Physician assistants are one of the fastest-growing and highest-paid professions in healthcare. Here’s what PAs actually earn across specialties, settings, and states.
PA Salary by Specialty
| Specialty | Median Salary | Salary Range |
|---|---|---|
| Cardiovascular/Cardiothoracic Surgery | $170,000 | $145,000-$185,000+ |
| Neurosurgery | $165,000 | $140,000-$180,000 |
| Orthopedic Surgery | $155,000 | $135,000-$175,000 |
| General Surgery | $148,000 | $128,000-$170,000 |
| Dermatology | $148,000 | $130,000-$165,000 |
| Emergency Medicine | $142,000 | $125,000-$160,000 |
| Gastroenterology | $140,000 | $120,000-$160,000 |
| Urology | $138,000 | $118,000-$155,000 |
| Cardiology (Non-Surgical) | $136,000 | $118,000-$155,000 |
| Oncology | $135,000 | $115,000-$155,000 |
| Hospitalist | $132,000 | $115,000-$150,000 |
| Urgent Care | $125,000 | $110,000-$145,000 |
| Internal Medicine | $122,000 | $105,000-$140,000 |
| Family Medicine | $118,000 | $100,000-$138,000 |
| Pediatrics | $115,000 | $98,000-$135,000 |
| Psychiatry | $128,000 | $110,000-$150,000 |
PA Salary by Setting
| Setting | Median Salary | Notes |
|---|---|---|
| Hospital (Surgical) | $145,000 | Includes call, weekend shifts |
| Hospital (Medical) | $132,000 | Hospitalist, specialty floors |
| Emergency Department | $140,000 | Shift work, nights, holidays |
| Physician Private Practice | $125,000 | Varies widely by specialty |
| Outpatient Clinic | $120,000 | M-F schedule common |
| Urgent Care | $125,000 | Extended hours, some weekends |
| Dermatology Office | $148,000 | Excellent hours, high demand |
| Government (VA, Military) | $120,000 | Strong benefits, loan repayment |
| FQHC/Community Health | $115,000 | Loan repayment programs |
| Locum Tenens (Travel) | $150,000-$200,000+ | Premium pay, temporary assignments |
PA Salary by State
| Rank | State | Mean Salary | Entry-Level | CoL-Adjusted |
|---|---|---|---|---|
| 1 | Connecticut | $148,000 | $118,000 | $128,200 |
| 2 | Washington | $146,000 | $116,000 | $132,700 |
| 3 | New Jersey | $145,000 | $115,000 | $129,500 |
| 4 | California | $143,000 | $115,000 | $102,900 |
| 5 | Alaska | $142,000 | $112,000 | $126,100 |
| 6 | New York | $140,000 | $112,000 | $113,800 |
| 7 | Massachusetts | $139,000 | $112,000 | $116,800 |
| 8 | Nevada | $138,000 | $110,000 | $140,800 |
| 9 | Hawaii | $137,000 | $108,000 | $100,700 |
| 10 | Oregon | $136,000 | $108,000 | $120,400 |
| — | National | $130,000 | $105,000 | — |
| 46 | Mississippi | $110,000 | $90,000 | $124,300 |
| 47 | West Virginia | $108,000 | $88,000 | $127,100 |
| 48 | Alabama | $107,000 | $87,000 | $116,300 |
| 49 | Arkansas | $105,000 | $86,000 | $118,600 |
| 50 | Kentucky | $104,000 | $85,000 | $113,000 |
PA Career Path & Salary Progression
| Career Stage | Salary Range | Timeline |
|---|---|---|
| PA Student | -$40,000-$60,000/year (tuition) | 2-3 years |
| New Graduate PA | $105,000-$120,000 | Year 1 |
| Experienced PA (3-5 years) | $125,000-$145,000 | Years 3-5 |
| Senior PA (7-10 years) | $135,000-$160,000 | Years 7-10 |
| Lead PA/Supervising PA | $145,000-$175,000 | Years 10+ |
| PA Administrator/Director | $150,000-$190,000 | Years 12+ |
PA vs. Nurse Practitioner
| Factor | PA | NP |
|---|---|---|
| Median salary | $130,000 | $126,000 |
| Education | Master’s (2-3 years) | Master’s (2-3 years) |
| Prior clinical experience required | Not required (recommended) | RN experience preferred |
| Education model | Medical (generalist) | Nursing (specialty-focused) |
| Specialty switching | Easier (generalist training) | Harder (specialty-specific) |
| Independent practice | Varies by state (growing) | 27 states + DC (full practice) |
| Prescribing authority | All 50 states (some need MD oversight) | All 50 states (some need oversight) |
| Job growth (2024-2034) | +28% | +40% |
PA Income vs. Education Cost
| Metric | Value |
|---|---|
| Average PA program cost | $90,000-$120,000 |
| Average student debt at graduation | $100,000-$115,000 |
| Starting salary | $105,000-$120,000 |
| Debt-to-income ratio | 0.8-1.1x |
| Typical payoff timeline | 5-7 years |
| NHSC loan repayment (if FQHC) | Up to $50,000 (2 years) |
| Military loan repayment | Up to $75,000+ |
Favorable debt-to-income ratio compared to medical school ($200,000-$300,000 debt, but higher eventual pay).
How to Maximize PA Salary
| Strategy | Potential Increase |
|---|---|
| Choose a surgical specialty | +$15,000-$40,000 |
| Work in a high-paying state | +$10,000-$20,000 |
| Take locum tenens assignments | +$20,000-$70,000 |
| Work nights/weekends (shift differentials) | +$5,000-$15,000 |
| Get specialty certification (CAQ) | +$3,000-$10,000 |
| Negotiate sign-on bonus | $5,000-$25,000 one-time |
| Move to urgent care or EM | +$5,000-$20,000 |
| Take on administrative/leadership role | +$10,000-$30,000 |
| Rural/underserved areas | +$5,000-$15,000 + loan repayment |
PA Job Market
| Factor | Status |
|---|---|
| Job growth (2024-2034) | +28% (much faster than average) |
| Positions added annually | ~40,000 |
| Unemployment rate | <1% |
| Demand by specialty | High across nearly all specialties |
| Rural demand | Very high — projected shortages |
| Telehealth roles | Growing, especially primary care |
| Team-based care trend | Increasing PA utilization |
The PA profession is one of the most in-demand in healthcare. Physician shortages are driving expanded roles for PAs across all settings.
PA Work-Life Balance
| Setting | Typical Schedule | Work-Life Rating |
|---|---|---|
| Outpatient/Primary Care | M-F, 40 hours | Excellent |
| Dermatology | M-F, 36-40 hours | Excellent |
| Urgent Care | 3x 12-hour shifts or rotating | Good |
| Emergency Medicine | 3x 12-hour shifts | Good (but nights) |
| Hospital Medicine | 7 on/7 off | Good (intense blocks) |
| Surgery | 50-60+ hours, call | Challenging |
| Locum Tenens | You choose | Excellent (but travel) |
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