Comparing CPC, CCA, CBCS, and CCS certification options

Medical Billing and Coding Certification Comparison

CPC vs CCA vs CBCS vs CCS vs CPB: side-by-side costs, exam details, salary data, and employer preferences for every major credential

Quick Summary

Choosing the right medical billing and coding certification depends on your budget, work setting, and career goals. Five credentials dominate the field: CPC and CPB from AAPC, CCA and CCS from AHIMA, and CBCS from NHA. Certified professionals earn an average of $66,979 per year, roughly 20.7% more than their uncertified peers at $55,721. Stacking multiple credentials pushes that average to $81,227.

CPC is the most widely recognized credential for outpatient/physician-office coding ($425 exam + $222/yr AAPC membership)
CBCS is the most affordable entry point at ~$117 and doesn't require membership fees
CCS is the strongest credential for hospital inpatient coding ($299-$399 exam fee)
Certified professionals earn 20.7% more than non-certified coders (AAPC 2025 Salary Survey)
Updated February 2026
Sources: AAPC 2025 Salary Survey, AHIMA Certification Programs, NHA Certification Guide
Key Takeaways
  • 1.Five medical billing and coding certifications dominate the field: CPC (AAPC), CCA (AHIMA), CBCS (NHA), CCS (AHIMA), and CPB (AAPC).
  • 2.Exam costs range from ~$117 (CBCS) to $647 (CPC or CPB with required AAPC membership).
  • 3.The CPC is the most requested credential in outpatient settings. The CCS is the gold standard for hospital inpatient coding.
  • 4.Certified professionals average $66,979/year vs. $55,721 for non-certified workers, a 20.7% premium (AAPC 2025 Salary Survey).
  • 5.Holding three or more certifications correlates with an average salary of $81,227 (AAPC 2025 Salary Survey).
  • 6.None of the five certifications require a college degree. CCA and CBCS require only a high school diploma.

CPC (AAPC)

Most Recognized

Outpatient coding standard

~$117

Most Affordable

CBCS exam (NHA)

+20.7%

Certification Premium

$66,979 vs. $55,721 avg.

$81,227

3+ Credentials Avg.

AAPC 2025 Survey

Medical Billing and Coding Certifications at a Glance

FeatureCPC (AAPC)CCA (AHIMA)CBCS (NHA)CCS (AHIMA)CPB (AAPC)
Issuing Body
AAPC
AHIMA
NHA
AHIMA
AAPC
Credential Level
Entry to mid-level
Entry-level
Entry-level
Advanced
Mid-level
Primary Focus
Outpatient physician coding
Inpatient & outpatient coding
Billing and coding
Hospital inpatient coding
Billing & revenue cycle
Exam Questions
100
105 (90 scored)
120 (100 scored)
107 (97 scored)
200
Time Limit
4 hours
2 hours
Not published
4 hours
5 hrs 40 min
Open/Closed Book
Open codebook
Open codebook
Closed book
Open codebook
Open codebook
Passing Score
70% (70/100)
300 (scaled)
390/500 (scaled)
300 (scaled)
70% (140/200)
Exam Cost
$425 (1 attempt)
$199 members / $299 non-members
~$117
$299 members / $399 non-members
$425 (1 attempt)
Membership Required
Yes ($222/yr)
No
No
No
Yes ($222/yr)
Experience Required
No (CPC-A if none)
No (recommended)
Training or 1-2 yrs experience
Yes (1-2 yrs)
Recommended (2 yrs)
CEUs for Renewal
36 per 2 years
20 per 2 years
10 CE credits per 2 years
20 per 2 years
36 per 2 years
Best For
Physician office coders
New coders seeking broad base
Training program graduates
Hospital coders
Billing specialists

Source: AAPC, AHIMA, NHA. Data current as of February 2026.

CPC (Certified Professional Coder)

AAPC's flagship coding credential. It focuses on outpatient physician-office coding using CPT, ICD-10-CM, and HCPCS Level II. The CPC is recognized across virtually all outpatient settings. Candidates who pass without documented experience receive the CPC-A (Apprentice) designation. Median salary: $58,895/year (AAPC 2025).

