Cardiothoracic Surgery PA Pay: Medicine's Highest-Paying PA Specialty
CT surgery has topped PA compensation surveys for years. The state PA baseline, plus the first-assist and call dynamics that create the CT premium.
VitalPost Editorial
By VitalPost Editorial · August 29, 2026
Dermatology PAs pair strong base pay with production upside few specialties can match. The state baseline and the productivity math behind derm PA income.
Dermatology PAs occupy one of the most economically distinctive corners of the profession: high-volume clinics, procedures from biopsies to cosmetic injectables, and — uniquely — widespread productivity-based pay that lets a busy derm PA's income scale with the practice they build. Surveys regularly place dermatology among the top PA specialties for total compensation.
According to the U.S. Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) program (May 2025), physician assistants in the United States earn an annual mean wage of $141,280 and an annual median wage of $135,880. The median is the midpoint — half earn more, half earn less — and it is usually the safer "typical" reference because the mean gets pulled around by the highest earners.
An honest note on the data: BLS publishes PA wages by state for the profession as a whole — not by specialty. The table below is the profession-wide baseline from the May 2025 federal survey. Dermatology roles generally sit above that baseline for the reasons covered here, but for specialty-specific dollar figures, consult the professional-association surveys linked in the references; we don't invent numbers the federal data doesn't contain.
| Rank | State | Annual mean wage |
|---|---|---|
| 1 | California | $169,110 |
| 2 | Washington | $164,430 |
| 3 | New Jersey | $162,100 |
| 4 | Oregon | $155,300 |
| 5 | New York | $155,150 |
| 6 | Vermont | $152,520 |
| 7 | New Hampshire | $150,150 |
| 8 | Alaska | $148,080 |
| 9 | Minnesota | $147,630 |
| 10 | Connecticut | $146,930 |
| 11 | Hawaii | $146,780 |
| 12 | Rhode Island | $146,630 |
| 13 | Massachusetts | $146,480 |
| 14 | District of Columbia | $146,230 |
| 15 | Indiana | $144,260 |
| 16 | Delaware | $143,840 |
| 17 | Virginia | $142,630 |
| 18 | Arizona | $140,850 |
| 19 | Montana | $140,800 |
| 20 | Iowa | $139,870 |
| 21 | Maryland | $139,740 |
| 22 | Colorado | $139,580 |
| 23 | Oklahoma | $138,700 |
| 24 | Missouri | $137,710 |
| 25 | Wyoming | $137,320 |
| 26 | Wisconsin | $136,750 |
| 27 | Ohio | $136,560 |
| 28 | Texas | $135,850 |
| 29 | Nevada | $135,790 |
| 30 | Maine | $134,690 |
| 31 | New Mexico | $134,670 |
| 32 | Florida | $134,470 |
| 33 | Nebraska | $132,810 |
| 34 | Idaho | $132,540 |
| 35 | Utah | $132,530 |
| 36 | Michigan | $132,140 |
| 37 | South Dakota | $131,910 |
| 38 | Illinois | $131,880 |
| 39 | North Dakota | $130,930 |
| 40 | Louisiana | $130,290 |
| 41 | North Carolina | $130,030 |
| 42 | West Virginia | $128,830 |
| 43 | Kansas | $127,240 |
| 44 | Pennsylvania | $125,160 |
| 45 | South Carolina | $120,720 |
| 46 | Kentucky | $119,990 |
| 47 | Arkansas | $118,430 |
| 48 | Tennessee | $117,300 |
| 49 | Georgia | $112,090 |
| 50 | Alabama | $110,860 |
| 51 | Mississippi | $106,820 |
Figures are U.S. Bureau of Labor Statistics OEWS annual mean wages, May 2025 (51 states/territories with published data; BLS suppresses states with samples too small to publish, and those are omitted rather than estimated).
Production percentage is the derm PA story. Many dermatology PAs earn a base plus a share of collections, so panel size, procedure mix, and cosmetic volume translate directly into income — top producers can meaningfully out-earn the specialty's own average. The trade-off is pace: derm clinics run dense schedules, and the premium is earned one fifteen-minute visit at a time.
The baseline still matters. Specialty premiums ride on top of local market rates, so a dermatology PA in a high-baseline state generally out-earns the same role in a low-baseline one. Cost of living then reshapes the real value — compare any two states with our cost-of-living tool before treating a bigger number as a better offer.
See who's hiring. Browse open Physician Assistant roles on VitalPost — free for clinicians, and pay is shown on a listing whenever the employer posts it.
A few caveats keep this table useful instead of misleading.
Median first, mean second. The mean is sensitive to a small number of very high earners; the median is the midpoint and usually the better proxy for a typical offer. Read both to understand the spread in your market.
One number, many jobs. Each state figure blends employers, settings, and experience levels — a first-year attending and a 25-year veteran, a rural solo practice and a flagship academic center — into a single average. Expect your own market position to move you off the line.
The survey measures wages, not packages. Bonuses, productivity incentives, call stipends, benefits, retirement match, paid time off, and loan repayment sit outside OEWS. Evaluate offers on total value.
Self-employment is invisible here. Partnership income and 1099 arrangements are not fully captured, which is one reason real-world compensation in some markets runs above what a wage survey suggests. And because PA pay is frequently hourly or shift-based in this specialty, always reduce competing offers to an effective hourly rate — including differentials — before comparing.
Browse open roles or create a free, anonymous profile and let employers come to you.
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