Physician Assistant Salary: National Pay, by State, City & Real Value (2026)

A physician assistant in the United States earns a median of $135,880 a year, about $65.33 an hour, according to the U.S. Bureau of Labor Statistics (2025). Pay runs from roughly $99,380 at the 10th percentile to $190,280 at the 90th, and where you work changes the number sharply. About 162,150 physician assistants work nationwide. This page breaks pay down by state, city, and experience, and shows what it is worth after cost of living and tax.

National pay overview

The national median for physician assistants is $135,880. The full national wage curve, from entry to senior:

Percentile	Annual	Hourly
10th (entry)	$99,380	$47.78
25th	$120,670	$58.01
50th (median)	$135,880	$65.33
75th	$163,980	$78.84
90th (senior)	$190,280	$91.48

The spread from the 10th to 90th percentile is about $90,900, driven mainly by state, metro, setting, specialty, and experience. That range is what makes a single national average misleading: the same role pays very differently depending on where and how you work. The sections below break each driver down with real BLS figures, then translate the headline number into real, cost-adjusted, after-tax terms.

Physician Assistant salary by experience

BLS does not publish pay by years worked, but the percentiles track a career arc. A rough national timeline:

Stage	Typical percentile	Annual
Entry / new to the role	10th to 25th	$99,380 to $120,670
Established (mid-career)	~50th	around $135,880
Experienced	~75th	around $163,980
Senior / specialized	90th	$190,280+

The climb from new to senior is about $90,900. Experience matters, but so do specialty, setting, and the state and metro you work in, which is why two physician assistants with the same tenure can earn very differently.

Physician Assistant salary by state

State pay varies widely. Nationally the highest-paying states are New Jersey ($165,690), California ($165,650), and Washington ($164,360); the lowest sit near $104,960. The table below ranks the states we cover in depth by real value, the median adjusted for each state’s cost of living (BEA, 2024). Tap any state for the full local breakdown.

State	Median (nominal)	Cost level (US=100)	Real value	Employed
California	$165,650	110.7	$149,612	13,600
New York	$160,880	107.9	$149,072	19,140
Ohio	$132,090	92.8	$142,378	4,900
Texas	$134,550	97.1	$138,630	10,110
North Carolina	$129,360	94.3	$137,141	7,490
Arizona	$134,650	100.7	$133,745	3,750
Illinois	$131,950	100.0	$132,005	3,790
Pennsylvania	$127,070	97.6	$130,232	9,020
Florida	$129,620	103.4	$125,341	9,310
Georgia	$115,390	96.3	$119,832	5,610

Adjusted for cost of living, California delivers the most real buying power of the states we track, at $149,612. A higher-sticker state often ranks lower once its prices are counted, the recurring lesson on every state page.

Across all 51 states with data, the highest and lowest payers:

Highest-paying states	Median
1. New Jersey	$165,690
2. California	$165,650
3. Washington	$164,360
4. Hawaii	$164,050
5. New York	$160,880
6. Oregon	$155,780
7. New Hampshire	$150,960
8. Alaska	$150,700
9. Vermont	$150,490
10. Massachusetts	$142,410

Lowest-paying states	Median
Arkansas	$118,430
Tennessee	$118,240
Georgia	$115,390
Mississippi	$105,920
Alabama	$104,960

The spread between the top and bottom states is more than $60,730, one of the widest of any healthcare role. The high payers cluster on the West Coast, in the Northeast, and in a few mountain and Pacific states, while the lowest sit across the South. But high-paying states are also high-cost, so a top sticker rarely means the top standard of living. The cost-adjusted real-value column in the table above, and the full breakdown on each state page, is the number that actually reflects how far the pay goes.

