How to Save as a PA-C (or Any Medical Professional Earning $100K+)

If you're a practicing PA, a PA student, or even considering PA school, you're probably asking yourself: Is the debt worth it? The good news? PA salaries are going up. The better news? You have more control over your income than you might think.

PA Salaries Are On the Rise (But Uneven)

According to the latest AAPA Salary Report, PA earnings rose 5.5% in 2024 alone. MGMA data shows:

• Surgical PAs: median is up 15% since 2020
• Non-surgical, non-primary care PAs: median is up 21%
• Primary care PAs: median is up 30%

Sounds great for primary care, right? Not so fast. That percentage growth only tells part of the story. You need to look at absolute numbers and actual earning potential across subspecialties.

The 3 Highest Paying PA Specialties in 2025

Using Marit Health salary data, these are the current top-paying specialties:

1. Dermatology — Average: $166K/year
• Avg. weekly hours: 37
• Also has highest percent of PAs earning $200K+
2. Critical Care — (as a critical care PA myself, I’m not mad about this!)
3. Cardiothoracic Surgery — Higher avg. hours/week but higher comp

Other honorable mentions: Psychiatry and Plastics, both with high intra-specialty pay variance (more on that below).

What Intra-Specialty Variance Means for Your Salary

Even within the same specialty, some PAs are earning double what others are. This is known as intra-specialty variance. Top specialties with high variance include:

• Dermatology
• Emergency Medicine
• Psychiatry
• Plastics

✅ High variance = higher ceiling. If you’re underpaid, the solution might be a better job in the same specialty, not switching fields.

Surprising Data: Why ENT and Emergency Med Aren’t the Same

ENT and Emergency Med have similar average salaries. But when it comes to hitting the $200K mark?

• Emergency Medicine: Nearly 8% of PAs earn $200K+
• ENT: One of the lowest percentages in the $200K club

👉 Translation: In Emergency Medicine, there’s room to grow (driven by intraspecialty variance). In ENT, the ceiling is much lower.

The Lowest Paying PA Specialties in 2025

Not all specialties are built equally. According to the same dataset, the lowest paying fields are:

• Neurology
• Gastroenterology (GI)
• Pediatrics
• Pain Management

Even worse? ❌ These specialties still work ~40 hours/week on average. So no - lower pay doesn’t necessarily equal better work-life balance.

Salary vs. RVU: Contract Structures Matter More Than You Think

The biggest factor in whether you hit $200K+? How you’re paid.

• Only 5% of salaried PAs hit $200K/year
• But 20%+ of PAs on RVU or percent-of-collections contracts do

💡 Dermatology contracts often use percent of collections, percent of net income, or productivity based wRVU metrics. Pediatrics? Mostly salary. Contract type may actually be a large underlying driver of differences in compensation between specialties.

Location, Cost of Living & Your Real Salary

Yes, PAs on the West Coast (California, Washington, Oregon) often earn more. Many sources cite that the primary driver of this is a broader scope of practice. But don’t be fooled by the headline number.

• California housing costs are 57% above the national average
• A $200K salary in San Francisco equates to earning $125K in Boise, Idaho (NerdWallet)

📍 If you're not being paid in the 75th percentile or above, high cost-of-living areas may slow down your wealth-building goals - even with an impressive salary number. 

What to Do If You Want to Earn More in 2025

1. Choose your specialty wisely. Dermatology, psychiatry, critical care, and CT surgery offer both high pay and high variance.
2. Understand your contract. Ask: Is this salary, RVU-based, or a percent-of-collections model?
3. Compare cost of living. Use tools like SmartAsset or NerdWallet calculators.
4. Negotiate like your future depends on it. Because it does.

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