Average Salary for a Physician Assistant in 2026

The May 2025 federal median salary for a physician assistant is $135,880, but that figure is only the midpoint of a much wider market. Earlier wage data placed the 10th to 90th percentile range at $86,280 to $170,790, so the “average” should be treated as a reference point, not an automatic offer target.

That distinction matters for clinicians comparing hospital employment, outpatient specialty work, government roles, telehealth, and flexible schedules. A higher gross salary can lose its advantage when it requires nights, weekends, call, long documentation blocks, or a costly commute. The useful question isn't what a PA earns. It's what remains after taxes and living costs, divided by the hours the job consumes.

What the National Average PA Salary Looks Like in 2026

The Bureau of Labor Statistics median annual wage of $135,880 in May 2025 is the clearest national reference point for physician assistant pay (BLS physician assistant profile). It is more useful for budgeting than a self-reported average because it reflects employer payroll data and reduces the influence of unusually high earners, signing payments, and locums income. It still cannot show whether a specific offer compensates fairly for its schedule.

The midpoint is not the market ceiling

Earlier BLS occupational wage data placed PA pay from $86,280 at the 10th percentile to $170,790 at the 90th percentile in May 2023, with a mean annual wage of $141,280 (BLS occupational wage table). These figures use different populations and reference periods, so they should not be combined into one precise forecast. They do establish a wide earnings range, which makes a national average a weak proxy for the value of a particular specialty, workload, or work week.

Statistic	Annual Salary	Source
10th percentile	$86,280	BLS May 2023 occupational wage data
Median, May 2025	$135,880	BLS physician assistant profile
Mean, May 2023	$141,280	BLS May 2023 occupational wage data
90th percentile	$170,790	BLS May 2023 occupational wage data

The mean exceeds the median because higher-paid roles pull the average upward. That makes it informative for describing the profession, but less reliable for planning a household budget. A clinician comparing offers also needs the guaranteed base, expected hours, call, weekends, commute, and benefits. A nominally higher salary may produce less usable income when it requires more unpaid documentation or limits time available for other work and family responsibilities.

Practical rule: Use the median to test whether an offer is plausible. Then assess setting, specialty, schedule, and benefits before calling it competitive.

For a new graduate, a conservative first-year planning target may be $115,000 to $125,000, depending on the market and role. This range is not a BLS statistic or a guaranteed quote. Build fixed expenses around guaranteed base pay, not a bonus or hoped-for annual adjustment. For FIRE planning, the relevant figure is after-tax savings generated per hour worked, not salary alone.

How Practice Setting and Specialty Shift PA Pay

Practice setting changes compensation because employers face different reimbursement models, staffing constraints, acuity levels, and operational demands. The BLS-based setting summaries show a clear hierarchy: hospitals at $136,630, outpatient care centers at $147,650, and government roles at $151,470 (BLS-based PA salary breakdown).

Practice Setting	Median Annual Pay	Setting Code
Hospitals	$136,630	Hospital
Outpatient care centers	$147,650	Outpatient care
Government	$151,470	Government

The difference between a conventional hospital role and a government or outpatient position is roughly $10,000 to $15,000 or more. That spread is large enough to change a career decision. A PA who prefers ambulatory procedural work might gain compensation while also avoiding some inpatient coverage, although the actual schedule depends on the employer.

Specialty changes the meaning of the number

Specialty comparisons require more caution than the setting data. Surgical subspecialties, dermatology, and cardiology can attract higher offers than primary care or urgent care, while primary care and urgent care often sit closer to the lower portion of the professional market. Specialty salary summaries from professional and employer datasets can also carry selection bias because highly paid clinicians may be more likely to report their compensation.

Don't treat a specialty label as a salary guarantee. “Dermatology” can describe a procedure-heavy outpatient role or a position with extensive medical dermatology follow-up. “Cardiology” can mean clinic work, inpatient consultation, procedural support, or a schedule that includes hospital coverage. The workload is part of the compensation data, even when the listing doesn't place a dollar value on it.

