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Last updated: 21 October 2026. Figures as of: BLS OEWS May 2025 (national, state and industry); BLS Employment Projections 2025–35; AAPC and AHIMA exam pages (accessed 21 October 2026).
Written by WageNorth Editorial. Fact-check: pending human review.
Part 1 of 2: Certification cost, CPC vs CCA, salary and pay by state
In this guide:
- Certification cost, CPC vs CCA, salary and pay by state (this page)
- Certification details, work setting, the remote reality, training cost and payback
Certification cost: CPC vs CCA at a glance
| CPC (AAPC) | CCA (AHIMA) | |
|---|---|---|
| Exam fee | $425 for one attempt or $499 for two (AAPC support page); an AAPC help-centre article lists $399 | $199 for members, $299 for non-members |
| Focus | Physician and outpatient coding | Entry-level coding credential |
| Ongoing cost | Annual AAPC membership and 36 continuing education units every two years | AHIMA’s renewal rules apply |
| Published pass rate | Not published on the pages we checked | 62% for first-time testers in 2025 |
The more advanced AHIMA credential, the CCS, costs $299 for members and $399 for non-members, with an 84% first-time pass rate in 2025. Course fees and code books come on top of the exam (Part 2). Confirm the current CPC price at checkout on aapc.com, because AAPC‘s own pages differ.
What official data say
The Bureau of Labor Statistics (BLS) doesn’t have a single “medical biller and coder” occupation. Coders are counted mainly under medical records specialists. Billing-focused roles are often counted under **billing and posting clerks**, which covers all industries, not only healthcare.
| BLS occupation (May 2025) | 10th percentile | Median | 90th percentile | Jobs |
|---|---|---|---|---|
| Medical records specialists | $37,000 | $51,140 ($24.59/hr) | $81,150 | 194,720 |
| Billing and posting clerks (all industries) | $37,290 | $48,500 ($23.32/hr) | $67,710 | 404,060 |
For medical records specialists, the middle half earned between $43,490 and $64,820. BLS projects employment to grow 7.8% from 2025 to 2035, with about 14,000 openings a year.
How you enter
BLS says medical records specialists typically need a postsecondary certificate. Some qualify with a high school diploma, and others have an associate or bachelor’s degree. BLS also notes that employers may prefer certified candidates, or expect new hires to earn certification soon after starting. The main credentials are:
- CPC (Certified Professional Coder) from AAPC, focused on physician and outpatient coding.
- CCA (Certified Coding Associate) from AHIMA, an entry-level credential.
- CCS (Certified Coding Specialist) from AHIMA, a more advanced credential often associated with hospital coding.
The factors that move pay
- Location. State medians for medical records specialists range from $41,500 to $72,040 (full table below).
- Setting. Hospitals pay more at the median than physician offices (Part 2).
- Credentials and experience. Certification can be required or preferred. With AAPC, the “apprentice” designation stays until you document experience (Part 2).
- Role scope. Auditing, compliance and health-information roles sit higher in the pay range. For example, health information technologists and medical registrars had a May 2025 median of $68,020.
- Remote or onsite. We found no official data on remote coders’ pay or on the share who work from home (Part 2).
The remote reality, in brief
Many coding jobs are advertised as remote, but no official US source measures how many coders work from home or what they earn. Employers often want experience or full (non-apprentice) certification before offering a remote role, so newly certified coders may need to start in an onsite or hybrid role (Part 2).
Is it right for you?
The work suits people who like detailed, rules-based tasks and long periods at a computer. BLS notes that medical records specialists typically spend many hours at a computer and that most work full time.
General information, not legal, financial or immigration advice. Rules vary by state/province; check the official source or a licensed professional.
In short: the CPC exam costs about $400–$425 for one attempt and the CCA $199–$299. Coders earn a median of about $51,000 (BLS, May 2025), and remote roles usually come after experience.
State medians, May 2025
| State | Median annual pay | Median hourly | Jobs |
|---|---|---|---|
| District of Columbia | $72,040 | $34.63 | 270 |
| Rhode Island | $63,960 | $30.75 | 650 |
| Hawaii | $63,180 | $30.37 | 400 |
| Washington | $62,270 | $29.94 | 5,010 |
| California | $61,810 | $29.71 | 18,700 |
| New York | $61,720 | $29.67 | 9,080 |
| Minnesota | $61,530 | $29.58 | 3,150 |
| Alaska | $61,090 | $29.37 | 1,070 |
| Ohio | $50,990 | $24.52 | 7,440 |
| Texas | $48,860 | $23.49 | 17,210 |
| Florida | $45,760 | $22.00 | 21,490 |
| Louisiana | $44,610 | $21.45 | 2,600 |
| Alabama | $43,810 | $21.06 | 2,330 |
| Arkansas | $41,740 | $20.07 | 1,920 |
| Mississippi | $41,500 | $19.95 | 2,310 |
Source: BLS OEWS May 2025 state estimates for medical records specialists (SOC 29-2072). The table shows the eight highest-paying areas, the largest states by employment, and the five lowest-paying states.
How to read this table
- Florida has the most jobs but a below-median wage. Its median of $45,760 is about $5,400 below the national figure, yet it employs more medical records specialists than any other state.
- High-paying states often have high living costs. DC, California, Washington and New York top the list, but housing and other costs there are also high.
- Remote work complicates the picture. If an employer in a high-wage state hires remote coders elsewhere, it may set pay by the worker’s location. Practices vary and there’s no official data, so ask each employer.
Metro data
BLS also publishes OEWS wages for metropolitan areas, which can differ a lot from the state figure. On the BLS OEWS site, search for “medical records specialists” and choose your metro area to see local percentiles.
What the spread means for planning
Even within one state, the 10th-to-90th-percentile range is wide: nationally, $37,000 to $81,150. New coders, especially those with apprentice status, are usually nearer the lower end. Coders with experience, specialty skills or auditing roles are more likely to be near the top. Use your state’s 10th and 25th percentiles to estimate first-year pay.
How far each state sits from the national median
Compared with the national median of $51,140, DC’s median is about 41% higher and Mississippi’s about 19% lower (WageNorth calculations from BLS figures). The five lowest-paying states in the table are all in the South. The three largest employers of medical records specialists, Florida (21,490 jobs), California (18,700) and Texas (17,210), sit on very different parts of the scale. A coder in California earns a median of about $13,000 a year more than one in Texas.
For a closer local comparison, BLS also publishes OEWS estimates by metropolitan area for medical records specialists (occupation code 29-2072).
In short: state medians range from about $41,500 to $72,000. Use your own state’s lower percentiles to plan realistic starting pay.
