From the Desk of ADPA President: Top-paid specialties for nurse practitioners, physician assistants.

James R. Kilgore, DMSc, PhD, PA-C, DFFAPA

From the Desk of the President of ADPA ,

 An article caught my attention that I think clearly shows the trend in the utilization of PAs and NPs within the US. The report was in the Becker’s Hospital Review (9.9.2025) entitled Top-paid specialties for nurse practitioners, physician assistants. The link is: https://www.beckershospitalreview.com/compensation-issues/top-paid-specialties-for-nurse-practitioners-physician-assistants/?origin=QualityE&utm_source=QualityE&utm_medium=email&utm_content=newsletter&oly_enc_id=9873J4003134I6T

For several years I personally have been collecting data on new PA graduate contracts. One of my personal areas of expertise is “Contract Negotiations”. Noted is the trend of a significant move toward Health Care System (HCS) employment as compared to single physician or small group practice contracts. Approximately 92% of all contracts in our database for new graduate PAs are with the systems, not much different from data regarding all health care providers and a move toward HCS contracts. The most enlightening information was the move in salary + productivity agreements that are now averaging between $140,000 - $180,000 for new PA graduates. A similar upward trend is being observed in other databases from the organizations that represent the PA profession.

Compensation for physician assistants and nurse practitioners varies across specialties, according to a survey conducted by consulting firm SullivanCotter. The “2025 Advanced Practice Provider Compensation and Productivity Survey” draws data from more than 785 health systems, hospitals and physician group practices representing more than 155,000 certified anesthesiologist assistants, certified nurse midwives, certified registered nurse anesthetists, nurse practitioners and physician assistants.

Here are the highest-paid specialties for NPs and PAs, according to survey data shared with Becker’s. The specialties are in descending order, based on annual median total cash compensation, which is equal to base salaries plus annual incentive awards.

Becker’s Editor note: The lists do not include additional premium-based compensation.

Nurse practitioners

Emergency medicine: $155,556

Anesthesiology – perioperative medicine: $154,336

Anesthesiology – pain medicine:  $154,089

Psychiatry – general:  $153,284

Psychiatry – inpatient:  $151,386

Cardiovascular surgery: $151,332

Pediatrics – neonatal-perinatal medicine: $150,977

Thoracic surgery: $149,755

Cardiology – invasive – interventional: $149,269

Psychiatry – outpatient: $149,180

Cardiology – electrophysiology: $149,163

Pediatrics – critical care medicine: $148,265

Radiology – diagnostic: $148,103

Cardiothoracic surgery: $147,039

Medical critical care: $146,401

Pediatrics – hospitalist: $145,741

Neurological surgery: $145,074

Pediatrics – general surgery: $144,980

Occupational and environmental medicine: $144,778

Psychiatry – child and adolescent: $144,677 

Physician assistants

Cardiovascular surgery: $166,250

Cardiothoracic surgery: $164,035

Psychiatry – general: $161,464

Orthopedic surgery – medical: $158,952

Cardiology – electrophysiology: $158,792

Oncology – medical oncology: $155,056

Radiology – interventional: $154,904

Pediatrics – neonatal-perinatal medicine: $154,622

Urgent care: $154,355

Dermatology:  $154,304

Obstetrics/gynecology – gynecologic oncology: $152,705

Emergency medicine: $152,250

Anesthesiology – perioperative medicine: $151,769

Occupational and environmental medicine: $151,222

Pulmonology – critical care medicine:  $150,521

Thoracic surgery:  $150,410

Medical critical care: $150,377

Surgical oncology – general: $148,549

Anesthesiology – pain medicine: $148,426

Vascular surgery: $148,141