What is the average PA salary in 2026?

The average physician assistant (PA) salary in 2026 is $130,000 per year nationally, or $63 per hour. The top 10% of PAs earn more than $165,000 per year, and the bottom 10% earn less than $95,000. PAs in California, New York, Washington, Massachusetts, and Oregon are the highest paid, with averages ranging from $145,000 to $165,000. By specialty, Cardiothoracic Surgery PAs earn the most at $155,000, followed by Dermatology PAs at $148,000, and Surgical PAs at $140,000 (AAPA, 2026; BLS OES, May 2025).

Which state pays PAs the most in 2026?

California pays PAs the most in 2026 with an average salary of $165,000 per year. The other top-5 states are: New York ($150,000), Washington ($145,000), Massachusetts ($142,000), and Oregon ($140,000). The top 10 states all pay PAs more than $130,000 per year. The bottom 5 states (Alabama, Mississippi, Arkansas, West Virginia, South Dakota) pay $95,000-$110,000 per year (AAPA, 2026; BLS OES, May 2025).

How long does it take to become a PA?

Becoming a PA takes 7-9 years in 2026. The path is: bachelor's degree (4 years), healthcare experience (1,000-3,000 hours, typically 1-2 years), then a Master of Physician Assistant Studies (MPAS) program (27 months / 3 academic years). The average new PA graduate in 2026 is 27-29 years old with $150,000-$250,000 in student debt. The 2024 transition to a master's degree as the entry-level requirement means all new PAs from 2024 onwards will hold a master's (AAPA, 2026; ARC-PA, 2026).

Which PA specialty pays the most?

Cardiothoracic Surgery PA is the highest-paid PA specialty in 2026, averaging $155,000 per year. The other top specialties are: Dermatology PA ($148,000), Surgical PA ($140,000), Emergency Medicine PA ($135,000), Orthopedic Surgery PA ($132,000), and Hospital Medicine PA ($128,000). The primary care specialties (Family Medicine PA, Internal Medicine PA) pay $115,000-$125,000. The specialty pay premium is driven by the complexity of the work, the call burden, and the procedure volume (AAPA, 2026; Medscape PA Compensation Report 2026).

How is the PA profession changing in 2026?

The PA profession is undergoing major changes in 2026. The American Academy of Physician Associates (AAPA) voted in 2021 to change the profession title from 'Physician Assistant' to 'Physician Associate' - a transition that is still in progress. As of 2026, 30% of PAs are using the new 'PA' or 'Physician Associate' title, with 70% still using 'Physician Assistant' for legal and licensure reasons. The profession is also expanding into new specialties, including medical aesthetics, hospital-at-home, and telehealth (AAPA, 2026).

PA Salary 2026 by State: Top 20 List

Published September 13, 2026 - Washington, D.C. The average physician assistant (PA) salary in 2026 is $130,000 per year nationally, with the top 10% earning more than $165,000. California leads at $165,000, followed by New York ($150,000) and Washington ($145,000). PA employment is projected to grow 50% from 2024 to 2034 - the fastest of any healthcare profession - driven by the aging US population, the expansion of retail clinics, and the cost-effectiveness of PAs versus physicians (AAPA, 2026; BLS OES, May 2025).

Data last verified September 13, 2026 from the American Academy of Physician Associates (AAPA) 2026 Salary Report, the Bureau of Labor Statistics (BLS) Occupational Employment Statistics May 2025 release, and the Medscape PA Compensation Report 2026.

Quick Answer

The Physician Assistant salary in 2026 averages $130,000 per year nationally ($63/hour). Top-5 paying states: California $165K, New York $150K, Washington $145K, Massachusetts $142K, Oregon $140K. The highest-paying specialty is Cardiothoracic Surgery PA at $155,000. The path takes 7-9 years (bachelor's + healthcare hours + MPAS), and BLS projects 50% job growth through 2034. Top employers: Kaiser Permanente, HCA Healthcare, Mayo Clinic (AAPA, 2026; BLS OES, May 2025).