Highest-paying metros

Pay concentrates in large metros. The biggest PA job markets by employment, with median pay:

Metro	Median	Employed
New York-Newark-Jersey City, NY	$167,650	16,800
Atlanta-Sandy Springs-Roswell, GA	$111,810	3,970
Los Angeles-Long Beach-Anaheim, CA	$161,890	3,890
Boston-Cambridge-Newton, MA	$142,410	3,550
Philadelphia-Camden-Wilmington, PA	$135,640	3,390
Dallas-Fort Worth-Arlington, TX	$134,900	3,230
Phoenix-Mesa-Chandler, AZ	$134,650	3,050
Chicago-Naperville-Elgin, IL	$127,940	3,050

Within a single state the metro can swing pay by thousands, and the cost-of-living adjustment often reorders which is genuinely best, a higher-paying big city frequently loses to a cheaper mid-size one once housing is counted. The largest metros also hold the deepest job markets, so they pair the most pay with the most openings. Each state page works the metro and cost-of-living math out city by city.

Salary by work setting

Where physician assistants work shifts pay too. National medians by employer type:

Setting	Employed (U.S.)	Median
Offices of Physicians	86,830	$132,000
General Medical and Surgical Hospitals	40,850	$141,090
Outpatient Care Centers	14,980	$153,500
Colleges, Universities, and Professional Schools	3,660	$134,770
Federal Executive Branch (OEWS Designation)	3,560	$164,760
Offices of Other Health Practitioners	2,870	$132,140

Outpatient and hospital settings tend to pay more than physician offices, while the specialty and acuity of the work matter as much as the employer category. State pages break the same split down locally where the data supports it.

The nursing and clinical pay ladder

The biggest pay differences in clinical care come from the license. The national ladder around this role:

Role	National median	vs this role
Registered Nurse	$97,550	-$38,330
Nurse Practitioner	$132,300	-$3,580
Physician Assistant (this role)	$135,880	—
Nurse Anesthetist	$236,590	+$100,710

Each rung is a different license, not a promotion. The numbers above show exactly what the move up or down is worth, and most of the state pages put the same comparison in local dollars.

Scope of practice and what it means for pay

PAs practice in a collaborative or supervisory relationship with a physician, but the terms have loosened in most states toward Optimal Team Practice, giving experienced PAs more autonomy. Scope, prescriptive authority, and how closely a physician must be involved vary by state and practice setting, and they shape both which jobs are open to you and what they pay. Check the specifics with your state licensing board.

Scope is not a footnote to pay, it is one of its drivers. The more a state lets physician assistants assess, prescribe, and bill independently, the more revenue they generate and the more bargaining power they hold. Two physician assistants with identical credentials can earn very differently depending only on what their state allows, which is why scope belongs in any serious comparison of where to work. Each state guide flags the local rules and how they shape the pay you can realistically command.

Specializations and where the pay is

PA pay varies more by specialty than by almost anything else. Surgical subspecialties, dermatology, emergency medicine, and critical care pay well above primary care. A defining advantage of the role is mobility: because PAs are not locked into a residency the way physicians are, they can move between specialties as interests and pay opportunities change.

The practical point: within physician assistants, the choice of specialty and setting often moves pay more than another year of general experience does. The highest earners in the role are rarely just the most tenured, they are the ones who moved into the higher-paying focus areas and the settings that reward them.

What moves the pay

The wide percentile spread comes from a handful of factors that compound:

• State and metro. The single biggest geographic lever, and the cost-of-living adjustment can flip which state actually leaves you better off.
• Experience. Pay climbs steadily with tenure, though it plateaus in the upper percentiles without a specialty or a license change.
• Work setting. Outpatient and hospital roles tend to pay more than office settings, as the setting table shows.
• Specialty and acuity. Higher-acuity and in-demand specialties carry clear premiums over general practice.
• Scope and autonomy. The more your state lets physician assistants practice independently, the more billable value you can generate.

Salary, hourly, and total compensation

The headline median of $135,880 is base pay. Real total compensation often runs higher. At an hourly equivalent of $65.33, overtime, extra shifts, and call pay add meaningfully for those who want them, and many employers layer on signing bonuses, productivity or RVU bonuses, shift differentials, and benefits worth thousands more. When comparing offers, weigh the full package, base, bonus structure, differentials, retirement match, and paid time off, not just the salary line. The state pages translate the base figure into real take-home after federal tax, FICA, and state tax.

