Nurse practitioner specialties can be quite lucrative. Anesthesiology NPs earn an average salary of $152,697. The job market looks promising too. The Bureau of Labor Statistics expects nurse practitioner positions to grow by 46% from 2023 to 2033, which means 135,500 new jobs across the country.

Nurse practitioners earn a median annual income of $93,600, though salaries vary by a lot based on specialty and location. Recent BLS data shows physician assistants earn more, with median salaries reaching $130,020 per year. The top-paying PA specialties show similar trends. Cardiovascular and cardiothoracic surgery PAs receive median compensation packages of $152,500. PAs who work in operating rooms or surgical centers earn the most at $158,000 annually.

This piece breaks down the highest-paying NP specialties and physician assistant jobs in 2025. You’ll learn about salary expectations for different specialties, geographic factors, and what drives earning potential in these healthcare careers.

Understanding the Salary Landscape for NPs and PAs

Advanced practice providers have amazing financial opportunities ahead in 2025. Let’s look at what these healthcare professionals earn and what shapes their income potential.

Average NP and PA salaries in 2025

The money keeps getting better for advanced practice providers in 2025. Nurse practitioners now earn an average annual salary of $132,000 nationwide, which works out to $63.46 per hour ^[1]. Physician assistants take home a median annual salary of $130,020 ^[2], showing these roles pay about the same.

NP salaries got a big boost lately. Average earnings jumped 14% in just one year—reaching $135,000 in 2023 compared to $121,000 in 2022 ^[3]. Education makes a difference too. NPs with doctoral degrees earn around $136,000 yearly, which is 7% more than previous years ^[3].

Where you work really affects how much you make. The Pacific region tops the charts at $170,000 ^[3]. California leads all states at $173,190, with Nevada ($148,670), Washington ($143,620), New Jersey ($140,470), and Oregon ($148,030) following behind ^[1]. These differences reflect local living costs and healthcare needs.

Growth trends in advanced practice roles

The job market looks incredibly strong for both NPs and PAs. The Bureau of Labor Statistics expects NP jobs to grow by 46% from 2021 to 2031 ^[4], adding 135,500 new positions across the country. PA jobs should grow by 28% from 2023 to 2033 ^[2], which is way ahead of the 4% average for all jobs.

Right now, 385,000 nurse practitioners can practice in the United States ^[5], and this number keeps growing fast. About 148,000 people worked as PAs in 2022 ^[6], and roughly 12,200 new PA jobs should open up yearly over the next decade ^[6].

This amazing growth comes from:

• More older patients who need healthcare
• People realizing how economical advanced practitioners are
• More states expanding what these professionals can do
• A bigger focus on preventing illness

Why specialty choice matters

Your specialty choice can make a huge difference in your paycheck. PAs who switch from primary care to specialized fields often see their income jump substantially. Primary care PAs usually earn $115,000-$125,000 ^[2], but those in cardiovascular surgery ($213,000), emergency medicine ($290,000), and oncology ($352,000) earn much more ^[7].

NP specialties also affect earning power. The top-paying NP fields include Psychiatry ($138,723), Cardiology ($132,000), and Pain Medicine ($128,000) ^[8]. Critical Care NPs bring home $130,000 yearly, while Emergency NPs earn about $126,000 ^[4].

PAs have one big advantage – they can switch specialties pretty easily throughout their careers ^[2]. This flexibility lets them plan strategically and boost their earning potential without going back to school.

These big pay differences between specialties make specialty choice a vital financial decision, along with personal interests and lifestyle needs.

Highest Paying Nurse Practitioner Specialties in 2025

Nurse practitioners can choose from several profitable specialties that rank among healthcare’s top-paying roles in 2025. These NPs earn premium salaries because of their advanced skills, vital responsibilities, and high market demand.

1. Esthetic Nurse Practitioner

Esthetic nurse practitioners top the list as 2025’s highest-earning NP specialty, with median annual earnings of $141,375 ^[9]. They work at medical spas, dermatology clinics, and private practices. Their daily work includes performing cosmetic procedures like Botox injections, dermal fillers, and skin rejuvenation treatments.