Key Points

  • CPT code assignment
  • ICD-10-CM diagnosis coding
  • HCPCS Level II
  • E/M level selection
  • Surgical coding

Common Jobs

  • Outpatient medical coder
  • Physician office coder
  • Coding specialist
  • Remote medical coder
CCA (Certified Coding Associate)

AHIMA's entry-level coding credential covering both inpatient and outpatient coding, including ICD-10-PCS for hospital procedures. It's less expensive than the CPC and provides broader foundational knowledge. The CCA serves as a stepping stone to AHIMA's advanced CCS certification.

Key Points

  • ICD-10-CM diagnosis coding
  • ICD-10-PCS procedure coding
  • CPT/HCPCS coding
  • Health record analysis
  • Medical terminology

Common Jobs

  • Entry-level hospital coder
  • HIM department coder
  • Outpatient coder
  • Coding trainee
CBCS (Certified Billing and Coding Specialist)

NHA's combined billing-and-coding credential and the most affordable option at ~$117. It's a closed-book exam (no code books allowed) that tests both billing and coding knowledge. The CBCS is NCCA-accredited and frequently bundled with training programs.

Key Points

  • Claims submission
  • Insurance verification
  • ICD-10 and CPT basics
  • Revenue cycle fundamentals
  • Payment posting

Common Jobs

  • Billing and coding specialist
  • Medical office billing clerk
  • Claims processor
  • Patient account representative
CCS (Certified Coding Specialist)

AHIMA's advanced hospital coding credential. The CCS exam includes medical scenarios (case studies) and requires prior experience or a coding credential. It's the strongest credential for inpatient coding, DRG assignment, and hospital revenue integrity roles.

Key Points

  • Inpatient DRG assignment
  • Complex case coding
  • ICD-10-PCS mastery
  • Clinical documentation analysis
  • Compliance auditing

Common Jobs

  • Hospital inpatient coder
  • Coding auditor
  • CDI specialist
  • Revenue integrity analyst
CPB (Certified Professional Biller)

AAPC's billing-specific credential. The CPB validates expertise in revenue cycle management, claims processing, denial management, and payer reimbursement. It pairs well with the CPC for professionals who handle both coding and billing. Median salary: $56,981/year (AAPC 2025).

Key Points

  • Claims management
  • Denial appeals
  • Payer contract interpretation
  • Revenue cycle management
  • Accounts receivable

Common Jobs

  • Medical billing specialist
  • Revenue cycle analyst
  • Denial management specialist
  • Billing supervisor
20.7%
Salary premium for certified medical billing and coding professionals over non-certified peers
Certified professionals average $66,979/year compared to $55,721 for those without certification. This gap grows wider with each additional credential you earn.

Source: AAPC 2025 Salary Survey

Which Medical Billing and Coding Certification Should You Choose?

The right certification depends on your career goals, budget, and current experience level. Here are the clearest paths:

You're new and want the most affordable option: Start with the CBCS (~$117) or the CCA ($199-$299). Both work as solid entry points. The CBCS is cheaper and covers billing, while the CCA provides broader coding knowledge across inpatient and outpatient settings.

You want to work in a physician office or outpatient clinic: The CPC is the most recognized credential for these settings. It costs more ($425 plus $222/year membership) but carries the most weight with outpatient employers.

You want to work in a hospital: Start with the CCA and advance to the CCS after gaining one year of coding experience. The CCS is the gold standard for hospital coding positions and DRG-based reimbursement work.

You work primarily in billing, not coding: The CPB is designed for billing professionals. It validates revenue cycle management skills that coding certifications don't cover in depth.

You want maximum versatility: Earn the CPC and CPB together for full coding-and-billing coverage in outpatient settings, or the CCA plus CCS for the strongest hospital combination.

You just graduated from a training program: Check whether your program includes a certification exam. Many NHA-approved programs bundle the CBCS exam in tuition. If not, choose based on your target work setting.

Total Cost Breakdown: Exam + First Year

1

CBCS (NHA) - ~$117 total

Exam fee only. No membership required. Often bundled free with NHA-approved training programs. Renewal: 10 CE credits every 2 years.

2

CCA (AHIMA Member) - $199 total

Exam fee with AHIMA membership discount. Non-members pay $299. AHIMA membership is optional but reduces the exam fee by $100. Renewal: 20 CEUs every 2 years.

3

CCS (AHIMA Member) - $299 total

Exam fee with membership discount. Non-members pay $399. Requires at least 1-2 years of coding experience or a prior credential. Renewal: 20 CEUs every 2 years.