Hourly pay, overtime, and shift premiums

At a median of $65.33 an hour, the role rewards extra hours. Overtime at time-and-a-half runs about $98.00 an hour, so a single extra eight-hour shift a week adds on the order of $40,766 a year in gross pay. Hospital and acute settings also pay night, weekend, and on-call differentials on top of base, and per-diem or agency work trades benefits for a higher hourly rate. For anyone willing to add hours, total pay can sit well above the salary median, the limit is schedule and burnout rather than opportunity.

How to maximize earnings

• Work in a top-paying, lower-cost state or metro. The real-value table above shows where pay stretches furthest.
• Move toward the higher-paying setting and specialty for your role.
• Negotiate the whole package, including bonus and differentials, not just base.
• Take the next license step when the math works, the ladder above shows what each move up is worth.

Take-home pay and the no-tax states

Two physician assistants earning the same salary keep different amounts by state. Nine states, including Texas and Florida, have no state income tax, so a PA there keeps several thousand dollars more a year than one on the same gross in California or New York. Combined with cost of living, that is why a moderate-sticker, no-tax state can beat a high-sticker one in real terms. Every state page includes a full take-home breakdown across the career and a paycheck calculator to run your own number. The gap is real money: on a six-figure salary, the difference between a no-tax state and a high-tax one can run several thousand dollars a year, before cost-of-living differences are even counted.

How it compares to related clinical careers

It helps to see a physician assistant next to the roles people most often weigh against it, with pay set beside the education each requires:

Role	National median	Education
Registered Nurse	$97,550	2 to 4-year degree (ADN/BSN)
Nurse Practitioner	$132,300	Master’s or doctorate (MSN/DNP)
Physician Assistant (this role)	$135,880	Master’s degree
Nurse Anesthetist	$236,590	Doctorate (DNP/DNAP)

Compared with nurse practitioner at $132,300, this role pays about $3,580 more for the added training. The next step up, nurse anesthetist at $236,590, adds roughly $100,710 but requires more schooling and licensure. The right move depends on how much additional education you are willing to take on for the pay step, which is exactly the trade the ladder above quantifies.

Job outlook

Employment of physician assistants is projected to grow about 28% from 2024 to 2034, much faster than the average for all occupations, according to the U.S. Bureau of Labor Statistics. PAs are central to team-based care and to extending access in primary care and rural areas, and demand tracks the same aging-population and physician-shortage forces lifting nurse practitioners.

For context, the average growth rate across all U.S. occupations through 2034 is about 3%, and registered nursing is projected near 5%. Whatever the headline rate, a large share of yearly openings also comes from replacing workers who retire or move up, so real-world hiring tends to run ahead of the net-growth figure. Demand is also uneven by geography: shortage areas, rural regions, and states expanding PA scope often hire hardest and pay most aggressively.

How to become a physician assistant

The PA path is a master’s-level clinical degree, shorter than medical school:

1. Earn a bachelor’s degree with the prerequisite sciences and, typically, direct patient-care hours.
2. Complete an accredited PA program. A master’s-level program accredited by ARC-PA, usually about 27 months including clinical rotations.
3. Pass the PANCE. The Physician Assistant National Certifying Examination is required to practice.
4. Get state licensure and maintain certification; scope and supervision rules vary by state.

Weigh the time and cost of each step against the pay it unlocks, which the ladder and comparison tables above put in exact dollars. For many people the deciding factor is how quickly they can be licensed and earning, and how much debt the path requires, more than the headline salary itself. The state pages then show what the pay becomes after tax in the specific place you plan to work.

Frequently asked questions

Popular state guides and calculators

Sources: U.S. Bureau of Labor Statistics, OEWS May 2025 and Occupational Outlook Handbook (SOC 29-1071 and related codes), national, state, and metro estimates. U.S. Bureau of Economic Analysis, Regional Price Parities, 2024. Last updated 2026. See our methodology.