These specialists earn between $121,912 and $164,704 each year ^[9]. Experience plays a big role in what they make. New esthetic NPs start at around $90,540 yearly, but veterans with 20+ years can earn up to $171,300 ^[10]—double what beginners make.

Their pay structure is different from other NP roles. Most cosmetic services aren’t covered by insurance, so many esthetic NPs work on performance-based pay that ties directly to their client revenue ^[10].

2. Neonatal Nurse Practitioner

Neonatal nurse practitioners come in second with yearly salaries ranging from $135,000 to $145,000 ^[11]. Some reports show median earnings as high as $147,680 ^[12]. These specialists take care of premature and medically fragile newborns in neonatal intensive care units.

Experience makes a big difference in this field. New NNPs start at $79,870 per year. With 10-19 years under their belt, they can make around $125,390—a 57% jump ^[13]. Veterans with 20+ years earn up to 88% more than beginners ^[13].

Location matters too. NNPs in Two Rivers, WI ($184,388) and Berkeley, CA ($167,319) earn some of the highest salaries nationwide ^[14].

3. Emergency Nurse Practitioner

Emergency nurse practitioners make between $120,000 and $130,000 yearly ^[11], with some earning up to $148,506 ^[12]. They provide urgent care in fast-paced emergency departments and trauma centers where quick decisions save lives.

The typical ENP salary in 2025 is $135,118, ranging from $122,969 to $149,930 based on experience and location ^[15]. California leads the pack—ENPs there average $161,540 yearly ^[15].

ENPs in San Jose-Sunnyvale-Santa Clara, CA ($191,250) and Napa, CA ($187,640) ^[15] earn the most, showing how location can boost earning potential.

4. Psychiatric Mental Health Nurse Practitioner

Psychiatric-mental health nurse practitioners earn $140,000 to $150,000 yearly ^[11], placing them among the highest-paid specialists. Their vital role in helping with the growing mental health crisis drives both job demand and salaries.

The Health Resources and Services Administration expects a 17% rise in PMHNP numbers between 2016 and 2030, but shortages will likely continue ^[16]. This supports strong salary growth. PMHNPs averaged $134,000 in 2022 ^[16]. High-demand areas like Waterbury, CT and Chattanooga, TN offer even more—between $200,650 and $232,909 ^[16].

5. Oncology Nurse Practitioner

Oncology nurse practitioners specialize in cancer treatment and earn $125,000 to $135,000 yearly ^[11]. Their expertise in complex treatments and patient support commands top-tier pay.

These specialists in Los Angeles average $131,698 yearly, with pay ranging from $109,679 to $151,651 ^[17]. Experience boosts earnings steadily—new practitioners start around $127,913, while those with 8+ years reach about $135,127 ^[17].

Highest Paid PA Specialties in 2025

Physician assistants in specialized fields are seeing remarkable salary growth in 2025. Let’s take a closer look at the five best-paying PA specialties and what makes them such attractive career choices.

1. Cardiovascular Surgery PA

Cardiovascular and cardiothoracic surgery PAs lead the specialty earnings with an average annual salary of $213,124 ^[18]. These skilled professionals work alongside surgeons during complex heart and lung procedures. They handle patient assessments before surgery and take care of post-operative care.

Most PAs in this field earn between $154,000 and $250,000, while top performers can make up to $270,000 yearly ^[18]. The specialty employs 2.4% of all PAs, who typically bring 7-9 years of experience to these challenging positions ^[1]. Their pay package usually comes with bonuses around $8,000 ^[1], which reflects the critical nature of cardiovascular procedures.

2. Dermatology PA

Dermatology PAs stand second among the highest-paid specialties, with total yearly earnings of $260,529 and a base salary averaging $178,170 ^[19]. These specialists treat various skin conditions and perform cosmetic procedures.

