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Best States to Be a Medical Records Specialists

After 2025 state income tax and 2024 cost of living, a medical records specialists salary goes furthest in District of Columbia — a $72,040 BLS median worth $62,540 in real terms (Gera US Real Pay Index 117.7).

Which US states are best for a medical records specialists after cost of living and tax?

For a medical records specialists, the Gera US Real Pay Index ranks District of Columbia #1: a $72,040 BLS median becomes $62,540 in cost-of-living-and-tax-adjusted terms (index 117.7). Florida ranks last ($44,249, index 83.3). Real BLS OEWS May 2025 across 51 states; re-dated annually.

Source:U.S. Bureau of Labor Statistics — Occupational Employment and Wage Statistics (OEWS)·As of May 2025 state estimates · updated annually · last refreshed

Gera US Real Pay Index

District of Columbia ranks #1 of 51 states for a medical records specialists. Index 100 = the average state; 117.7 means pay goes 17.7% further after tax and cost of living.

How this is calculated
117.7

Medical Records Specialists — real pay by state (best first)

#StateBLS medianState taxCost (RPP)Real payIndex
1District of Columbia$72,040$3,308109.9$62,540117.7
2Wisconsin$60,280$2,04394.1$61,892116.5
3Rhode Island$63,960$1,799102.3$60,776114.4
4New Mexico$57,470$1,58792.2$60,603114.1
5Alaska$61,090102.4$59,682112.3
6Minnesota$61,530$2,69598.6$59,658112.3
7Oklahoma$53,460$2,00287.8$58,580110.3
8Wyoming$54,21092.7$58,485110.1
9South Dakota$51,61088.6$58,260109.7
10Washington$62,270107.0$58,189109.5
11Vermont$57,560$1,51098.0$57,219107.7
12Connecticut$60,940$1,817103.6$57,063107.4
13South Carolina$54,280$1,75893.7$56,024105.5
14Nebraska$51,670$1,59190.1$55,580104.6
15Iowa$50,640$1,88487.8$55,554104.6
16Colorado$59,020$1,937103.1$55,393104.3
17New York$61,720$2,790107.9$54,605102.8
18Hawaii$63,180$3,272110.0$54,487102.6
19Massachusetts$60,350$2,798105.8$54,420102.4
20Ohio$50,990$62092.8$54,293102.2
21Missouri$50,750$1,50490.8$54,225102.1
22California$61,810$1,813110.7$54,188102.0
23Idaho$53,460$1,92495.5$53,968101.6
24Illinois$56,440$2,653100.0$53,810101.3
25Delaware$56,060$2,43499.8$53,729101.1
26Tennessee$48,78091.9$53,09799.9
27Oregon$59,000$4,359103.4$52,86599.5
28North Dakota$46,28089.0$52,02497.9
29Maine$52,090$1,90197.0$51,71497.3
30Kentucky$48,410$1,80690.2$51,69197.3
31Kansas$48,160$1,88890.1$51,37596.7
32West Virginia$47,360$1,40389.5$51,35096.7
33Georgia$51,550$2,13296.3$51,32196.6
34Montana$50,190$1,82394.6$51,10496.2
35Utah$52,870$2,40698.9$51,04496.1
36North Carolina$49,620$1,56794.3$50,94495.9
37Virginia$53,290$2,264101.1$50,46895.0
38Texas$48,86097.1$50,34294.8
39Nevada$50,300100.0$50,31194.7
40Indiana$47,670$1,40093.3$49,57793.3
41Maryland$54,220$2,243105.0$49,52293.2
42Louisiana$44,610$96388.2$49,48293.1
43Michigan$48,120$1,79996.2$48,14390.6
44New Hampshire$49,210104.2$47,24288.9
45Alabama$43,810$1,92688.8$47,15588.8
46Arizona$47,630$716100.7$46,59987.7
47Mississippi$41,500$1,02187.0$46,55387.6
48Pennsylvania$46,840$1,43897.6$46,53287.6
49Arkansas$41,740$1,41986.9$46,37987.3
50New Jersey$50,240$1,228108.8$45,04684.8
51Florida$45,760103.4$44,24983.3

"Real pay" = BLS median − 2025 state income tax, divided by the state's 2024 BEA cost of living (US = 100). Only the 51 states for which BLS publishes a median for this occupation are ranked; suppressed cells are excluded, never set to zero.

Where does your salary go furthest?

Enter a salary and a state. We adjust for 2025 state income tax and the 2024 BEA cost of living to show your real, purchasing-power-equivalent pay — then rank every state.

In District of Columbia, a $72,040 salary is worth about $58,503 in cost-of-living-and-tax-adjusted terms.

State income tax $7,744 (≈ top marginal 10.75% (upper bound)) · take-home $64,296 · BEA cost of living 109.9 (US = 100).

The same salary goes furthest in South Dakota — worth $81,322, a $22,819 gain over District of Columbia.

#StateReal valueCost (RPP)
1South Dakota$81,32288.6
2Arkansas$79,63386.9
3Louisiana$79,22188.2
4Mississippi$79,20487.0
5Iowa$78,96687.8
6North Dakota$78,95789.0
7Tennessee$78,41591.9
8Oklahoma$78,11487.8
9Wyoming$77,72192.7
10Alabama$77,05088.8
11Kentucky$76,70790.2
12West Virginia$76,61489.5

Estimate only. State income tax is approximated from each state's 2025 flat rate (or top marginal rate as an upper bound for graduated states) and ignores federal tax, deductions and credits. The pre-published occupation and state pages use exact 2025 bracket math. Cost of living is the 2024 BEA Regional Price Parity (All Items).

Medical Records Specialists — real pay FAQ

What is the best state to be a medical records specialists?
By the Gera US Real Pay Index, District of Columbia is the best state for a medical records specialists: a BLS median of $72,040 is worth $62,540 after the 2025 state income tax ($3,308) and the 2024 BEA cost-of-living adjustment (RPP 109.9), an index of 117.7 where the average state is 100.
Does the highest-paying state also leave you best off?
Not necessarily. District of Columbia has the highest headline BLS median for a medical records specialists at $72,040, but after state tax and cost of living it ranks #1 of 51 on real pay (index 117.7). That gap is exactly what the Gera US Real Pay Index reveals.
Where does a medical records specialists salary go least far?
Florida ranks last of 51 states for a medical records specialists: a $45,760 BLS median is worth only $44,249 after tax and cost of living (index 83.3). Higher local prices and/or income tax less far than the national average erode the headline pay.

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Related on GeraJobs

Sources: U.S. Bureau of Labor Statistics — Occupational Employment and Wage Statistics (OEWS) (May 2025 state estimates, US federal public domain); U.S. Bureau of Economic Analysis — Regional Price Parities (All Items), by state (2024 (US = 100)); Tax Foundation — 2025 State Individual Income Tax Rates and Brackets. The Gera US Real Pay Index for a medical records specialists is computed by GeraJobs from these figures; no figure is modelled or interpolated.

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