10 Highest-Paying Physician Assistant Specialties for 2025

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Physician assistants (PAs), also known as physician associates due to their expanding scope of practice, are playing an increasingly important part in primary care due to the ongoing physician shortage. The Health Resources & Services Administration (HRSA) projects a 12% shortage in doctors in 2027, jumping to 15% by 2032 and 16% by 2037.

Interestingly, the HRSA predicts a continuing overage of PAs. It projects that the supply of PAs between 2022 and 2037 will rise by 24% while the demand only increases by 13%, leaving an adequacy of 108% or an 8% overage nationwide. However, this overage is on a national scale, so it doesn’t take into account areas with a PA deficit or hospitals, especially those in health professional shortage areas or medically underserved areas, trying to make up for missing primary care doctors by utilizing PAs. 

The Bureau of Labor Statistics (BLS) anticipates a substantial 28% jump in demand for PAs between 2023 and 2033, with nearly 13,000 PA job openings each year of this decade. Because PAs can provide many of the same services as doctors but take much less time to complete their education and training, hospitals often tap them to fill staffing gaps, accounting for a chunk of the increasing demand.

The demand for PAs will also hinge on specialty, as some specialties have larger gaps than others. Specializing in a specific patient population or medical field can help your career prospects and your pocketbook. Vivian Health dove into our proprietary salary data to compare the average pay of real jobs posted on our site by hospitals and staffing agencies throughout 2024 to predict which specialties would command a premium in 2025. Here’s what we learned.

10 Top Paying PA Specialties Projected in 2025

PAs have over 60 specialties to choose from, meaning you can likely find a role that matches your interests and career goals. Vivian compared salary data for all PA specialties with job postings in 2024 to help predict which of these specialties should garner top pay in 2025. Armed with transparent salary details, you’re better equipped to negotiate your employment contracts or make important decisions about changing your area of practice to a more lucrative specialty. 

In previous years, we ranked physician assistant specialties using the top 10 highest average salaries among all travel jobs. However, travel physician assistant jobs aren’t as plentiful as other travel roles, and the travel industry as a whole hasn’t bounced back as anticipated. Many PA specialties had few, if any, travel jobs posted to our site throughout last year. Thus, the top 10 highest-paying PA specialties varied significantly based on staff PA jobs versus travel roles. 

Taking this into account, we changed our breakdown this year. Instead of ranking the 10 highest average salaries by specialty based on travel jobs, we provided a list of the top 5 staff and top 5 travel specialties based on average wages within each role type. 

We used average weekly pay instead of the maximum salary as this number can skew high or low based on a small number of unusually high-paying or low-paying jobs and may not accurately represent the highest-paying specialties over time. However, we provide the highest weekly rate to show the ceiling relative to 2024 job postings. 

The salaries provided represent jobs posted throughout 2024. They may differ from rates seen on Vivian’s current healthcare job pages as rates can vary weekly, sometimes even daily, due to new jobs posting and previous openings being filled. Nevertheless, the PA specialties listed in this annual review typically rank at the top of the staff or travel pay scale and should continue to do so in 2025.

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Top 5 Highest Average PA Staff Wages by Specialty

The one PA specialty you’ll see on both top 5 lists is cardiovascular/cardiothoracic surgery physician assistants. Ranking second for the highest average staff pay and first for the highest average travel salary, these specialized PAs frequently earn some of the highest wages and regularly appear on our countdown each year. Other than this specialty, the remaining four differ on both lists this year. The list below represents the top five staff PA specialties based on our research. 

1. Hospitalist Physician Assistant

• Relevant Certifications: BLS / PA-C / CAQ-HM
• Average Weekly Staff Rate: $3,870
• Highest Weekly Staff Rate: $4,615

Hospitalist PAs oversee patient care from admission to discharge, guiding treatment decisions for acute and chronic conditions. They perform initial assessments, interpret diagnostic tests and adjust treatment plans as needed. They keep hospital care cohesive by facilitating communication among multiple providers and ensuring each specialty’s recommendations are correctly implemented. Daily rounds let them monitor clinical progress and address complications promptly. They also document each step of a patient’s treatment, ensuring continuity and accuracy in medical records. 

