The healthcare industry is experiencing an unprecedented shortage of medical professionals, and Physician Assistants (PAs) have emerged as one of the most sought-after roles in 2025. With average salaries climbing toward $135,000 annually and employers offering visa sponsorship and green card pathways, the PA profession represents a golden opportunity for both domestic and international healthcare workers.
From major hospital systems to specialized clinics, healthcare facilities across America are competing fiercely for qualified PAs. If you’re considering a career in medicine with excellent earning potential, job security, and immigration benefits, this comprehensive guide reveals everything you need to know about physician assistant salaries and opportunities.
Physician Assistant Salary Overview: What PAs Really Earn in 2025
Physician assistants occupy a unique position in the healthcare ecosystem, earning competitive salaries while enjoying greater work-life balance than physicians. Below is a breakdown of PA compensation across experience levels and settings.
| Experience Level | Annual Salary Range | Hourly Equivalent |
|---|---|---|
| Entry-Level PA (0-2 years) | $95,000 – $108,000 | $46–$52 |
| Mid-Career PA (3-7 years) | $110,000–$125,000 | $53–$60 |
| Experienced PA (8-15 years) | $120,000–$135,000 | $58 – $65 |
| Senior PA (15+ years) | $130,000–$150,000+ | $63–$72+ |
The median physician assistant salary in the United States sits at $121,530 per year, according to recent industry data. However, specialization, location, and employer type significantly impact earning potential.
Highest-Paying Specialties for Physician Assistants
Not all PA roles are created equal. Certain medical specialties command premium salaries due to complexity, demand, or required expertise.
| Specialty | Average Annual Salary | Key Responsibilities |
|---|---|---|
| Cardiovascular/Cardiothoracic Surgery | $135,000–$150,000 | Surgical assistance, post-op care, cardiac procedures |
| Emergency Medicine | $125,000–$140,000 | Trauma response, acute care, fast-paced diagnostics |
| Orthopedic Surgery | $122,000 – $138,000 | Joint replacement assistance, fracture care, sports medicine |
| Dermatology | $118,000 – $135,000 | Skin cancer screening, cosmetic procedures, biopsies |
| Oncology | $115,000 – $132,000 | Cancer treatment coordination, chemotherapy management |
| Psychiatry | $110,000–$128,000 | Mental health assessment, medication management |
| Family Medicine/Primary Care | $95,000–$115,000 | Preventive care, chronic disease management, wellness |
Why the variance? Surgical specialties and emergency medicine demand longer hours, higher stress tolerance, and advanced technical skills, which translates to higher compensation packages.
Top-Paying States for Physician Assistants
Geography plays a massive role in PA compensation. States with higher costs of living, underserved populations, or booming healthcare industries offer significantly better salaries.
- California – $145,000+ Average
California leads the nation in PA compensation, driven by Silicon Valley’s tech-fueled healthcare startups, major hospital systems like Stanford Health Care and Kaiser Permanente, and a chronic shortage of medical providers in both urban and rural areas. - Alaska – $139,000+ Average
Remote locations, challenging work environments, and limited healthcare access create premium opportunities for PAs willing to work in Alaska’s frontier communities. Many positions include housing allowances and relocation bonuses. - Washington—$132,000+ Average
Seattle’s thriving biotech sector and major employers like UW Medicine and Providence Health create strong demand for PAs across multiple specialties. - New York – $128,000+ Average
From Manhattan’s prestigious hospitals to upstate community health centers, New York offers diverse PA opportunities. Major employers include NYU Langone, Mount Sinai, and NewYork-Presbyterian. - Connecticut – $127,000+ Average
High cost of living and proximity to major pharmaceutical companies drive Connecticut’s competitive PA salaries, with Yale New Haven Health leading in recruitment. - Texas – $118,000+ Average
Texas combines lower living costs with strong healthcare demand, making it an attractive destination for PAs seeking maximum purchasing power. Houston Methodist, Baylor Scott & White, and UT Southwestern actively hire PAs.
Major Employers Offering Physician Assistant Positions
Certain healthcare organizations are known for competitive PA compensation, comprehensive benefits, and visa sponsorship programs for international candidates.
| Healthcare System | Average PA Salary | Locations | Visa Sponsorship |
|---|---|---|---|
| Mayo Clinic | $125,000 – $142,000 | MN, AZ, FL | Yes (H-1B, EB-3) |
| Cleveland Clinic | $118,000 – $135,000 | OH, FL, NV, London | Yes |
| Kaiser Permanente | $122,000 – $138,000 | CA, OR, WA, CO | Yes |
| Johns Hopkins Medicine | $120,000 – $140,000 | MD, DC, FL | Yes |
| Mass General Brigham | $125,000–$142,000 | MA | Yes (limited) |
| HCA Healthcare | $110,000–$128,000 | 21 states nationwide | Yes |
| Providence Health | $118,000–$135,000 | Western US | Yes |
These organizations not only offer competitive salaries but also provide continuing education stipends, malpractice insurance, retirement matching, and pathways to permanent residency for foreign-trained PAs.
