PA Salary 2026: A Guide to the Highest-Paid Specialties

How Much Physician Associates Make, the Highest-Paid Specialties, and What Actually Drives Income

If you’re a physician associate, or considering becoming one, salary and earning potential is probably one of the first questions on your mind.

Specialty, setting, and even schedule design can dramatically change what you take home. Two clinicians with the same experience can have completely different incomes depending on how they structure their careers.

Let’s break down what physician associates actually earn today, where the highest pay is, and how to think about your earning potential long term.

What is the average PA salary in the US?

Physician associate compensation continues to trend upward, but the exact number varies depending on the source and how compensation is defined.

According to the U.S. Bureau of Labor Statistics, the median annual salary for PAs is $133,260 as of May 2024, with the top 10% earning more than $182,200. The American Academy of Physician Associates reports median compensation reached $134,000 in 2024, reinforcing that range. Medscape places average PA compensation closer to ~$130,000–$132,000, depending on specialty mix and bonus inclusion.

What this tells you:

• Floor of the market sits around $120K
• True median lands around $130K–$135K
• Top earners push beyond $180K

The Highest-Paid Physician Associate Specialties Right Now

The latest specialty breakdown from the American Academy of Physician Associates aligns closely with broader industry reporting.

Top-paying specialties include:

• Internal Medicine (General) — ~$140,000
• Cardiovascular/Cardiothoracic Surgery — ~$171,000
• Dermatology — ~$166,000
• Emergency Medicine — ~$155,070
• Urgent Care — ~$147,000
• Critical Care — ~$146,000
• Plastic Surgery — ~$145,500
• Neurosurgery — ~$145,000
• Radiology — ~$143,950
• Orthopaedic Surgery — ~$143,821

Medscape supports this pattern, noting that dermatology, emergency medicine, and surgical specialties consistently rank among the highest-compensated fields.

Takeaway:
If your goal is to increase your income, the fastest lever is still specialty selection, not tenure.

Highest-Paying States for PAs

Geography is one of the most overlooked drivers of compensation. According to the U.S. Bureau of Labor Statistics, PA salaries can vary by $40K–$70K+ depending on location.

Highest-Paying States (BLS Data)

• California — ~$149,000+
• Washington — ~$145,000+
• Oregon — ~$143,000+
• Alaska — ~$142,000+
• Nevada — ~$141,000+

Mid-Range Markets

• Texas — ~$130K–$135K
• Florida — ~$125K–$130K
• North Carolina — ~$125K

These markets tend to balance volume, population growth, and moderate cost structures.

Lower-Paying Regions

• Midwest and some Southeastern states often report $115K–$125K averages

But that doesn’t tell the full story. Higher salaries don’t always equal better earning potential. In high-cost states like California, higher salaries are often offset by cost of living, competitive job markets and less flexibility. Meanwhile, in smaller or underserved markets, rates may be lower on paper but demand is higher and flexibility is often greater This is especially true in rural areas and critical access hospitals.

These markets often rely more heavily on locum tenens PAs, which can significantly increase earnings.

Regional Demand Is Reshaping Compensation

BLS and industry data show that demand is shifting faster than salary benchmarks can keep up. Regions with provider shortages, aging populations and limited specialty coverage are increasingly offering higher hourly rates, flexible schedules and faster hiring timelines. This is why many clinicians are rethinking where they work, not just what they do.

Most employed physician associates land in the $55–$80/hour equivalent range. In high-demand regions or specialties, that number often rises to $90–$120+ per hour. This is where geography and specialty intersect. A PA in a rural emergency department may out-earn a PA in a major metro, despite lower average salaries on paper.

Maximize Earning Potential as a Locum Tenens PA

Locum tenens isn’t just a different way to work. It’s a different compensation model. Instead of being paid a fixed annual salary, physician associates working locum tenens are typically paid hourly or per shift, which creates far more flexibility in how income is earned.

Typical Locum Tenens PA Hourly Rates

While rates vary by specialty, location, and urgency, most locum tenens physician associates fall into the following range:

• $90–$120/hour — common range for urgent care and general hospital roles
• $120–$160+/hour — high-demand specialties like emergency medicine, critical care, and surgical subspecialties

In some cases, especially in urgent or hard-to-fill roles, rates can go even higher. As a locum tenens physician associate, you’ll work in different locations across the country in facilities that are experiencing staff shortages. You’ll take on temporary assignments to ensure that patients continue to receive the highest quality care. Contact our team today or browse our job board to see our current list of available openings and find out how much physician associates can make working locum tenens.