Medical Billing Salary

San Francisco vs Sacramento: Medical Billing and Coding Specialist Salary (2026)

Compare medical billing and coding specialist salaries between San Francisco, CA and Sacramento, CA. All figures are 2026 estimates projected from BLS 2025 data.

San Francisco, CA
$44,153
$21.23/hr
Sacramento, CA
$44,598
$21.45/hr

Side-by-Side Comparison

MetricSan Francisco, CASacramento, CA
Median Salary$44,153$44,598
Hourly Rate$21.23$21.45
Entry Level (P10)$29,388$28,172
25th Percentile$34,344$33,548
75th Percentile$51,500$52,586
Top Earner (P90)$63,779$63,209
Total Employed1,8801,340
Side-by-side bar chart comparing San Francisco ($44,153) and Sacramento ($44,598) medical billing and coding specialist salaries.San FranciscoSacramentoMedian Salary$44,153$44,598Entry Level (P10)$29,388$28,172Top Earner (P90)$63,779$63,209US Median $30,349

Verdict

San Francisco and Sacramento are closely matched on overall medical billing and coding specialist compensation, each winning on different metrics.

The salary gap between San Francisco and Sacramento is $445 (1.01%). Sacramento's median is +46.95% compared to the US national median of $30,349.

Salary Range Comparison

The full salary range (10th to 90th percentile) in San Francisco spans $34,391,Sacramento spans $35,037. Sacramento has a wider pay range, suggesting more variation in pay between entry-level and experienced medical billing and coding specialists.

San Francisco
P10 (Entry)$29,388
P25$34,344
Median$44,153
P75$51,500
P90 (Top)$63,779
Sacramento
P10 (Entry)$28,172
P25$33,548
Median$44,598
P75$52,586
P90 (Top)$63,209

Cost-of-Living Adjusted Comparison

After cost-of-living adjustment, Sacramento ($41,809 effective) pays 9.48% more than San Francisco ($38,190 effective).

San Francisco
Nominal: $44,153
CoL Index: 115.613
Adjusted: $38,190
Sacramento
Nominal: $44,598
CoL Index: 106.67
Adjusted: $41,809

Cost-of-living adjustment: salary × (100 / CoL index). Index of 100 = national average.

Which City Is Right for You?

Choose San Francisco if…

  • Better top-earner potential ($63,779)
  • Larger job market (1,880 employed)
  • You prefer the California area and lifestyle

Choose Sacramento if…

  • Higher median salary ($44,598/year)
  • Better purchasing power (CoL-adjusted: $41,809)
  • You prefer the California area and lifestyle

Historical Salary Growth Comparison

Based on BLS OEWS metropolitan area data, medical billing and coding specialist salaries in San Francisco grew -29.8% from 2021 to 2025, compared to -27.9% growth in Sacramento over the same period.

San Francisco, CA

+-29.8%

$61,470 (2021) → $43,152 (2025)

Sacramento, CA

+-27.9%

$60,460 (2021) → $43,587 (2025)

View Full Salary Data

Frequently Asked Questions

Which city pays medical billing and coding specialists more: San Francisco or Sacramento?

Sacramento has a higher median medical billing and coding specialist salary at $44,598/year, compared to San Francisco at $44,153/year — a difference of $445 (1.01%).

What is the hourly rate difference between San Francisco and Sacramento?

San Francisco medical billing and coding specialists earn $21.23/hr while Sacramento hygienists earn $21.45/hr (2026 est.).

Should I relocate from San Francisco to Sacramento as a medical billing and coding specialist?

Consider more than just salary when comparing San Francisco and Sacramento. Factor in cost of living (CoL-adjusted: San Francisco = $38,190, Sacramento = $41,809), job availability (1,880 vs 1,340 employed), commute, and career growth potential.

What do entry-level medical billing and coding specialists earn in San Francisco vs Sacramento?

Entry-level (10th percentile) medical billing and coding specialists earn $29,388 in San Francisco and $28,172 in Sacramento. The San Francisco area offers higher starting salaries.

Related Comparisons

AP

Written by Amina Patel, CPC

Career Analyst

Amina has 10 years of experience in medical billing. She specializes in outpatient coding for multi-specialty practices.

Clinically reviewed by Liam Johnson, RHITData verified by Sofia Nguyen, CCS

Methodology & Data Source

All salary figures are 2026 projections based on BLS OEWS May 2025 data. A 2.32% CAGR (derived from 6-year national BLS trends) was applied to estimate current compensation. Cost-of-living adjustments use BEA Regional Price Parity data. Actual salaries vary by employer, certifications, and experience.

Data Sources & Methodology

Source: BLS, OEWS , released .

Compiled and verified by Amina Patel, CPC, a licensed medical billing and coding specialist with 10+ years of clinical experience. · View source data at BLS.gov