Medical Billing vs Medical Coding: Duties and Pay

In BLS data, medical coders and billing clerks are two different occupations. Pick a state to compare their official May 2025 wages side by side.

Coding vs billing pay by state

Data as of May 2025 (BLS OEWS, released May 15, 2026).

Official definitions

Medical coders are counted in SOC 29-2072, Medical Records Specialists. For billing, this page uses SOC 43-3021, Billing and Posting Clerks, the occupation defined by billing tasks. The U.S. Department of Labor's O*NET descriptions of the two occupations read:

"Classify medical and healthcare concepts, including diagnosis, procedures, medical services, and equipment, into the healthcare industry's numerical coding system. Includes medical coders."
O*NET, 29-2072.00 Medical Records Specialists

"Compile, compute, and record billing, accounting, statistical, and other numerical data for billing purposes."
O*NET, 43-3021.00 Billing and Posting Clerks

The billing definition does not name any industry, and BLS publishes its wages for all industries combined as well as for each industry. That is why the table below also shows healthcare industries separately.

What coders do, according to BLS

"Medical coders assign the diagnosis and procedure codes for patient care, population health statistics, and billing purposes."
BLS Occupational Outlook Handbook: Medical Records Specialists (last modified August 27, 2026)

BLS adds that coders also work as the liaison between healthcare providers and billing offices. Coders supply the codes used for billing purposes; billing and posting clerks prepare the invoices.

Pay by healthcare industry, May 2025

Employment and median annual wage, BLS OEWS national industry-specific estimates
Industry	Coders: jobs	Coders: median	Billing clerks: jobs	Billing clerks: median
All industries	194,720	$51,140	404,060	$48,500
Ambulatory Health Care Services	55,630	$47,730	127,200	$47,870
Offices of Physicians	34,860	$47,120	65,230	$47,570
Outpatient Care Centers	9,510	$50,900	11,300	$48,080
Hospitals (all ownerships)	55,530	$59,120	37,680	$48,960
Insurance Carriers	3,820	$62,650	5,640	$50,000

"Coders" means SOC 29-2072 Medical Records Specialists; "billing clerks" means SOC 43-3021 Billing and Posting Clerks. Industry rows are private ownership except hospitals, which combine private, state and local government hospitals. Source: BLS OEWS May 2025 national and industry-specific files.

Medical records specialists had the higher median in outpatient care centers, hospitals and insurance carriers; billing and posting clerks were higher in ambulatory health care services and offices of physicians. Across all industries the gap was $2,640 in favor of medical records specialists. State results vary more, which the tool above shows.

Training and certification

BLS says medical records specialists typically need a postsecondary certificate, and that certification may be required or preferred. For coder credentials and their fees, see the CPC, CCA and CCS comparison; for timing, the timeline planner.

Frequently asked questions

Does medical billing or medical coding pay more?

Nationally, in May 2025 the median annual wage was $51,140 for medical records specialists, the occupation that includes medical coders, and $48,500 for billing and posting clerks. The order flips in some places: in 6 states (Arizona, Florida, New Hampshire, New Jersey, North Dakota, Pennsylvania) billing and posting clerks had the higher median.

What does a medical coder do?

BLS says medical coders assign the diagnosis and procedure codes for patient care, population health statistics, and billing purposes, and that they also work as the liaison between healthcare providers and billing offices.

What do billing and posting clerks do?

The official definition of Billing and Posting Clerks (SOC 43-3021): compile, compute, and record billing, accounting, statistical, and other numerical data for billing purposes, and prepare billing invoices for services rendered or for delivery or shipment of goods. Sample job titles include Biller, Billing Clerk and Billing Specialist.

Is billing included in the medical coder salary data?

No. Medical records specialists (SOC 29-2072) and billing and posting clerks (SOC 43-3021) are separate occupations in BLS data, each with its own wage estimates.

Which pays more in hospitals and physician offices?

In hospitals (all ownerships) the median was $59,120 for medical records specialists and $48,960 for billing and posting clerks. In offices of physicians it was $47,120 and $47,570.