Medical Billing and Coding Specialist Salary (2026): CPB Pay Guide for All 50 States

Certified medical billing and coding specialists in the United States earn a national median of $30,349 per year — roughly $14.59/hour. Pay sits above the U.S. healthcare-support median and continues to rise faster than inflation, driven by chronic revenue-cycle staffing shortages, the growing complexity of payer claim edits and prior-authorization workflows, the No Surprises Act enforcement environment, and the rapid expansion of physician practice consolidation and MSO-employed billing teams.

The national median is only the middle of the distribution. Three numbers describe the real range of medical billing and coding specialist compensation:

• Entry-level specialists (10th percentile): $21,958/year — typically newly certified billers in their first 1–2 years, often working full-cycle claims at small physician practices, ambulatory surgery centers, or third-party billing companies.
• Median specialist (50th percentile): $30,349/year — the working CPB- or CCS-credentialed specialist with 3–7 years of revenue-cycle experience, frequently cross-trained across charge capture, claim scrubbing, denial management, and A/R follow-up.
• Top-earning specialists (90th percentile): $48,159/year — senior specialists in high-cost metros, denial-management leads, appeals specialists with payer-contract expertise, revenue-cycle supervisors, AAPC CPB-credentialed instructors, AHIMA CCS-credentialed inpatient hospital coders, and remote contract specialists working with multiple practices through MSO and RCM platforms.

Geographic location explains less of the gap for billing specialists than for clinical roles because the work is increasingly remote. Specialists in Sunnyvale, CA earn a median of $52,776, while colleagues in Clinton, MS earn around $13,869. State labor-market conditions for in-person hospital business-office roles, the local mix of physician-practice versus hospital employers, the strength of major MSO/RCM platforms (R1 RCM, Conifer, Optum, Change Healthcare/Veradigm), and demand from specialty-specific billing (anesthesiology, radiology, pathology) all push pay in measurable ways beyond cost of living.

Medical Billing Specialist Salary vs Medical Coder Salary — Are They the Same?

Closely related, but the focus differs. A medical billing and coding specialist (sometimes called medical billing specialist, biller, claims specialist, or revenue-cycle specialist) typically owns the full claim lifecycle — verifying eligibility, capturing charges, applying codes (ICD-10-CM, CPT, HCPCS Level II) when coding is bundled with billing, scrubbing claims through clearinghouse edits, submitting to payers, posting payments, working denials, and pursuing aging A/R. A medical coder focuses specifically on translating physician documentation into compliant codes, generally without owning claim submission or A/R follow-up. Many small and mid-size practices employ specialists who do both functions; large hospitals and academic centers separate the two roles.

The dominant credentials for the combined billing-and-coding role:

• CPB — Certified Professional Biller, awarded by the American Academy of Professional Coders (AAPC). The flagship billing credential.
• CCS — Certified Coding Specialist, awarded by the American Health Information Management Association (AHIMA). Hospital-inpatient focus.
• CPC — Certified Professional Coder (AAPC). Physician-practice coding focus.
• CMRS — Certified Medical Reimbursement Specialist, awarded by the American Medical Billing Association (AMBA).
• COC — Certified Outpatient Coder (AAPC); hospital outpatient and ASC focus.
• CCS-P — Certified Coding Specialist — Physician-based (AHIMA).

The same job goes by several names in salary surveys and job ads:

• Medical billing and coding specialist salary / medical billing specialist pay
• Medical biller salary / billing specialist pay
• CPB salary / certified professional biller pay
• Medical claims specialist salary / claims processing specialist pay
• Revenue cycle specialist salary / RCM specialist pay
• A/R specialist salary / denial management specialist pay / appeals specialist salary

All of these reference SOC code 29-2072 (Medical Records Specialists) in the Bureau of Labor Statistics Occupational Employment and Wage Statistics survey — the BLS combines medical billing, medical coding, and medical-records functions under a single SOC code, so the bench-level pay data reported here covers all three role variants.