4

CPC (AAPC) - $647 first year

$425 exam fee (1 attempt) plus $222/year AAPC membership (required). Two-attempt option: $499 + $222 = $721. Renewal: 36 CEUs every 2 years plus annual membership.

5

CPB (AAPC) - $647 first year

$425 exam fee (1 attempt) plus $222/year AAPC membership. If you already hold the CPC, you won't pay a second membership fee. The same 36 CEUs can cover both credentials.

$81,227
Average annual salary for medical billing and coding professionals holding three or more certifications
Each additional credential adds roughly $4,000 to $10,000 in annual earning potential. The investment in a second or third certification typically pays for itself within the first year.

Source: AAPC 2025 Salary Survey

Salary by Medical Billing and Coding Certification

Your certification directly affects what you'll earn. According to the AAPC 2025 Salary Survey, here's how credentials stack up:

Non-certified medical billing and coding professionals average $55,721/year. Those with one certification jump to an average of $62,689. Two certifications push the average to $71,130, and three or more credentials reach $81,227.

Among specific credentials, the CPC carries a median salary of $58,895, while the CPB comes in at $56,981. The CCS typically commands the highest individual-credential salaries because it qualifies holders for advanced hospital coding, auditing, and CDI positions.

The BLS reports a broader median of $50,250/year for all medical records specialists (SOC 29-2072), which includes both certified and uncertified workers. The gap between BLS and AAPC figures highlights the measurable financial benefit of getting certified.

Stacking Multiple Medical Billing and Coding Certifications

CombinationBest ForWhy It Works
CPC + CPB
Full coding-and-billing coverage in outpatient settings
AAPC offers combined prep courses. The same 36 CEUs cover both credentials, and you only pay one membership fee.
CCA + CCS
The AHIMA progression for hospital coding careers
CCA plus one year of experience meets CCS eligibility. Both require 20 CEUs per cycle from the same organization.
CPC + CCS
Professionals working across outpatient and inpatient settings
Combines AAPC's outpatient strength with AHIMA's hospital coding expertise. Maximizes your employer options.
CBCS + CPC
Budget-conscious career starters building toward top credential
Start affordably with the CBCS (~$117), gain experience, then add the CPC for stronger employer recognition and higher pay.

Source: AAPC and AHIMA certification program details

2.5%
Unemployment rate among CPC-certified coders
That's well below the national average. Certification doesn't just boost your salary, it also provides meaningful job security in a field with strong demand.

Source: AAPC 2025 Salary Survey

What Employers Prefer by Work Setting

Employer preferences vary by setting, and knowing which certification each type of employer values can save you time and money.

Physician offices and outpatient clinics: The CPC is the most frequently requested credential. Some postings accept the CCA or CBCS for entry-level positions.

Hospitals and health systems: The CCS is preferred for inpatient coding. The CCA is accepted for entry-level hospital coding. Some hospitals also accept the CPC for outpatient facility coding.

Billing companies and revenue cycle firms: The CPB or CPC for billing roles, CBCS for entry-level positions. Many billing companies value practical experience alongside any recognized credential.

Remote coding positions: CPC or CCS are most commonly required, depending on outpatient vs. inpatient records. Remote employers typically require at least 2 years of experience plus a recognized credential.

Training programs and schools: The CBCS is common because many programs are NHA-approved and bundle the exam. Graduates often earn the CPC or CCA later for career advancement.

Regardless of which credential you start with, gaining practical experience matters most for career growth. Employers value certified professionals who can demonstrate accurate, efficient work on real medical records. See our how to become a medical coder guide for a complete roadmap.

14,200
Annual job openings for medical records specialists (SOC 29-2072)
The BLS projects 7% employment growth through 2034, faster than the average for all occupations. Strong demand means employers are actively competing for certified talent.

Source: BLS Occupational Outlook Handbook, 2024-2034

Frequently Asked Questions

Explore Individual Certification Guides

Angela R.

Angela R.

Medical Billing & Coding Specialist | Consultant

Angela worked as a medical billing and coding specialist for multiple chiropractors and orthopedic surgeons. After years in the field, she started her own medical billing and coding consulting company, working with numerous clients throughout Southern California. She brings firsthand industry experience to every article on this site.