Physician Assistant Salary by Work Setting
Where you work matters as much as what specialty you choose. Different healthcare environments offer varying compensation structures.
| Work Setting | Salary Range | Pros | Cons |
|---|---|---|---|
| Hospital (Inpatient) | $115,000–$135,000 | Comprehensive benefits, diverse cases | Long shifts, high stress |
| Outpatient Clinics | $105,000–$125,000 | Better hours, predictable schedule | Lower pay ceiling |
| Emergency Departments | $125,000–$140,000 | Fast-paced, high earning potential | Irregular hours, burnout risk |
| Surgical Centers | $120,000 – $138,000 | Specialized skills, team environment | Long procedures, physical demands |
| Urgent Care | $110,000–$128,000 | Flexible hours, variety | High patient volume |
| Private Practice | $100,000 – $130,000 | Autonomy, relationship building | Business management required |
| Telemedicine | $95,000–$115,000 | Work from home, flexibility | Lower compensation, isolation |
Visa Sponsorship and Green Card Pathways for International PAs
Foreign-trained Physician Assistants face unique challenges entering the U.S. healthcare system, but opportunities exist for those who navigate the process strategically.
Eligible Visa Types for PAs
H-1B Visa (Specialty Occupation)
- Salary Range: $95,000–$135,000
- Duration: Up to 6 years
- Requirements: PA degree, certification, job offer from sponsoring employer
- Top Sponsors: Mayo Clinic, Cleveland Clinic, Kaiser Permanente
EB-3 Visa (Skilled Worker Green Card)
- Processing Time: 2-4 years
- Permanent Residency: Yes
- Requirements: PA certification, NCCPA credential, employer sponsorship
- Ideal For: PAs seeking long-term U.S. careers
TN Visa (Canadian and Mexican PAs)
- Salary Range: $95,000–$130,000
- Duration: Renewable annually
- Requirements: PA degree, job offer
- Fastest Route: For NAFTA/USMCA citizens
Steps to Secure U.S. PA Employment as a Foreign Professional
- Obtain NCCPA Certification → The National Commission on Certification of Physician Assistants credential is essential
- State Licensure → Each state has different requirements; research before applying
- Target Sponsoring Employers → Focus on major healthcare systems with proven sponsorship track records
- Credential Evaluation → Foreign degrees must be evaluated by approved agencies
- Network Strategically → Join the American Academy of PAs (AAPA) and attend conferences
Additional Compensation Beyond Base Salary
Smart PAs understand that total compensation extends far beyond base pay. Here’s what to negotiate:
Sign-On Bonuses: $5,000 – $25,000 for in-demand specialties
Relocation Assistance: $3,000 – $15,000 for geographic moves
CME Allowances: $2,000 – $5,000 annually for continuing education
Malpractice Insurance: Fully covered by employer (saves $3,000 – $8,000/year)
Retirement Matching: 3% – 6% of salary in 401(k) contributions
Production Bonuses: 10%–20% additional earnings for high-volume practices
Loan Repayment Programs: Some rural and underserved employers offer $20,000–$50,000 in student loan forgiveness
Career Growth and Salary Progression
Physician assistant careers offer clear advancement pathways that translate to higher earnings:
Years 1-3: Build clinical foundation, focus on certification maintenance
Years 4-7: Specialize in a high-demand area, pursue additional certifications
Years 8-12: Senior PA roles, department leadership, mentoring
Years 12+: PA leadership, education, or transition to administrative roles earning $150,000+
Many experienced PAs also diversify income through locum tenens (temporary) positions, telemedicine side gigs, or medical consulting, adding $15,000–$40,000 to annual earnings.
Why Physician Assistant Demand Is Exploding
Several converging factors make 2025 the ideal time to pursue a PA career:
Aging Population: Baby boomers require more medical care, creating massive demand Physician Shortage: The U.S. faces a projected shortage of 86,000 physicians by 2036.
Cost-Effective Care: PAs provide quality care at a lower cost than physicians
Rural Health Needs: Underserved communities desperately need medical professionals Scope of Practice Expansion: Many states have expanded PA autonomy, increasing hiring
The Bureau of Labor Statistics projects 27% job growth for physician assistants through 2031—far exceeding the average for all occupations.
Frequently Asked Questions About Physician Assistant Salary
What is the starting salary for a new physician assistant?
Entry-level PAs typically earn $95,000–$108,000 annually, with higher salaries in surgical specialties and high-cost-of-living areas.
Do Physician Assistants get bonuses?
Yes. Sign-on bonuses range from $5,000 to $25,000, and production bonuses can add 10%–20% to base salary in high-volume practices.
Which PA specialty pays the most?
Cardiovascular and cardiothoracic surgery PAs command the highest salaries at $135,000–$150,000, followed by emergency medicine at $125,000–$140,000.
Can international PAs work in the United States?
Yes, this can be achieved through sponsorship of an H-1B visa, EB-3 green cards, or TN visas for Canadian or Mexican citizens. Major health systems actively sponsor foreign PAs.
Is being a PA worth it financially?
Absolutely. With average salaries of $121,000, strong job growth, and lower educational costs than physicians, PAs enjoy excellent ROI on their education investment.
Do PAs make more in hospitals or clinics?
Hospital-based PAs, especially in emergency and surgical departments, typically earn $10,000–$20,000 more than outpatient clinic PAs.
Final Thoughts: Your Path to a $135,000 Healthcare Career
The Physician Assistant profession stands at the intersection of clinical excellence, financial stability, and career flexibility. With salaries climbing toward $135,000 for experienced practitioners, visa sponsorship opportunities for international candidates, and explosive job growth projected for the next decade, there has never been a better time to pursue this rewarding career.
Whether you’re a recent graduate, a healthcare professional considering a career pivot, or an international candidate seeking U.S. opportunities, the PA path offers a clear route to professional fulfillment and financial security.
The healthcare industry needs you. The opportunities are real. The time to act is now.