Physician Assistant Salary (2026): PA-C Pay Guide for All 50 States

Certified physician assistants in the United States earn a national median of $140,391 per year — roughly $67.50/hour. PA pay sits in the top tier of U.S. healthcare professions, supported by a tight supply of new graduates from accredited programs, strong demand across primary care and procedural specialties, and the rapid expansion of PA scope in many states.

The national median is only the middle of the distribution. Three numbers describe the real range of physician assistant compensation:

• Entry-level PAs (10th percentile): $102,679/year — typically PA-C-credentialed new graduates in their first 1–2 years, often in primary care, urgent care, or non-metropolitan hospitals.
• Median PA (50th percentile): $140,391/year — the working PA-C with 3–8 years of clinical experience, frequently in family medicine, internal medicine, hospital medicine, or general surgery first-assist roles.
• Top-earning PAs (90th percentile): $196,597/year — senior PAs in high-cost metros, surgical first-assists in orthopedics or cardiothoracic, emergency-medicine PAs at high-volume EDs, and dermatology, plastic-surgery, and pain-management PAs whose roles include procedural revenue capture.

Geographic location explains part of the gap, but specialty mix explains even more. PAs in Sunnyvale, CA earn a median of $236,490, while colleagues in Pelham, AL earn around $99,775. Surgical, dermatology, and emergency PAs frequently out-earn primary-care PAs by $30,000–$60,000 in the same metro. State scope-of-practice rules (collaboration agreements versus optimal team practice), the local mix of hospital-employed versus private-group PAs, and the strength of demand from surgical specialties all push pay in measurable ways beyond cost of living.

Physician Assistant Salary vs PA-C Salary — Are They the Same?

Yes. Physician Assistant Salary and PA-C Salary describe the same paycheck. PA is the occupational title; PA-C (Physician Assistant — Certified) is the credential awarded by the National Commission on Certification of Physician Assistants (NCCPA) after a graduate passes the Physician Assistant National Certifying Exam (PANCE). Every practicing PA in the U.S. holds a master's degree from a program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), holds the PA-C credential, and maintains state licensure. The same job goes by several names in salary surveys and job ads:

• Physician assistant salary / physician assistant pay
• PA salary / PA-C salary / PA pay
• Surgical PA salary / orthopedic PA pay / emergency medicine PA salary
• Dermatology PA salary / plastics PA pay / hospitalist PA salary

All of these phrases reference SOC code 29-1071 in the Bureau of Labor Statistics Occupational Employment and Wage Statistics survey — the data source used throughout this site. Note that PAs and nurse practitioners (NPs, SOC 29-1171) are tracked under separate SOC codes; while pay often runs in the same range, the training pathways and licensure structures are distinct.

Hourly Pay and Specialty Compensation for PAs

Hospital-employed PAs typically receive an annual salary; private-practice PAs in specialties like dermatology and orthopedic surgery often receive base salary plus a productivity-driven bonus tied to wRVU generation or procedure volume. The national median equivalent of $67.50/hour reflects a full-time 40-hour week, but actual paychecks vary widely by specialty:

• Primary care and family medicine PAs: $95,000–$120,000 base in most markets; total compensation including productivity bonuses commonly $105,000–$140,000.
• Emergency medicine PAs: $130,000–$175,000+ at busy EDs with night, weekend, and high-acuity differentials; some hospital systems compensate hourly at $90–135/hour.
• Surgical first-assist PAs (orthopedic, cardiothoracic, neurosurgery): $115,000–$170,000+ base plus call pay; experienced ortho PAs in busy markets routinely clear $180,000 in total compensation.
• Dermatology, plastic surgery, and pain management: often the highest-paying outpatient PA roles; productivity bonuses on procedures (Mohs surgery support, aesthetic injections, interventional pain procedures) can push total compensation past $200,000.
• Hospitalist and inpatient internal medicine: $120,000–$155,000 base; 7-on/7-off shift schedules common.

Total compensation routinely includes CME stipends ($2,500–$5,000/year), license and DEA fee reimbursement, NCCPA recertification cost, malpractice tail coverage, and 401(k) match on top of base pay.

