Explore surgical NP and PA salary ranges, hourly rates, and how first-assist responsibilities and locum work shape earning potential in 2026.
Surgical NPs and PAs provide pre-operative, intraoperative, and post-operative care across a broad range of surgical specialties. The combination of first-assist responsibilities, acute care skills, and surgical team integration creates a scope of practice that commands competitive compensation. Most earn between $130,000 and $140,000 annually, with surgical volume, trauma experience, and rural versus academic setting driving variation above the median.
| Source | What it Measures | NP Compensation | PA Compensation |
|---|---|---|---|
| AANP/AAPA Compensation Reports (2025) | Median annual compensation | ~$135,000 | ~$140,000 |
| Medscape APRN Compensation Report (2025) | Average total NP/PA compensation | ~$130,000 | ~$138,000 |
| Bureau of Labor Statistics, OEWS (2025) | Mean annual wage (all-specialty proxy) | ~$133K–$136K | ~$130K–$135K |
Surgical APPs with trauma experience and first-assist certification consistently earn at the top of the compensation range. Acute care surgical settings command the highest locum premiums.
| Compensation Type | Hourly Rate |
|---|---|
| W-2 employed NP/PA (BLS mean, ~2,080 hrs) | ~$64 /hr |
| Locum tenens — lower band | $90 /hr |
| Locum tenens — upper band | $115 /hr |
Sources: BLS OEWS 2025; Barton Associates market data 2025–2026.
Trauma and acute care surgical locum assignments command the highest rates, reflecting the critical skills and credentialing required for these high-acuity roles.
Surgical APP compensation peaks in markets where surgical volume and limited APP supply combine. Rural trauma centers, high-volume surgical programs, and critical access hospitals pay the highest locum premiums. First-assist certification significantly expands both assignment availability and rate potential across all surgical subspecialties.
Surgical APPs with trauma experience and first-assist certification access the widest range of high-paying locum assignments across both urban and rural markets.
A full-time surgical APP divides time between pre-operative clinic visits, intraoperative first-assist responsibilities, and post-operative care management. Daily responsibilities include surgical site assessments, drain and wound management, discharge planning, and cross-disciplinary coordination with anesthesia and nursing. The combination of OR and clinic responsibilities creates one of the most varied APP roles in the market.
Locum rates range from $90 to $115 per hour. The four scenarios below use representative rates from within that band.
To exceed $225,000: target trauma and acute care surgery assignments, first-assist responsibilities, and underserved surgical markets at the top of the rate band.
Surgical APPs who combine first-assist certification with trauma experience and willingness to work in rural and underserved markets access the highest-paying locum assignments in the specialty.
A $100/hr locum rate versus a $64/hr W-2 equivalent is a meaningful structural advantage. 1099 surgical APPs unlock business deductions across licensing, CME, travel, and equipment; higher retirement contributions through a SEP-IRA or Solo 401(k); the Qualified Business Income deduction of up to 20%; and S-corp structuring at higher income levels. Barton partners with Earned to help locum APPs navigate these decisions.
Barton coordinates your job search from start to finish!
We’ll schedule a phone consultation to discuss your interests, goals, and work history to find the right opportunities.
Your Barton rep will submit your information to the facility you want to take an assignment at and work on next steps.
Barton handles licensing, credentialing, and travel arrangements before you arrive so you’re ready on day one.
Most earn between $130,000 (Medscape NP) and $140,000 (AAPA PA). Surgical volume, trauma experience, and rural versus academic setting drive variation above the median.
W-2 employed NPs and PAs average approximately $64 per hour based on BLS data. Locum tenens rates range from $90 to $115 per hour.
Hybrid models combining employed income with regular locum shifts can push total compensation above $183,000. Full-time locum at $115/hr working 15 shifts per month yields approximately $207,000 annually.
Rural trauma centers, high-volume surgical programs, and critical access hospitals pay the highest locum premiums. First-assist certification significantly expands both assignment availability and rate potential.
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