For a five-year comparison, model the job rather than the title. A dermatology outpatient role may offer a different accumulation path from hospitalist medicine because the schedule, bonus opportunity, and clinical intensity can diverge. The headline salary difference matters, but so do the hours required to earn it and the likelihood that you can sustain the work.

State-Level Pay and the Cost-of-Living Trap

State salary pages are useful only when you understand what the number represents. A statewide figure can combine metropolitan and nonmetropolitan areas, different employer mixes, and specialty concentrations. If one large metro supplies much of the reported employment, the state median may not describe the offer waiting in a rural clinic or a smaller city.

Read the geography before comparing offers

Start with the state figure, then identify the metro or nonmetro area behind the opportunity. Check whether the role's pay reflects a government employer, outpatient care center, hospital, or private practice. The source mix matters because setting can move compensation independently of geography.

Recent state-level summaries illustrate why nominal pay isn't enough. One source lists Hawaii near $194,100 median pay, while another reports California at $196,350 (state-level physician assistant salary comparisons). These figures are not directly interchangeable with the BLS national median because methodologies and reference periods can differ. They are useful as a warning: a high state number doesn't tell you what the clinician can spend or save.

California's tax burden can reduce disposable income, while Hawaii's housing and everyday costs can erode a similarly high salary. A lower nominal offer in a state with lower housing costs or no state income tax may produce more usable cash. Don't assume that a higher gross figure wins until you've tested rent, taxes, commuting, insurance, and schedule restrictions.

A practical comparison should include a regional cost measure, the applicable state tax structure, and the value of the schedule. For broader relocation context, London living cost 2026 data demonstrates the same analytical principle: nominal income has to be read alongside local living expenses.

Adjust nominal salary for local costs and state tax burden before comparing offers. Then price the time required to earn it.

A PA evaluating Texas or Tennessee against California or Hawaii should calculate expected after-tax cash, recurring housing expense, and travel requirements. The result won't produce a universal “best state.” It will reveal which offer supports the clinician's own savings and lifestyle priorities.

Full-Time, Telehealth, and Flexible Role Comparisons

A salaried offer becomes easier to compare when translated into dollars per hour worked. A $140,000 hospital salary divided across a 40-hour workweek produces a rough gross hourly figure of about $67, before accounting for call, charting after the scheduled day, commuting, benefits, or weekend coverage. That calculation is illustrative, not a claim about every hospital schedule.

Telehealth can protect time without necessarily maximizing nominal pay. Part-time and per-diem work can create a higher visible hourly rate, while locums may offer a still higher gross rate but remove employer-paid benefits. The correct comparison depends on the hours that disappear from your week.

Role Type	Typical Annual Gross	Effective $/Hour Worked	Call / Weekends	Boundary Cost
Full-time hospital PA	Salary-based	Depends on actual hours	May be required	Commute, charting, coverage
Telehealth PA	Variable	Depends on paid clinical blocks	Often limited, role-specific	Screen time and volume
Part-time or per-diem PA	Variable	Often rate-based	Role-specific	Less benefit protection
Locums PA	Variable	Rate-based, benefits may be absent	Assignment-specific	Travel, gaps, administrative work

Some market discussions place telehealth around $55 to $75 per hour, part-time or per-diem roles around $60 to $90 per hour, and locums around $75 to $95 per hour, but those figures are not included in the verified federal data. Treat them as negotiation hypotheses that require confirmation in the actual listing and contract, not as dependable market benchmarks.

The boundary calculation

Telehealth can reduce commute time, eliminate some on-call expectations, and create predictable shift blocks. It can also offer less RVU credit or fewer productivity bonuses, depending on how the organization measures visits and follow-up care. A locums assignment may produce more gross cash per worked hour while providing no paid time off, retirement match, or employer-sponsored health coverage.