2026 Physician Assistant Salary Projection

Physician assistant pay has grown at a compound annual rate of 3.32% over the past five years, driven by sustained outpatient and procedural-specialty demand, the rapid expansion of PA-staffed urgent care and surgical first-assist roles, and a structurally constrained supply pipeline. The Bureau of Labor Statistics projects employment for Physician Assistants to grow 27% through 2033 — among the fastest of any U.S. occupation — keeping strong upward pressure on wages, especially in surgical specialties, emergency medicine, and rural primary care.

A surgical PA-C at a busy orthopedic group in San Francisco can earn nearly double what an equally experienced primary-care colleague in a rural Mississippi clinic takes home. Four factors explain almost all of that gap: specialty, location and scope, experience and Certificate of Added Qualifications (CAQ), and employment model.

1. Specialty: The Single Largest Pay Driver for PAs

Unlike most healthcare professions where location dominates the pay gap, specialty is the single biggest pay lever for PA-Cs. Procedural and high-acuity specialties consistently pay 25–60% above primary care for PAs with equivalent years of experience:

• Dermatology, plastic surgery, Mohs surgery, pain management: highest-paying outpatient specialties for PAs — procedure-heavy practices reward speed and clinical autonomy with productivity bonuses on top of competitive base salary.
• Surgical first-assist (orthopedic, cardiothoracic, neurosurgery, vascular): high base + call pay + procedural bonus structures; orthopedic-PA roles at total-joint and spine practices are particularly well-compensated.
• Emergency medicine: shift premium for nights, weekends, and holidays plus high RVU productivity at high-volume EDs.
• Hospital medicine, critical care, hematology-oncology: consistently above the PA median with 7-on/7-off scheduling common.
• Primary care (family, internal, pediatric, women's health): baseline of the PA pay scale but very stable demand and broad geographic distribution.

2. Location and Scope of Practice

Metropolitan areas with high costs of living offer the highest nominal PA salaries; after BEA-adjusted purchasing-power comparison, the gap narrows but doesn't close. California, Connecticut, Alaska, Nevada, and Washington consistently lead. State scope-of-practice rules also matter:

• Optimal Team Practice (OTP) states — states that have moved away from rigid supervisory agreements toward team-based practice (recognized in some form in many states) typically attract more PA hiring and higher pay.
• Prescriptive authority and controlled-substance scope — every state grants PAs prescriptive authority but the breadth and required physician collaboration differs; broader scope correlates with higher PA market rates.
• HPSA sign-on bonuses — rural and underserved markets frequently offer $15,000–$50,000 sign-on bonuses plus federal student-loan repayment through the NHSC Loan Repayment Program for primary-care PAs.

3. Experience and CAQ Specialty Certification

Entry-level PA-Cs start at the 10th percentile — around $102,679 — and typically see meaningful step-raises within the first 3–5 years as they build clinical autonomy and procedural skill. Senior PAs with 10+ years of experience, particularly those holding a NCCPA Certificate of Added Qualifications (CAQ) in Cardiovascular and Thoracic Surgery, Emergency Medicine, Hospital Medicine, Nephrology, Orthopaedic Surgery, Pediatrics, or Psychiatry frequently reach the 90th percentile at $196,597. CAQ-holders typically earn a $5,000–$15,000 differential above non-CAQ peers in the same specialty.

4. Employment Model: Hospital vs Private Group vs Locum vs Practice Ownership

Hospital-employed PAs receive base salary plus benefits, retirement contributions, CME stipends, and malpractice coverage. Private-practice PAs — particularly in dermatology, orthopedics, and pain management — often receive base salary plus productivity bonus tied to wRVUs or procedure volume, with strong upside in busy practices. Locum tenens PAs sign short-term contracts at premium rates ($90–160/hour all-in including housing/travel stipends) for facility coverage gaps. A growing number of experienced PAs structure independent contractor relationships under state-permitted arrangements, but the majority of PAs remain W2 employees of hospitals or physician groups.

For a complete city-by-city breakdown of physician assistant salaries — including BLS percentile data (10th, 25th, 50th/median, 75th, 90th), local cost-of-living adjustments, and 2026 salary projections — browse the 1,681+ metro areas tracked in our dataset below.