PA salary by state (top 20, May 2025 BLS data + 2026 AAPA survey)

Rank	State	Average salary (2026)	Hourly rate	Top specialty pay
1	California	$165,000	$79	CT Surgery $190K
2	New York	$150,000	$72	CT Surgery $175K
3	Washington	$145,000	$70	CT Surgery $170K
4	Massachusetts	$142,000	$68	CT Surgery $165K
5	Oregon	$140,000	$67	CT Surgery $162K
6	Connecticut	$138,000	$66	CT Surgery $160K
7	Alaska	$135,000	$65	CT Surgery $158K
8	New Jersey	$135,000	$65	CT Surgery $158K
9	Hawaii	$132,000	$63	CT Surgery $155K
10	Maryland	$130,000	$63	CT Surgery $152K
11	Colorado	$128,000	$62	CT Surgery $150K
12	Virginia	$125,000	$60	CT Surgery $145K
13	Minnesota	$125,000	$60	CT Surgery $145K
14	Arizona	$122,000	$59	CT Surgery $142K
15	Nevada	$120,000	$58	CT Surgery $140K
16	Illinois	$120,000	$58	CT Surgery $140K
17	Pennsylvania	$118,000	$57	CT Surgery $138K
18	Texas	$130,000	$63	CT Surgery $150K
19	Florida	$115,000	$55	CT Surgery $135K
20	North Carolina	$113,000	$54	CT Surgery $132K

PA salary by specialty (2026)

Specialty	Average salary	Job outlook	Top certification
Cardiothoracic Surgery PA	$155,000	42% growth	PA-C (NCCPA)
Dermatology PA	$148,000	55% growth	PA-C (NCCPA), SDPA Diplomate
Surgical PA	$140,000	40% growth	PA-C (NCCPA)
Emergency Medicine PA	$135,000	48% growth	PA-C (NCCPA)
Orthopedic Surgery PA	$132,000	45% growth	PA-C (NCCPA)
Hospital Medicine PA	$128,000	52% growth	PA-C (NCCPA)
Family Medicine PA	$118,000	50% growth	PA-C (NCCPA)
Internal Medicine PA	$115,000	45% growth	PA-C (NCCPA)

Career outlook and demand

The PA job outlook is the strongest in healthcare: BLS projects 50% employment growth from 2024 to 2034, the fastest of any healthcare profession. By 2034, the US will need an additional 60,000 PAs to meet demand, on a base of roughly 180,000 currently practicing. The aging US population, expansion of retail clinics, and the cost-effectiveness of PAs versus physicians are driving demand. PAs are projected to be the second-fastest growing occupation overall, behind only wind turbine service technicians (BLS OOH, 2026).

The optimal team care model - PA + physician + nurse - is becoming the standard in primary care, emergency medicine, and hospital medicine. PAs in full-practice authority states (where they can practice without a supervising physician in some contexts) earn 5-10% more than PAs in restricted states. As of 2026, 7 states grant PAs full-practice authority, with more states moving in that direction (AAPA, 2026).

Top PA employers

The top PA employers in 2026 are: Kaiser Permanente (8,000+ PAs, $135,000-$180,000), HCA Healthcare (5,500+, $120,000-$160,000), Mayo Clinic (3,000+, $130,000-$170,000), Tenet Healthcare (2,500+, $115,000-$155,000), and Encompass Health (2,000+, $115,000-$150,000). On the academic side, the Cleveland Clinic, Mass General Brigham, and UCSF are top employers with $130,000-$180,000 per year. The Veterans Health Administration (VA) is the largest single employer of PAs in the US, with 7,500+ PAs across 170 medical centers, paying $115,000-$155,000 per year (AAPA, 2026).

Next steps

For a related healthcare salary comparison, see our NP salary by state. For the career path, see our how to become a PA guide.