The useful metric is:

Effective hourly compensation = total realized compensation ÷ all work-related hours.

Count patient care, mandatory meetings, chart completion, inbox work, credentialing, commuting, and call. A role that pays well for scheduled hours can still be a poor FIRE vehicle if unpaid work expands beyond the nominal week.

Compensation Beyond Base Pay

An offer letter rarely tells the whole compensation story in its first line. Base salary, productivity incentives, quality payments, benefits, signing money, loan repayment, CME, and malpractice coverage can all alter the economic value of a PA position. The contract also determines whether those components are guaranteed, conditional, delayed, or subject to repayment.

Separate guaranteed money from contingent money

A candidate should model each component separately:

• Base salary: Fixed pay is the safest foundation for budgeting, but its share of total compensation varies by contract.
• Productivity or wRVU bonus: Ask for the threshold, conversion rate, measurement period, and whether the employer can change the formula.
• Quality incentive: Confirm the metric, responsible department, payout timing, and whether the clinician can control the result.
• Benefits valuation: Price health coverage, retirement contributions, paid leave, malpractice, licensing, and CME rather than treating them as vague perks.

The compensation graphic describes a representative structure in which base salary accounts for 60% to 75%, productivity or wRVU bonus for 5% to 15%, quality incentives for 2% to 8%, and benefits for $25,000 to $45,000 annually. Those figures are presented as a planning illustration in the supplied asset, not as universal BLS findings.

Signing bonuses and loan repayment deserve the same scrutiny. A $5,000 to $20,000 signing bonus or $20,000 to $50,000 in loan repayment over two to five years can be meaningful, but only if the repayment obligation is acceptable. Review the clawback schedule, termination language, and any restrictive covenant before counting the payment as spendable income.

A productivity clause can also create burnout risk. If the threshold is unrealistic, the “bonus” becomes unpaid overtime disguised as upside. Before comparing two similar base salaries, use the WeekdayDoc RVU calculator or a spreadsheet to convert expected volume and administrative time into an effective hourly figure.

The tax treatment of compensation also matters for clinicians using a business entity. For a separate discussion of reasonable owner compensation, review how to set your S-corp salary with a qualified tax professional.

Reading PA Pay Through a FIRE Lens

A salary is useful only in relation to spending, taxes, savings, and time. The BLS median of $135,880 provides a reasonable gross anchor, but it doesn't reveal disposable income. Federal taxes, state taxes, payroll deductions, insurance premiums, retirement contributions, housing, and debt payments determine how much can reach an investment account.

A rough personal model might produce disposable cash in the $85,000 to $95,000 range after taxes and benefits deductions, but the result depends heavily on filing status, location, insurance, retirement choices, and household finances. That range should be treated as a scenario, not a promise. Use your own paystub or a detailed calculator before making a FIRE commitment.

Gross pay is only the first input

The familiar 4% rule is a planning heuristic, not a guarantee. Applied to annual spending, it implies that a household spending $85,000 to $95,000 would need approximately $2.1 million to $2.4 million in invested assets, calculated as spending divided by 0.04. That is an illustrative FIRE target and doesn't account for taxes, sequence risk, changing expenses, or healthcare costs.

Scenario	Gross Annual	Effective Savings Rate	Years to FIRE (4% rule)	Weekly Hours
National median role	$135,880	Personal calculation	Depends on assets and spending	Contract-specific
Higher-paid specialty role	$160,000	Personal calculation	Depends on assets and spending	Contract-specific
No-call flexible role	$120,000	Personal calculation	Depends on assets and spending	Contract-specific

The table intentionally leaves savings rate and years open. Those outcomes can't be calculated without starting assets, spending, taxes, investment returns, and household income. A $160,000 specialty role may accelerate savings, but if it requires more than 45 hours each week, the extra income may buy less freedom per hour. A $120,000 no-call telehealth role may support a lower savings rate while preserving recovery time and making the work sustainable.

