When instituted in 1954, the Padma Bhushan was classified as "Dusra Warg", a class II award under the three-tier Padma Vibhushan awards, which were preceded by the Bharat Ratna in hierarchy. On 15 January 1955, the Padma Vibhushan was reclassified into three different awards as the Padma Vibhushan, the Padma Bhushan and the Padma Shri. The criteria included "distinguished service of a high order in any field including service rendered by Government servants", but excluded those working with the public sector undertakings with the exception of doctors and scientists. The 1954 statutes did not allow posthumous awards; this was subsequently modified in the January 1955 statute. The design was also changed to the form that is currently in use; it portrays a circular-shaped toned bronze medallion 1 3⁄4 inches (44 mm) in diameter and 1⁄8 inch (3.2 mm) thick. The centrally placed pattern made of outer lines of a square of 1 3⁄16 inches (30 mm) side is embossed with a knob carved within each of the outer angles of the pattern. A raised circular space of diameter 1 1⁄16 inches (27 mm) is placed at the centre of the decoration. A centrally located lotus flower is embossed on the obverse side of the medal and the text "Padma" is placed above and the text "Bhushan" is placed below the lotus written in Devanagari script. The State Emblem of India is displayed in the centre of the reverse side, together with the national motto of India, "Satyameva Jayate" (Truth alone triumphs) in Devanagari script, which is inscribed on the lower edge. The rim, the edges and all embossing on either side is of standard gold with the text "Padma Bhushan" of gold gilt. The medal is suspended by a pink riband 1 1⁄4 inches (32 mm) in width with a broad white stripe in the middle. It is ranked fifth in the order of precedence of wearing of medals and decorations of the Indian civilian and military awards.
20 awards were presented in 2000, followed by 32 in 2001, 25 in 2002, 32 in 2003, 19 in 2004, 30 in 2005, 37 in 2006, 32 in 2007, 35 in 2008 and 31 in 2009. These included 37 foreign recipients; one each from China, the Czech Republic, Germany, and South Africa, two from France, three from Japan, five each from Russia and the United Kingdom and 18 from the United States. Individuals from 10 different fields were awarded, which includes 69 from art, 12 from civil services, 60 from literature and education, 26 from medicine, 22 from public affairs, 43 from science and engineering, 18 from social work, 4 sports person, 27 from trade and industry and 10 from other fields.
In 2003, Rashtriya Swayamsevak Sangh's (RSS) volunteer Dattopant Thengadi refused to accept the award "until revered K. B. Hedgewar (RSS founder) and Shri Guruji (RSS ideologue M. S. Golwalkar) are not offered the Bharat Ratna". Historian Romila Thapar, who had earlier refused the award in 1992, did so again in 2005. In a letter she wrote to the then President A. P. J. Abdul Kalam, she mentioned that she had refused the award when the Ministry of Human Resource Development contacted her. However, she was surprised to see her name in the list of awardees. Civil servant S. R. Sankaran also refused to accept the award in 2005 without citing any reason.