Physician assistants averaged a salary of $155,000 in 2026, continuing a run of steady raises since 2022, according to a report from Medscape.
The topline number hides a more complicated picture: pay growth varies widely by specialty setting, state and gender, and base salary itself grew more slowly than the bonus and incentive pay layered on top of it.
The report, “More Money, Same Ceiling: Medscape PA Compensation Report 2026,” published Sept. 11, collected data from 2,014 physician assistants practicing in the U.S.
Here are 13 things to know:
- Average PA compensation reached $155,000 in 2026, a 20% climb from Medscape’s 2022 report. But the growth wasn’t evenly split: Base pay increased 17%, from $118,000 to $138,000, while productivity pay doubled, from $5,000 to $10,000.
- Practice setting still drives pay, and operating room and surgery settings took the top spot in 2026, climbing 19% to $168,000 from $141,000 in 2022.
- About 60% of PAs anticipated a pay increase in 2025, compared with 55% who reported an actual raise in the 2022 report. Of those expecting a bump, 52% predicted only a 1% to 10% raise, while more than one-third of all respondents didn’t expect a raise at all.
- When asked how much future income mattered when they decided to become a PA, 72% of respondents rated it a four or five on Medscape’s five-point scale, while only 8% rated it a one or two.
- Fifty-nine percent of PAs said they are paid fairly, but 63% still said the pay gap between PAs and physicians is too large relative to PAs’ contributions, compared with just 2% who called it too small.
- The gender pay gap for PAs narrowed but didn’t close. Men averaged $165,000 and women averaged $150,000, a $15,000 gap, down from an $18,000 gap in Medscape’s 2025 report.
- The highest-paid age range for PAs was 35 to 44 range, with PAs in that group averaging $164,000.
- PAs employed by a hospital system earned $160,000, up from $146,000 in 2022, while PAs employed by a medical group earned $151,000, up from $141,000 in 2022.
- Geography increasingly shapes PA pay. The West remained the highest-paying region, climbing to $165,000. PAs in the North earned an average salary of $156,000, followed by the South at $151,000. The Midwest was the lowest-paying region, with PAs earning an average of $148,000.
- Exurban areas were the top-paying local market, with an average PA salary of $159,000. PAs in urban areas earned $157,000 on average, and PAs in suburban and rural areas both averaged $153,000.
- Pure productivity pay is now the top-earning structure. PAs paid entirely on productivity or incentive, with no base salary, averaged $167,000 — edging out salary-plus-incentive pay and hourly-plus-incentive pay.
- About half of PAs were eligible for bonuses, but the average PA bonus fell 50%, from $8,000 to $4,000.
- About 60% of PAs now bill independently under their own National Provider Identifier rather than a supervising physician’s.
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