The correct formula is:

Effective savings rate = invested portion ÷ (gross income minus taxes).

Retirement contributions, account selection, and employer matching can change the result. Clinicians managing retirement accounts can also review practical super contribution tips, while remembering that account rules differ by country and plan.

Why the Highest Salary Is Not Always the Best Offer

A high headline salary can conceal a low hourly return. Consider a $170,000 trauma surgery role with 60-hour weeks, 1:4 call, and mandatory weekend coverage against a $130,000 outpatient endocrinology role with no call and a 40-hour week. Using only scheduled weekly hours, the trauma role produces a rough gross hourly figure of about $54.49, while the outpatient role produces about $62.50.

Those figures are simplified. They don't include additional charting, overnight interruptions, commute time, benefits, or the clinical risk associated with each position. The point is analytical: a $40,000 nominal premium can disappear once the denominator includes the time required to earn it.

Role	Headline Pay	Weekly Hours	Call/Weekends	Effective $/Hour
Trauma surgery PA	$170,000	60	1:4 call, weekends	About $54.49 before extra work
Outpatient endocrinology PA	$130,000	40	No call, no weekends	About $62.50 before extra work

Compensation design can extend the workday

RVU thresholds often look attractive because they promise upside. The risk appears when the threshold requires volume beyond a sustainable schedule, or when charting and inbox work happen outside paid clinical hours. A bonus that depends on over-scheduling can reward the employer while transferring the time cost to the PA.

Call and weekend obligations deserve a separate line in the comparison. Ask whether night coverage is paid as a stipend, included in salary, or expected without a separate payment. Check holiday rotation, response time, backup requirements, and whether “home call” still requires rapid availability.

Sign-on money also needs contract-level analysis. A repayment clause can convert a bonus into deferred compensation, while a noncompete or restrictive covenant can limit the value of leaving. Before accepting a premium, calculate compensation per total hour, including commute and uncompensated administrative work.

A salary premium isn't compensation until you know what time, availability, and restrictions it purchases.

Evaluating a PA Job Listing Against Work-Life Priorities

A PA can screen most listings quickly by separating guaranteed pay from conditional pay and stated hours from implied availability. The objective isn't to find one universal salary target. It's to determine whether the offer matches clinical intensity, schedule boundaries, and financial goals.

Start with the contract's measurable terms:

1. Base salary: Confirm the guaranteed amount, pay period, probation terms, and adjustment process.
2. RVU bonus structure: Find the threshold, conversion rate, payout frequency, reconciliation rules, and employer discretion.
3. PTO accrual: Check the days earned, accrual method, carryover rules, and whether leave is front-loaded or earned over time.
4. CME and malpractice: Verify the CME allowance, paid education days, license coverage, tail malpractice protection, and claims-made obligations.
5. Schedule and call: Define shift length, expected patient volume, inbox ownership, call frequency, weekends, holidays, and response-time requirements.

Phrases such as “flexible as needed,” “some on-call,” and “RVU threshold subject to adjustment” need clarification before you compare the offer with another role. They may be harmless shorthand, or they may leave the employer room to expand duties without increasing pay.

Translate the package into total compensation and effective hourly compensation. Then run the resulting savings amount through your own FIRE model, using the national median only as a benchmark. The WeekdayDoc market pulse and salary calculator can help organize salary comparisons, while the contract scanner can help identify terms that deserve professional review.

Rank the final decision in this order: schedule predictability, guaranteed compensation, benefits value, clinical intensity, and then upside. A role with a lower base may be rational if it protects evenings, weekends, and recovery. A higher offer may be rational if the workload is explicit, the incentives are attainable, and the total package compensates for the added demands.

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WeekdayDoc lists physician assistant roles with salary information and filters for work patterns such as remote, hybrid, no call, and no weekends. Visit WeekdayDoc to compare openings by compensation, specialty, and the schedule boundaries that matter to your financial and professional life.