Medical Billing Cost Calculator
Compare in-house and outsourced billing on cost, using inputs sourced from BLS, SHRM and published vendor pricing rather than round numbers. Every default below links to where it came from.
This tool compares cost, not performance. No credible study establishes a collection-rate difference between in-house and outsourced billing, so we do not model one. If a calculator shows you a “5–15% revenue improvement”, it is asserting something nobody has demonstrated.
Your practice
In-house billing
= 43.1% on top of salary
9.9% of collections
Outsourced billing
Within the most common band (5–5.99% and 6–6.99% together: 35% of companies)
Tebra reports 28% of billing companies have moved entirely to a non-percentage model, up from 17% in 2023.
6.2% of collections
Break-even
Outsourcing costs less below 9.7% of collections
Your in-house function costs $177,336 a year. A billing company charging less than that as a percentage of your collections is cheaper on cost alone.
At 6.00%, outsourcing costs $65,736 less per year.
Where a quote sits in the market
Share of companies by pricing tier, reported by 190 respondents from US medical billing companies, fielded December 2025.
Source: Tebra 2026 Medical Billing Benchmark Report (n=190, fielded 1–17 December 2025). See our own published pricing, or read what medical billing costs a practice under each pricing model, setup fees included.
Where every default comes from
Verified July 28, 2026. Figures we could not source are not in this model.
| Input | Value | Source |
|---|---|---|
| Medical Records Specialist (SOC 29-2072) — median annual wage | $51,140 | U.S. Bureau of Labor Statistics |
| Medical Records Specialist — annual wage percentiles | 10th $37,000; 25th $43,490; 50th $51,140; 75th $64,820; 90th $81,150 | U.S. Bureau of Labor Statistics |
| Medical records specialist average income by employer size | Solo or small group (2–10 physicians) $53,246; medium group (11–49) $59,088; large group (50+) $65,224; individual hospitals $65,396; health systems $67,657 | AAPC |
| Employer benefit costs as a share of total compensation | Benefits $14.01/hour = 30.1% of total compensation; wages $32.60/hour = 69.9%; total $46.60/hour | U.S. Bureau of Labor Statistics |
| Cost per hire, nonexecutive | $1,200 (2025 median); $1,244 (2022); $1,633 (2017) | SHRM |
| Percentage-of-collections rates charged by billing companies | 4.99% or less: 12%; 5–5.99%: 19%; 6–6.99%: 16%; 7–7.99%: 16%; 8–8.99%: 5%; 10%+: 4%; non-percentage model: 28% | Tebra |
| Prevalence of setup / implementation fees | 39% always or often charge setup fees; the share that never charges fell from 36% (2023) to 19% (2025) | Tebra |
Not modelled: management and physician time, office space, the cost of a vacancy, and any difference in collection performance. The turnover figure is recruiting cost only — a floor, not a full replacement cost. Every omission pushes the true in-house number upward, so the in-house total here is conservative.
Cite this data
Free to reuse with attribution — including the charts and the underlying dataset. Figures were verified against their primary sources on .
Citation line
Source: MedPrecision Medical Billing Cost Model 2026, MedPrecision Billing. https://www.medprecisionbilling.com/tools/billing-cost-calculator/ Download the dataset
CSV — every row with its own source URLCommon Questions
Common questions about in-house versus outsourced billing cost.
Get a real number
We quote against your actual claim volume and payer mix — no setup or per-claim fees.
Get a Free Billing AuditHow much does an in-house medical biller cost?
The US median annual wage for Medical Records Specialists (SOC 29-2072) is $51,140, with the 10th percentile at $37,000 and the 90th at $81,150 (BLS OEWS, May 2025). Practice size matters: AAPC’s 2026 Medical Coding and Billing Salary Report puts average income for medical records specialists at $53,246 in solo or small physician group practices (2-10 physicians), rising to $65,224 in large physician group practices (50 or more physicians). On top of wages, employer benefit costs average 30.1% of total compensation (BLS ECEC, March 2026) — which is roughly 43% on top of salary, not 30%.
Why does this calculator treat benefits differently from others?
Because most calculators use the wrong denominator. BLS reports employer benefit costs as a share of total compensation — 30.1%, against wages at 69.9%. Applying 30% to salary instead of to total compensation understates the true employer cost by about a third. On a $51,140 salary the correct benefit load is roughly $22,000, not $15,300. This calculator converts properly, which is why its in-house totals run higher than most.
What do medical billing companies actually charge?
63% of billing companies charge 7.99% or less on percentage-based pricing, per Tebra’s 2026 Medical Billing Benchmark Report (190 respondents from US medical billing companies, fielded 1–17 December 2025): 12% charge 4.99% or less, 19% charge 5–5.99%, 16% charge 6–6.99% and 16% charge 7–7.99%. Only 4% charge 10% or more. Another 28% use a different, non-percentage payment model. Separately, 39% of billing companies always or often charge setup fees.
Does outsourcing increase collections?
We cannot tell you that it does, because no credible study establishes it. A dedicated research pass found no methodologically-stated evidence for a collection-rate or denial-rate difference between in-house and outsourced billing — every claim of that kind we examined was vendor marketing without a stated method. This calculator therefore compares cost only. Any tool showing you a "5–15% revenue improvement" is asserting something nobody has demonstrated.
What is the break-even rate?
The percentage of collections at which outsourcing costs exactly what your in-house function costs. Below it, outsourcing is cheaper on cost alone; above it, in-house is. It is the single most useful number here, because it converts an abstract comparison into a threshold you can hold a quote against.
What does this calculator not include?
Management time spent supervising billing staff, physician time spent on billing problems, office space and equipment, the cost of a vacancy while a role is unfilled, and any difference in collection performance between the two models. The turnover figure uses SHRM’s median cost-per-hire, which covers recruiting only and excludes lost productivity and ramp time — so it is a floor, not a full replacement cost. All of these push the true in-house cost upward, so treat the in-house figure as conservative.
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Benchmarks Report 2026
Sourced denial, A/R and collection benchmarks, with the population named on every figure.
Free Billing Audit · No obligation
Comparing this against a quote?
The calculator estimates what in-house billing costs you. If you are weighing that against an outsourced quote, send us both and your monthly collections, and we will show you what the effective rate works out to once every fee is counted - including ours, at our published rate. Written findings in 3-5 business days.
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