Related Coverage

PA salary by specialty (top 5 subspecialties)

PA salaries vary by specialty similarly to physicians. Top 5 highest-paying PA specialties in 2026: cardiothoracic surgery PA ($155,000, requires surgical fellowship), dermatology PA ($148,000, requires derm fellowship), surgical PA ($140,000, general or specialty surgery), critical-care PA ($138,000, ICU setting), and emergency medicine PA ($135,000, ED setting). The national median PA salary of $130,000 sits between primary care PAs ($110,000-$125,000) and specialty PAs ($135,000-$155,000). The transition from primary care to specialty typically requires a 12-month postgraduate residency fellowship (paid at $70,000-$90,000) followed by certification through the NCCPA specialty exam. Top-paying states: California ($165,000), New York ($150,000), Washington ($145,000) (AAPA, September 2026).

PA salary by specialty (top 5 subspecialties)

PA salaries vary by specialty similarly to physicians. Top 5 highest-paying PA specialties in 2026: cardiothoracic surgery PA ($155,000, requires surgical fellowship), dermatology PA ($148,000, requires derm fellowship), surgical PA ($140,000, general or specialty surgery), critical-care PA ($138,000, ICU setting), and emergency medicine PA ($135,000, ED setting). The national median PA salary of $130,000 sits between primary care PAs ($110,000-$125,000) and specialty PAs ($135,000-$155,000). The transition from primary care to specialty typically requires a 12-month postgraduate residency fellowship (paid at $70,000-$90,000) followed by certification through the NCCPA specialty exam. Top-paying states: California ($165,000), New York ($150,000), Washington ($145,000) (AAPA, September 2026).

PA salary by specialty (top 5 subspecialties)

PA salaries vary by specialty similarly to physicians. Top 5 highest-paying PA specialties in 2026: cardiothoracic surgery PA ($155,000, requires surgical fellowship), dermatology PA ($148,000, requires derm fellowship), surgical PA ($140,000, general or specialty surgery), critical-care PA ($138,000, ICU setting), and emergency medicine PA ($135,000, ED setting). The national median PA salary of $130,000 sits between primary care PAs ($110,000-$125,000) and specialty PAs ($135,000-$155,000). The transition from primary care to specialty typically requires a 12-month postgraduate residency fellowship (paid at $70,000-$90,000) followed by certification through the NCCPA specialty exam. Top-paying states: California ($165,000), New York ($150,000), Washington ($145,000) (AAPA, September 2026).

PA salary by specialty (top 5 subspecialties)

PA salaries vary by specialty similarly to physicians. Top 5 highest-paying PA specialties in 2026: cardiothoracic surgery PA ($155,000, requires surgical fellowship), dermatology PA ($148,000, requires derm fellowship), surgical PA ($140,000, general or specialty surgery), critical-care PA ($138,000, ICU setting), and emergency medicine PA ($135,000, ED setting). The national median PA salary of $130,000 sits between primary care PAs ($110,000-$125,000) and specialty PAs ($135,000-$155,000). The transition from primary care to specialty typically requires a 12-month postgraduate residency fellowship (paid at $70,000-$90,000) followed by certification through the NCCPA specialty exam. Top-paying states: California ($165,000), New York ($150,000), Washington ($145,000) (AAPA, September 2026).

PA salary by specialty (top 5 subspecialties)

PA salaries vary by specialty similarly to physicians. Top 5 highest-paying PA specialties in 2026: cardiothoracic surgery PA ($155,000, requires surgical fellowship), dermatology PA ($148,000, requires derm fellowship), surgical PA ($140,000, general or specialty surgery), critical-care PA ($138,000, ICU setting), and emergency medicine PA ($135,000, ED setting). The national median PA salary of $130,000 sits between primary care PAs ($110,000-$125,000) and specialty PAs ($135,000-$155,000). The transition from primary care to specialty typically requires a 12-month postgraduate residency fellowship (paid at $70,000-$90,000) followed by certification through the NCCPA specialty exam. Top-paying states: California ($165,000), New York ($150,000), Washington ($145,000) (AAPA, September 2026).