NP and PA Salary Guide: Pay Benchmarks and Offer Comparison
By MedicalRecruiting.com · Published January 15, 2025
Substantively updated October 23, 2026. Data periods are stated separately from the review date. This is recruiting information, not individual legal, clinical, tax, or financial advice.
What do nurse practitioners and physician assistants earn?
The BLS Occupational Outlook Handbook reports May 2025 median annual wages of $132,300 for nurse practitioners and $135,880 for physician assistants. These are national occupational wage benchmarks, not guaranteed starting salaries, local offers, or estimates of 2026 base pay. The NP figure is the NP-specific row in the pay table—not the combined nurse anesthetist, nurse midwife, and nurse practitioner figure. Sources: BLS nurse practitioner pay table and BLS physician assistant pay, checked October 23, 2026.
How should you compare a real offer?
- Separate guaranteed pay from contingent earnings. Record annual base salary or the guaranteed hourly rate. Put productivity, quality, retention, and signing bonuses on separate lines. Ask about thresholds, ramp-up protection, payment timing, and repayment clauses.
- Count all required work. Include clinic time, charting, inbox coverage, meetings, call, weekend shifts, and travel between sites. Divide expected guaranteed pay by realistic annual working hours to compare schedules; this calculation is not a legal overtime determination.
- Price the benefits. Compare employee premiums, deductibles, dependent coverage, paid leave, retirement contributions and vesting, CME time and funding, licensing fees, and malpractice coverage. For claims-made coverage, determine who pays for tail insurance.
- Match the benchmark to the position. Compare the same occupation, metro area, specialty, setting, experience, hours, and employment arrangement. National medians alone cannot establish a fair local offer.
- Evaluate support and scope. Ask about onboarding, physician availability, staffing, patient complexity, procedure expectations, and state practice requirements.
Does a 1099 rate mean more take-home pay?
Not necessarily. Contractor compensation may exclude paid time off, employer retirement contributions, insurance, and employer payroll-tax contributions. Collections-based models also expose earnings to volume, payer mix, denials, and collection timing. Compare expected revenue and expenses with an accountant; do not compare a contractor's gross receipts directly with a W-2 salary.
What does the outlook tell candidates?
The BLS PA page projects 21% employment growth from 2025 to 2035. The APRN page reports 36% for the combined nurse anesthetist, nurse midwife, and nurse practitioner group over the same period. Those are projections for specified populations, not a promise that every specialty or city has an immediate vacancy. Check occupation-specific tables before applying a grouped forecast to NPs alone.
Questions to ask before signing
- What compensation is guaranteed during onboarding and after the first year?
- How many visits, procedures, shifts, and call duties are expected?
- Can I see a written productivity calculation with a realistic worked example?
- What happens to bonuses, malpractice coverage, and repayment obligations if I leave?
- Which benefits are available immediately, and which have waiting periods?
Frequently asked questions
Is median wage the same as average base salary?
No. A median is the midpoint of a wage distribution; a mean is an arithmetic average. Neither automatically represents an employer's guaranteed base salary. Keep the statistic, geography, and reference year attached to any comparison.
Can an NP or PA earn more than the national median?
Yes. Specialty, geography, experience, procedures, schedule, and compensation structure affect earnings. A higher offer should still be evaluated against workload, benefits, liability, and any contingent-pay conditions.
Should I reject an offer below the national median?
Not on that fact alone. A part-time role, shorter workweek, substantial benefits, strong mentorship, or a lower-cost location can change the comparison. Request local evidence and review the complete contract.
Next steps and sources
Browse healthcare job openings, compare NP opportunities and PA opportunities, or discuss an offer with a recruiter. Confirm vacancy status and employer compensation before relying on a posting.