By VitalPost Editorial · August 15, 2026
Emergency departments lean heavily on PAs — and pay for it. The state-by-state PA baseline, plus what pushes EM PA compensation above it.
Emergency medicine is one of the largest and best-paying PA practice settings: departments staff PAs across fast-track and main-ED roles, around the clock, every day of the year. That 24/7/365 reality — nights, weekends, holidays — is exactly why EM consistently shows up above the all-specialty average in PA compensation surveys.
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. Emergency medicine 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).
Shift differentials do the heavy lifting. EM PA pay is usually hourly, and the premium lives in the details: night and weekend differentials, holiday rates, patient-acuity mix, and whether you're covering fast track or running high-acuity pods with significant autonomy. Rural and single-coverage EDs — where the PA is the front line — often pay the strongest rates of all.
The baseline still matters. Specialty premiums ride on top of local market rates, so a emergency medicine 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.
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