Bigger employer, higher income

AAPC's 2025 Medical Coding and Billing Salary Report shows the average medical coding income varies by type of employer, with larger healthcare provider organizations offering higher wages. This trend, like income variations by state economies, has proved consistent in 10-plus years of surveying income by workplace.

Health systems, individual hospitals, and physician practices

The American Hospital Association reports that there are over 407 U.S. health systems, and that 67 percent [MD1] of U.S. hospitals are part of these health systems. Health systems also include physician groups, urgent care clinics, and rehabilitation centers. As the largest employer type, the health system pays medical records specialists an average of $68,290 a year, which is approximately 15.4 percent more income than the medical office of a solo physician or small physician group.

Medical records specialists employed by individual hospitals earn the second highest income at $65,502 per year, followed by those employed by large physician group practices (50 or more physicians), earning $65,042, then medium group practices (11-49 physicians) earning $59,411, and finally, solo physicians or small physician group practices (2-10 physicians) earning $57,797. 

Salaries by practice size

Other employers

Besides physician offices, hospitals, and health systems, other organizations relying on billing and coding staff include ambulatory surgery centers, walk-in clinics, assisted living and long-term care facilities, home health agencies, hospice groups, telehealth companies, labs, and imaging centers.

Other employers not related to direct patient care include software and durable medical equipment vendors, insurance companies, government agencies, educational institutions, billing companies, risk adjustment vendors, healthcare consulting firms, and some law offices.

Trends by employer type

Only 8.9 percent of AAPC's 2024 Salary Survey respondents report working for small physician practices in 2024. This number represents a notable shift from 22.4 percent in 2010. More than 43 percent of medical coders, billers, and other healthcare business professionals now work for the largest employer types, which include health systems, inpatient and outpatient hospitals, inpatient-only hospitals, and outpatient-only hospitals.