Hourly Pay for Medical Billing and Coding Specialists

Most billing specialists are paid hourly, with salaried exceptions for lead, supervisor, and revenue-cycle-manager roles. The national median equivalent of $14.59/hour reflects a full-time 40-hour week, but actual paychecks vary widely by credential, setting, and remote-work arrangement:

• West Coast and Northeast metros (in-person hospital business offices): commonly $24–34+/hour for experienced multi-credentialed specialists; California, Washington, Massachusetts, New York, and New Jersey lead the in-person billing-specialist pay scale.
• Midwest and South: $17–24/hour median range, with metro hospital systems and large MSO billing operations at the upper end of that band.
• Remote and work-from-home roles: the segment has expanded dramatically since 2020 — large RCM platforms (R1 RCM, Conifer Health, Optum, AGS Health) and physician-billing companies (Greenway Revenue Services, athenahealth RCM, ECG Management Consultants) hire specialists nationally and pay based on credential and experience rather than local geography. Top remote contract specialists at competitive platforms can clear the 90th percentile while working from any state.
• Specialty billing (anesthesiology, radiology, pathology, ED physician group billing, orthopedic surgery): typically $3–6/hour above generalist rates because of complex modifiers, time-based coding rules, and high claim volumes per FTE.
• Denial management and appeals specialists: reliable above-base pay for specialists who recover otherwise-lost revenue from payer denials and underpayments.
• Travel and interim billing specialists (RCM consulting engagements): hourly rates often 35–55% above staff for short-term backlog and conversion projects.

Total compensation routinely runs 10–15% above headline base wages once productivity bonuses (denial recovery, claim-throughput, A/R-days improvement), AAPC/AHIMA recertification reimbursement, tuition support for additional specialty credentials, and 401(k) match are counted in.

2026 Medical Billing and Coding Specialist Salary Projection

Medical billing and coding specialist pay has grown at a compound annual rate of 2.32% over the past five years, driven by chronic revenue-cycle staffing shortages widely documented by HFMA and MGMA, the growing complexity of payer claim edits and prior-authorization workflows, the No Surprises Act enforcement environment requiring new dispute-resolution workflows, the rapid expansion of physician practice consolidation and MSO-employed billing teams, and the post-pandemic normalization of remote billing work. The Bureau of Labor Statistics projects employment for SOC 29-2072 (Medical Records Specialists) to grow 9% through 2033 — faster than average — keeping upward pressure on wages, especially for credentialed specialists in denial management, appeals, specialty practices, and remote contract roles.

A senior denial-management specialist at an anesthesiology billing company can earn nearly double what an entry-level biller at a rural primary-care practice takes home. Four factors explain almost all of that gap: credential stack, practice setting and specialty, remote-work arrangement, and career-path role.

1. Credential Stack: CPB, CCS, CPC, CMRS, and Specialty Add-Ons

The single biggest pay-shaping decision for a billing-and-coding specialist is which credentials to stack. Entry-level specialists without certification start near the 10th percentile at $21,958. Within 6–18 months most pass at least one of the foundational certifications, which carries a measurable hourly bump at almost every employer. Senior specialists with 5+ years of experience and multiple credentials frequently reach the 90th percentile at $48,159:

• AAPC CPB — the flagship Certified Professional Biller credential, focused on the full claim lifecycle, payer rules, and revenue cycle management.
• AHIMA CCS — Certified Coding Specialist; hospital inpatient and outpatient coding focus. Strong premium at hospital business offices and academic medical centers.
• AAPC CPC — Certified Professional Coder; physician-practice coding focus. Most widely held single credential in the specialty.
• AAPC COC — Certified Outpatient Coder; hospital outpatient department and ASC focus.
• AHIMA CCS-P — Certified Coding Specialist — Physician-based; physician-practice coding focus.
• AAPC CIC — Certified Inpatient Coder; hospital inpatient focus with DRG, MS-DRG, and POA assignment competency.
• AAPC CRC — Certified Risk Adjustment Coder; HCC coding for Medicare Advantage, ACO, and value-based payment models. Among the highest-paying specialty credentials.
• AMBA CMRS — Certified Medical Reimbursement Specialist; billing-focused.
• AAPC specialty credentials (CASCC, CANPC, CCC, CCVTC, CEDC, CEMC, CFPC, CGIC, CGSC, CHONC, CIRCC, COBGC, COSC, CPCD, CPEDC, CPMA, CPCO, CPRC, CRHC, CSFAC, CUC) — single-specialty coding certifications (anesthesiology, urology, cardiology, ED, family practice, GI, general surgery, oncology, interventional radiology, OB/GYN, ortho/spine, pediatrics, plastics, RHC, surgical assist, urology) — each commands above-generalist pay for specialists in that specialty.

2. Practice Setting and Specialty

Where you bill matters as much as how long you've billed:

• Specialty physician billing companies (anesthesiology, radiology, pathology, ED group billing, orthopedic surgery, urology): the highest-paying single setting for billing specialists; complex modifiers, time-based coding rules, and high claim volumes per FTE.
• Hospital business offices and academic medical centers: stable mid- to high-range pay with structured career ladders to lead specialist, supervisor, and revenue-cycle manager roles; pension or 403(b) at not-for-profit systems.
• MSO and physician-practice management companies (MEDNAX/Pediatrix, USACS, US Anesthesia Partners, Envision): centralized billing operations with above-median pay for specialty-aligned billers.
• RCM platforms (R1 RCM, Conifer Health, Optum, AGS Health, Change Healthcare): volume-based career paths with promotion to denial-management lead and team supervisor.
• Third-party physician billing companies (regional and national): a major employer category, often hiring remote staff nationally; pay competitive with hospital business offices for credentialed specialists.
• Ambulatory surgery centers (ASCs) and surgical hospitals: COC-credentialed specialists fit well; reliable mid-range pay.
• Federally Qualified Health Centers (FQHCs) and Critical Access Hospitals (CAHs): stable pay with PSLF eligibility.

3. Remote Work and 1099 Contracting

Medical billing has become one of the most remote-friendly healthcare careers since 2020. Major RCM platforms, physician-billing companies, and MSOs hire specialists nationally with pay based on credential and experience rather than local geography. The shift has created two distinct pay markets:

• W2 remote staff specialists — base pay competitive with in-person hospital business-office roles, plus benefits, retirement contribution, AAPC/AHIMA recertification reimbursement, and tuition support.
• 1099 contract billing specialists — bill multiple practices or RCM platforms at $25–55+/hour, set their own hours, but self-fund benefits and quarterly tax payments. Top contractors with specialty CPB+CRC+CPMA stacks reach the 90th percentile working from any state.
• RCM platform productivity-based roles — pay tied to claim throughput, denial recovery, or A/R-days improvement; top producers frequently exceed staff hourly equivalents by 25–40%.

4. Career-Path Role: Specialist → Lead → Auditor → Manager

The bench billing-specialist pay scale tops out at the 90th percentile, but the career path opens additional layers. Lead specialists, denial-management leads, and appeals specialists with strong payer-contract expertise earn at or above the 90th percentile of the bench scale. AAPC CPMA-credentialed auditors performing payer audit response, internal compliance audits, and pre-submission review reach further into management-level pay. Revenue-cycle supervisors, revenue-integrity analysts, charge-capture analysts, and revenue-cycle managers — typically with multiple AAPC and AHIMA credentials plus an associate or bachelor's degree — anchor the high end of the SOC code and frequently progress into healthcare-administration roles tracked under separate SOC codes.

For a complete city-by-city breakdown of medical billing and coding specialist salaries — including BLS percentile data (10th, 25th, 50th/median, 75th, 90th), local cost-of-living adjustments, and 2026 salary projections — browse the 1,687+ metro areas tracked in our dataset below.