Beyond direct care, hospitalist PAs educate patients and families on diagnoses, therapies and discharge instructions. Their focus on quality improvement often involves collaborating on hospital initiatives that enhance outcomes. Many also handle inpatient transitions, manage consults and oversee safe discharge planning to reduce readmission rates and coordinate follow-up.

2. Cardiovascular/Cardiothoracic Surgery Physician Assistant

• Relevant Certifications: BLS / ACLS / PA-C / CAQ-CVTS
• Average Weekly Staff Rate: $4,615
• Highest Weekly Staff Rate: $4,922

Cardiovascular/Cardiothoracic Surgery PAs handle complex heart and lung procedures in tandem with surgeons. They do vein harvesting, chest closure and advanced monitoring of cardiac function. Proficiency in specialized equipment like heart-lung bypass machines helps them manage critical events before, during and after surgery. Cardiovascular/cardiothoracic surgery PAs help optimize outcomes in high-risk, often life-saving surgeries by bridging pre-op assessments, intraoperative demands and post-op follow-up.

Responsibilities often include obtaining patient consent, reviewing imaging results, ensuring anesthesia coordination and guiding patient positioning. During bypass operations, they assist in placing conduits, controlling hemostasis and administering medications. Post-op, they track hemodynamics, adjust treatment plans and respond to complications like arrhythmias or bleeding. Some also manage ICU care and facilitate timely consults. They provide patient education on lifestyle changes for long-term cardiac health.

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3. Occupational Medicine Physician Assistant

• Relevant Certifications: BLS / PA-C / CAQ-OM
• Average Weekly Staff Rate: $3,533
• Highest Weekly Staff Rate: $4,182

Occupational Medicine PAs focus on preventing and managing work-related illnesses and injuries. They evaluate employees’ fitness for specific job roles through pre-employment screenings, assess and treat work-related incidents and develop and implement workplace health and safety programs. By identifying occupational hazards, they propose interventions that reduce risks, boost productivity and support regulatory compliance. 

Their responsibilities involve helping patients navigate workers’ compensation claims and advocating for safe workplace policies. Occupational medicine PAs are often involved in injury prevention programs, providing ergonomic assessments and recommending protective measures. They collaborate with employers, safety officers and industrial hygienists when addressing environmental exposures or designing return-to-work plans. These PAs also educate employees on injury prevention, workplace safety and safe equipment handling. Thorough documentation of clinical encounters and workplace assessments ensures a seamless flow of information and accountability.

4. Emergency Medicine Physician Assistant

• Relevant Certifications: BLS / ACLS / PA-C / CAQ-EM
• Average Weekly Staff Rate: $3,415
• Highest Weekly Staff Rate: $4,500

Emergency Medicine PAs handle everything from minor fractures to severe traumas, providing rapid evaluations, diagnoses and interventions under high-pressure conditions within emergency departments. They often perform advanced procedures like intubation, wound closure and sedation for painful treatments. Their role also involves interpreting ECGs and imaging scans, then quickly deciding on interventions or specialist consults.

Alongside trauma resuscitations, they manage acute medical crises such as heart attacks, strokes and sepsis, coordinating with nurses and first responders to stabilize patients. Shifts can involve juggling multiple cases, so clear communication and quick thinking are essential. Patient education is a priority, often guiding families through discharge instructions, medication regimens and follow-up needs. Despite the intensity, the impact on patient outcomes is immediate and profound.

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5. Pediatrics Physician Assistant

• Relevant Certifications: BLS / PA-C / CAQ-PEDS
• Average Weekly Staff Rate: $3,354
• Highest Weekly Staff Rate: $4,808

Pediatrics PAs focus on caring for infants, children and adolescents, diagnosing acute and chronic conditions. They handle everything from routine check-ups to disease management, ensuring young patients thrive. They interpret lab tests, administer immunizations and prescribe treatments suited for a child’s weight, age and developmental stage. Communication is key, with PAs educating parents on milestones, nutrition and common health concerns like ear infections or allergies. They also address behavioral and mental health issues, creating comprehensive treatment plans alongside pediatricians. 

