Healthcare Recruiting
Physician Assistant Salary by State 2026: Where PAs Earn the Most
Physician Assistant is one of the fastest-growing professions in healthcare. The BLS projects 28% growth in PA employment through 2033, faster than almost any other clinical role. In 2026, the national median PA salary reached approximately $130,000, with surgical specialty PAs commonly exceeding $150,000.
National PA Salary Benchmarks (2026)
| Specialty | Median Base | Top 10% | Typical Sign-On |
|---|---|---|---|
| Primary Care PA (FM / IM) | $118,000 | $148,000 | $8,000–$18,000 |
| Emergency Medicine PA | $135,000 | $172,000 | $15,000–$25,000 |
| Surgical PA (General) | $142,000 | $175,000 | $15,000–$30,000 |
| Orthopedic Surgery PA | $155,000 | $190,000 | $20,000–$35,000 |
| Cardiothoracic Surgery PA | $162,000 | $200,000 | $20,000–$35,000 |
| Dermatology PA | $135,000 | $175,000 | $10,000–$25,000 |
| Cardiology PA | $138,000 | $175,000 | $15,000–$25,000 |
| Hospitalist PA | $132,000 | $165,000 | $15,000–$25,000 |
| Oncology PA | $140,000 | $178,000 | $15,000–$25,000 |
| Critical Care PA | $148,000 | $185,000 | $18,000–$30,000 |
Top 15 Highest-Paying States for PAs (2026)
| Rank | State | Median PA Salary |
|---|---|---|
| 1 | California | $148,000+ |
| 2 | Alaska | $145,000+ |
| 3 | Washington | $140,000+ |
| 4 | Nevada | $138,000+ |
| 5 | Oregon | $136,000+ |
| 6 | Connecticut | $135,000+ |
| 7 | Rhode Island | $134,000+ |
| 8 | New Jersey | $133,000+ |
| 9 | New York | $132,000+ |
| 10 | Massachusetts | $130,000+ |
| 11 | Minnesota | $128,000+ |
| 12 | Hawaii | $127,000+ |
| 13 | New Hampshire | $125,000+ |
| 14 | Maryland | $125,000+ |
| 15 | Colorado | $123,000+ |
Surgical PA Deep Dive
Surgical PAs are the highest-paying PA subspecialty. First-assist PAs in cardiothoracic, neurosurgery, and orthopedic surgery routinely earn $160,000-$200,000. Reasons:
- Significant call coverage (in-house call pay or differential)
- Hands-on OR responsibilities reduce surgeon workload substantially
- High hospital/clinic RVU contribution from assisted procedures
- Specialty credentialing (RNFA, CSA, etc.) commands premium
Sign-On Bonuses and Retention
- Primary care PA: $8K-$18K
- Emergency medicine PA: $15K-$25K
- Surgical PA: $20K-$35K with 2-3 year commitment
- Cardiothoracic/neurosurgery PA: $30K-$50K with 3-year commitment
- Rural / HRSA designated: + loan repayment up to $100K
What PAs Negotiate in 2026
- CME stipend ($2K-$5K)
- PANCE renewal + state license reimbursement
- Malpractice with tail coverage
- Paid procedural certifications (ATLS, ACLS, PALS, NRP)
- Protected CME days (separate from PTO)
- Clear clinical-vs-admin hour breakdown (surgical PAs in particular)
- Call compensation structure (per-call vs. added base)
- Panel size / patient caps (primary care)
Bottom Line
PA compensation is strong across specialties in 2026. Surgical PAs, EM PAs, and Critical Care PAs command the highest premiums. States with larger healthcare systems and full PA practice laws pay best.
Ava Health places PAs across all specialties nationwide. Contact us for current PA openings.
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