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The following table includes the top 25 highest-paying Physician Assistant (PA) specialties. The figures represent the average total income from all PA positions, along with estimated salary ranges and professional demand levels.
The data is sourced directly from the most recent National Commission on Certification of Physician Assistants (NCCPA) Statistical Profile of Board Certified PAs by Specialty.
Please note that the statistics referenced report on the full 2024 calendar year. The NCCPA 2024 Statistical Profile by Specialty is the primary authoritative source that reports on PA certification, workforce distribution, and compensation data across all 50 states for over 159,000 board-certified PAs. Due to the scale of that effort, a natural reporting lag exists.
The NCCPA collects data throughout the calendar year, then spends months verifying accuracy before publication. The 2024 data was finalized in August 2025, and the 2025 Specialty Report is expected to follow the same cycle with a release in August 2026.
Every salary figure in this guide comes directly from the NCCPA. The NCCPA is the only certifying body for PAs in the United States, meaning every board-certified PA must maintain a professional profile with them. No job board or crowd-sourced platform has that kind of direct access to the entire profession.
The 2024 Specialty Report reflects aggregated data from 159,514 board-certified PAs, an 84% response rate, which is why medical groups and hospital HR departments treat NCCPA compensation data as the gold standard.
The salary ranges we reference account for the NCCPA's own breakdowns across income percentiles and hours-worked brackets, including distinctions between PAs working standard schedules and those logging 40+ hours per week. Where you see a range rather than a single number, it reflects that variation within the NCCPA's published data.
Demand levels, difficulty ratings, and work-life balance scores were developed through a combination of industry research, workforce trend analysis, and firsthand professional experience within PA practice settings.
Salary matters, but picking a specialty based on compensation alone is the fastest way to burn out within five years. The right specialty depends on three factors: what you find clinically interesting, the lifestyle you want to live, and the earning potential that meets your financial goals.
Not sure which specialty aligns with your goals? Our PA admissions experts work one-on-one with applicants to match them to the right specialty and build an application strategy that gets them into a top program.
The following factors affect PA salaries outside of just the specialty:
Certifications and niche skills: Credentials like a Certificate of Added Qualifications (CAQ) or specialized procedural training can give you leverage that generic experience cannot. Employers pay more for PAs who bring verified, specialized skills to the table because it reduces onboarding time and expands what the practice can offer patients.
Cardiothoracic and vascular surgery PAs are paid the highest salaries, with an average income of $155,036 a year and a total salary range from $130K to $210K+.
Pediatrics-general pays the least of any PA specialty at $107,574 in average 2024 income, nearly $22,000 below the NCCPA's reported average PA income of $129,291.
The lower pay reflects the setting more than anything else. Pediatric PAs work almost exclusively in outpatient clinics, seeing routine well-child visits, managing common illnesses, and coordinating care for kids with chronic conditions.
Yes, PAs can make six figures, and the majority already do. According to the NCCPA, the average income for PAs is $129,291. PAs in high-paying specialties or high-demand areas, or those taking on additional call and productivity bonuses, can push past $200,000 in total compensation.
Physicians earn significantly more than PAs, with most earning over $300,000 annually compared to the NCCPA's reported mean PA income of $129,291. Physicians complete 11+ years of post-high school education and training, hold independent licensure, and carry full diagnostic and prescriptive authority.
In comparison, PAs complete around 6-7 years of education and practice with physician oversight, though that distinction is narrowing as more states expand PA autonomy.
California leads the nation as the top-paying state for PAs, with an average wage of over $140,000 a year, according to the NCCPA. Raw numbers only tell part of the story, though. Indiana has the highest hourly mean wage when adjusted for cost of living, meaning a PA earning $130,000 there keeps more purchasing power than one earning $160,000 in San Francisco.
Dermatology offers the best work-life balance of any PA specialty. Dermatology PAs work almost exclusively in outpatient clinic settings, seeing scheduled patients during regular business hours with no overnight calls, no ICU shifts, and no weekend trauma coverage.
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