Thorough documentation helps track growth patterns and immunization history. Pediatrics PAs promote healthier outcomes and encourage open dialogue between families and providers by offering anticipatory guidance and early intervention. Their goal is to support each child’s physical, emotional and developmental needs, building a safe, trusting environment.

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Top 5 Highest Average PA Travel Wages by Specialty

Travel PA jobs have historically been limited because obtaining licensure in multiple states is time-consuming and expensive. Unlike the Enhanced Nurse Licensure Compact, which is fully operational with 42 states or U.S. territories in the Compact, the PA Compact has only recently hit the threshold of enough states to move forward. The PA Compact Commission is working to make the Compact operational, with only 13 states having enacted it thus far. Although you may have difficulty finding travel contracts for these roles, the following list represents the PA travel roles with the highest average pay by specialty—typically higher than staff PAs in the same specialty.

1. Cardiovascular/Cardiothoracic Surgery Physician Assistant

• Relevant Certifications: BLS / ACLS / PA-C / CAQ-CVTS
• Average Weekly Travel Rate: $6,724
• Highest Weekly Travel Rate: $6,724

Cardiovascular/Cardiothoracic Surgery PAs handle complex heart and lung procedures in tandem with surgeons. They do vein harvesting, chest closure and advanced monitoring of cardiac function. Proficiency in specialized equipment like heart-lung bypass machines helps them manage critical events before, during and after surgery.

Responsibilities often include obtaining patient consent, reviewing imaging results, ensuring anesthesia coordination and guiding patient positioning. During bypass operations, they assist in placing conduits, controlling hemostasis and administering medications. Post-op, they track hemodynamics, adjust treatment plans and respond to complications like arrhythmias or bleeding. Some also manage ICU care and facilitate timely consults. They provide patient education on lifestyle changes for long-term cardiac health. By bridging pre-op assessments, intraoperative demands and post-op follow-up, they help optimize outcomes in high-risk, often life-saving surgeries.

2. Critical Care/Intensive Care Physician Assistant

• Relevant Certifications: BLS / ACLS / PA-C / CAQ-HM
• Average Weekly Travel Rate: $5,692
• Highest Weekly Travel Rate: $5,753

Critical Care/Intensive Care PAs treat patients with life-threatening conditions in specialized hospital units, guiding advanced interventions like intubation, central venous access and ventilator management. They monitor blood gases, vital signs and sedation levels, adjusting therapies in real time. Precision is essential as they coordinate with critical care physicians or intensivists to handle various critical conditions, including trauma, severe infections, organ failure and post-surgical recovery.

Their work includes analyzing complex data, from intracranial pressures to vasopressor requirements while coordinating daily care plans through interdisciplinary rounds. Critical/intensive care PAs also counsel families on prognosis, explaining complex interventions and facilitating end-of-life decisions when necessary. By blending continuous assessment with quick decision-making, these PAs maintain stability in dynamic clinical settings, aiming to reduce complications and improve survival rates.

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3. Obstetrics/Gynecology Physician Assistant

• Relevant Certifications: BLS / PA-C / CAQ-OBGYN
• Average Weekly Travel Rate: $4,884
• Highest Weekly Travel Rate: $4,884

Obstetrics/Gynecology (OB/GYN) PAs focus on women’s health, providing essential medical care related to pregnancy, childbirth and gynecological concerns. They assist obstetricians and gynecologists in delivering comprehensive care to female patients, including everything from routine exams to delivering babies vaginally or assisting with Cesarean sections, depending on the hospital and state. Some OB/GYN PAs also help with postpartum care, providing guidance on breastfeeding and recovery. 

OB/GYN PAs evaluate menstrual disorders, menopause symptoms and sexual health issues, often prescribing contraceptive methods or hormone therapy. They may conduct pelvic exams, pap smears and prenatal visits to monitor fetal development. Patient education is a key component, covering topics like family planning, safe sex practices and risk prevention. Their expertise addresses a broad spectrum of reproductive health needs so women receive specialized care throughout their lives.

4. Family Practice Physician Assistant

• Relevant Certifications: BLS / PA-C
• Average Weekly Travel Rate: $4,023
• Highest Weekly Travel Rate: $4,023

Family Practice PAs provide primary care for people of all ages, managing acute and chronic conditions while promoting preventive medicine across the lifespan. They conduct physical exams, order and interpret lab work and medical imaging, diagnose illnesses, prescribe medications, develop treatment plans and collaborate with physicians on complex issues. 

