Certified Outpatient Coder (COC)® certification

Take the COC Exam and become a Certified Outpatient Coder.

With some physicians choosing to join hospital groups over private practices, the need for certified outpatient coders continues to escalate, making COC certification a smart career move. A COC certification demonstrates your mastery of outpatient hospital coding, including working knowledge of ambulatory payment classifications (APCs), payment status indicators, and Medicare severity-diagnosis-related groups (MS-DRGs). Coders who earn their COC credential go on to report outpatient services in a variety of settings, such as:

  • Hospital emergency departments

  • Outpatient hospital clinics

  • Outpatient therapy departments

  • Outpatient cancer centers

  • Dialysis services

  • Outpatient radiology departments

  • Ambulatory surgery centers

Exam format

100 multiple-choice questions

Online or in-person options

AAPC offers online and in-person proctored exams. Choose to take the exam at home in a quiet, private location or through your local chapter or a licensed instructor. Learn more about the online proctored exam and how to prepare for the current exam.

Time allowed

In-person and online exams are administered in one sitting, with four hours to complete the exam.

Equipment required for online exam

A reliable internet connection and an external webcam that can be positioned to show your face, hands, keyboard, and the area around the keyboard (about 10 inches) are required.

Experience requirements

A high-level knowledge of medical terminology, anatomy, and pathophysiology, along with understanding of the proper application of CPT® procedure codes, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes.

Not ready yet? We recommend taking our COC preparation course.

Approved code books

Note: Code sets are updated annually, so it’s essential to use the current calendar year's code books when taking the COC certification exam.

Any officially published updates (errata) for the above code books may also be used.

Maintaining your certification

To maintain your credential, you must maintain your AAPC annual membership, and earn 36 continuing education units (CEUs) every two years.


One attempt for $399 or $499 for two attempts. Of note:

  • 80% of AAPC students pass on the first attempt.

  • Students who train with AAPC are three times more likely to pass the certification exam.

What students are saying

  • Lamontica Alexander


    It hasn't even been a year since I passed my exam and I've had 3 remote job offers, with no experience.

    Lamontica Alexander

  • Joe Delgado testimonial


    It's worth it I swear. Invest into it and it will reward you!

    Joe Delgado

  • Nilayana Sterling testimonial


    As a stay at home mom and homeschooling two kids, it was a challenge; but if I can do, so can you all.

    Nilayana Sterling

  • Danielle Ledford student testimonial


    I took the online AAPC course. It was full of useful information and I passed my test the first time.

    Danielle Ledford

About the COC exam

The COC exam contains 100 multiple-choice questions (proctored). The exam consists of questions regarding the correct application of CPT®, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes used for coding and billing outpatient facility/hospital and freestanding ASC services to insurance companies.

Whether you take the exam online or in-person, you must complete the COC exam within four hours and answer 70% of the questions correctly to pass.

Need help preparing for an exam?