside for experienced and credentialed professionals. 

Remote work expands your employer pool beyond your local market. A credentialed coder in a low-wage state can, in many cases, compete for positions paying California or New York rates. This geographic arbitrage is one of the more underappreciated salary levers in this field. 

One caveat: remote pay varies by employer type and volume. Remote positions at large health systems or insurance carriers tend to pay more than remote work through smaller billing vendors. Before accepting a work-from-home offer, benchmark it against what comparable credentialed professionals earn locally. 

The Certification Premium: CBCS and Beyond 

Certified professionals consistently out-earn their non-credentialed peers. The margin is well-documented: certified medical records specialists average $62,689 per year – roughly 16.6% more than those without credentials, according to AAPC data. 

The Certified Billing and Coding Specialist (CBCS) is one of the most accessible and widely recognized entry-level credentials in the field. It signals to employers that you've been tested on the fundamentals – medical terminology, billing procedures, and coding accuracy – and met a measurable standard. 

"If you have coding credentials, that looks good on your resume. They show you have a knowledge base employers are looking for, making them more likely to consider you."

– Robyn Korn, MBA, RHIA, CPHQ, Adjunct Instructor of Medical Coding at Purdue University Global

From there, stacking credentials (adding specialty certifications in areas like risk adjustment or auditing) is how professionals push past the $70,000 and $75,000 thresholds. Specialization in inpatient facility coding tends to bring in some of the highest salaries in the field. 

If you're ready to start building toward certification, Health Tech Academy's 12-week Medical Billing and Coding Specialist Program is built around in-demand skills and CBCS exam preparation.  

Hear from One of Our Students 

Health Tech Academy vs Community and Online Colleges  

Entry-Level Vs Experienced: The Salary Arc 

The starting range for entry-level billing and coding roles sits around $30,000–$40,000 annually, or $15–$20 per hour.  

• With two to three years of experience and a credential like the CBCS, crossing the $50,000 threshold is common.  
• Senior professionals with advanced certifications and a decade of experience regularly land in the $60,000–$80,000 range.  
• The BLS puts the top 10% in this field above $74,200. 

The salary progression in this profession isn't steep at the start, but it climbs with credentialing and specialization faster than many adjacent healthcare administrative roles. 

Medical Billing and Coding Salary Drivers  

• Specialty coding requires a premium. Coders who work in high-complexity specialties – oncology, cardiovascular, or orthopedics – earn more than generalists. The coding is more intricate, the documentation heavier, and the demand for accuracy higher. 
• Medicare risk adjustment is a high-growth niche. As value-based care expands, risk adjustment coders are increasingly sought after. Some AAPC instructor roles in this niche have been trending toward $97,000+. 
• Coding auditors earn more than standard coders. Reviewing claims for compliance and accuracy carries a premium, since errors in auditing can have legal and financial consequences for the organization. 

The AAPC focuses more on coding in physicians' offices and clinics, while the American Health Information Management Association (AHIMA) credentials provide broader exposure across hospital and outpatient settings.  

Knowing which pathway aligns with your target employer can affect hiring and salary negotiations. 

Frequently Asked Questions and Answers 

What is the Average Medical Billing Salary in the United States in 2026? 

The BLS median for medical records specialists is $50,250 per year. The average (mean) sits at $53,690. Certified professionals typically earn above both figures. 

Which States Pay the Most for Medical Billing and Coding? 

Washington State, California, Rhode Island, and Washington, D.C., are consistently among the highest paying. California metro markets have reported median salaries above $80,000 for credentialed coders. Washington, D.C. reports a median of $62,810. 

Does Certification Significantly Affect Medical Billing Salaries? 

Yes. Certified professionals earn roughly 16.6% more than non-certified peers. Holding two certifications pushes the average to $71,130; three or more to $76,035. The CBCS is a strong entry point for those entering or pivoting into the field. 

Do Hospital Billers Earn More than those at Clinics? 

Not automatically. Insurance carriers are the highest-paying employers by industry, followed by large health systems. Hospital pay is competitive, but not always the ceiling. Clinic positions often trade top pay for a more manageable pace and direct provider relationships. 

Is Remote Medical Billing Paid Less? 

Remote roles average slightly below the national median in some datasets, but credentialed professionals – particularly those in risk adjustment, auditing, or working for large insurers – can earn at or above median rates remotely. Geographic arbitrage is an opportunity for experienced coders in lower-wage states. 

How Long does it Take to Become a Certified Medical Biller and Coder? 

Training programs vary in length. Health Tech Academy's Medical Billing and Coding Specialist Program is designed to get students ready and prepared for the CBCS credential in under three months. 

What's the Job Growth Outlook for this Field? 

The BLS projects 9% growth through 2033, significantly faster than the average for all occupations, with roughly 14,900 openings per year. The shift toward electronic health records, value-based care, and an aging patient population is sustaining this demand.