Through routine checkups and patient education, they help individuals maintain wellness and manage conditions like hypertension and diabetes. Their skill set extends to minor procedures and wound care, often acting as a point of continuity for families over time. They gather medical histories, track patient progress and update records with each visit, ensuring accuracy and accessibility across the healthcare team. PAs in family practice also coordinate referrals and follow-up appointments, forming strong patient-provider relationships that support long-term health.

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5. General Surgery Physician Assistant

• Relevant Certifications: BLS / ACLS / PA-C
• Average Weekly Travel Rate: $3,679
• Highest Weekly Travel Rate: $8,400

General Surgery PAs handle patient care throughout the surgical process, from pre-op evaluations to closing incisions. They keep track of lab results, refine treatment plans with the surgeon, manage pain medications, oversee antibiotic regimens and educate patients about post-op wound care. Procedures range from minor excisions to major abdominal interventions. In laparoscopic cases, they manipulate instruments and maintain clear visualization of the operative field. General surgery PAs are often hands-on, retracting tissue, performing hemostasis and placing drains. 

After surgeries, they follow each patient’s recovery, looking for complications and adjusting treatments. These PAs handle wound checks and suture removal, addressing concerns for seamless follow-up. Documentation is key so they maintain accurate records and facilitate communication among caregivers.

Elevate Your Salary with PA Specialties

Becoming a PA is a long-term commitment that requires obtaining a license to practice medicine. To earn licensure, you must earn an undergraduate degree, graduate from a master-level Accreditation Review Commission on Education for the Physician Assistant accredited entry-level PA program and pass the Physician Assistant National Certifying Examination or PANCE. Once passed, PAs earn the National Commission on Certification of Physician Assistants (NCCPA) certification and can use the PA-C designation. However, they must still apply for licensure within their state(s) of practice.

While salaries for PAs vary based on education, experience, facility and location, specialty can significantly affect how much you take home each pay period. Specializing in specific patient populations or conditions can boost a PA’s salary. 

Specialty certifications offered by the NCCPA are called Certificates of Added Qualifications (CAQs). These voluntary credentials prove that a Board-Certified PA has advanced knowledge and expertise in their chosen field. While the NCCPA doesn’t offer CAQs for every specialty, it currently offers the following certifications that align with popular ones:

• Cardiovascular and Thoracic Surgery CAQ
• Dermatology CAQ
• Emergency Medicine CAQ
• Geriatric Medicine CAQ (Coming in 2026)
• Hospital Medicine CAQ
• Nephrology CAQ
• Obstetrics and Gynecology CAQ
• Occupational Medicine CAQ
• Orthopaedic Surgery CAQ
• Pediatrics CAQ
• Palliative Medicine and Hospice Care CAQ
• Psychiatry CAQ

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Additional Physician Assistant Specialties

While these PA specialties didn’t land in the top 10 highest-paying positions on this year’s list, they still present attractive career opportunities. These specialized fields, ranging from pain management to pediatrics, provide unique opportunities to develop specific skills and expertise. PAs can gain valuable experience and contribute to delivering high-quality patient care by pursuing a career in one of these niche areas.

Specialty	Avg Weekly Staff Pay	Max Weekly Staff Pay
Cardiology	$3,290	$4,308
Dermatology	$3,199	$4,182
Orthopedic Surgery	$3,175	$3,846
Gastroenterology	$3,006	$3,590
Integrative Health	$2,981	$3,077
Urology	$2,969	$3,764
Pain Management	$2,853	$3,173
Urgent Care	$2,842	$4,000
Neurosurgery	$2,740	$3,590

Demand for PAs within a specific field can vary by state, city and facility based on local needs, potentially driving up salaries in some locations but not others. Whether you’re a current PA looking to specialize or a student contemplating a career path, our analysis, which we update annually, provides valuable insight into where the greatest earning potential lies within this essential healthcare profession.

Download the Vivian App and take your healthcare career to the next level by applying for staff or travel positions within one of these high-paying PA specialties.

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