The specialty attracts 3.2% of PAs ^[1]. Their earnings mix a base salary (median $120,000) with performance bonuses (median $15,000) ^[1]. Location plays a big role in earnings potential – Berkeley, CA leads with annual salaries reaching $211,074 ^[20].

3. Emergency Medicine PA

Emergency medicine PAs take third place with yearly earnings around $207,141 ^[21]. These vital care providers thrive in high-pressure environments while treating patients from all walks of life.

Emergency medicine PAs can earn $139.86 per hour ^[22], which adds up to about $290,916 for full-time work. The field employs 6.7% of PAs ^[1], who typically have 6 years of experience. Scotts Valley, CA ($376,472) and Nome, AK ($360,879) offer the highest salaries ^[22].

4. Occupational Medicine PA

Occupational medicine PAs focus on workplace health and injury care, earning $138,000 yearly ^[1]. Their work involves employee health screenings, treating work injuries, and creating safety programs.

These specialists make up just 1.2% of all PAs ^[1] but bring substantial experience (median 15 years) to their work. They typically earn a base salary of $133,588 plus performance bonuses around $5,061 ^[1].

5. Orthopedic Surgery PA

Orthopedic surgery PAs complete the top five list with yearly earnings of $113,692 ^[23]. Their total pay can reach $160,000 with added bonuses and profit sharing ^[23].

These PAs help during orthopedic surgeries, read diagnostic images, and manage patient care before and after procedures. The specialty employs 10.1% of PAs ^[24]—the largest share among top-paying specialties—with most bringing 7 years of experience to their roles.

Key Factors That Impact Earning Potential

Advanced practice providers can boost their earnings beyond just picking a specialty. Let’s look at what drives compensation for nurse practitioners and physician assistants.

Geographic location and state regulations

Your practice location makes a big difference in your income. The Pacific region tops the salary charts at $170,000, while the East South Central region (Alabama, Kentucky, Mississippi, Tennessee) comes in lowest at $143,000 ^[25]. This $27,000 gap shows how market forces and regulations shape earnings.

State practice authority laws shape compensation too. NPs earn more in states with full practice authority than in states with restrictions ^[3]. When NPs can work without physician oversight, they become more valuable and earn higher pay ^[25].

Specialty demand and job availability

Different specialties can mean very different paychecks. Psychiatric Mental Health NPs earn premium salaries because of nationwide shortages ^[2]. The same goes for surgical-specialty PAs and CRNAs – they help healthcare organizations cut costs while keeping quality high ^[2].

Advanced certifications and education level

Education pays off in this field. NPs with doctoral degrees earn $136,000 on average each year—that’s 7% more than last year ^[25]. Master’s degree holders average $132,000, up 4% from last year ^[25].

Experience adds up too. APRNs with over 10 years of practice earn $152,000-$154,000 yearly, while those with 6-10 years make $138,000 ^[25].

Practice setting and patient volume

Your workplace choice affects your earnings:

• Hospital settings (inpatient): $139,000 for NPs ^[8]
• Hospital-based outpatient: $128,000 ^[8]
• Medical offices/urgent care: $119,000 ^[8]

PAs in operating rooms and surgical centers earn the most at $158,000 ^[26]. Educational settings offer lower pay, with median salaries around $115,160 ^[27].

Payment structure matters too. NPs paid by the hour average $137,000 yearly compared to $131,000 for salaried NPs ^[25]. This difference exists because hourly workers can pick up extra shifts and overtime.

Career Planning Tips for Aspiring NPs and PAs

A strategic career plan will maximize your potential in the highest paying nurse practitioner specialties and physician assistant roles. Let’s take a closer look at practical steps that will position you for success in these lucrative healthcare careers.

Start with a clear goal and timeline

Your five-year career plan will enable you to take charge of your professional development ^[7]. Write out your original short and long-term objectives using the SMART methodology. Your goals should be Specific, Measurable, Achievable, Relevant, and Time-bound ^[7]. This organized approach lets you reassess and redirect as your career grows.

Each annual goal needs a concrete first action step. You should identify resources that will help you succeed through professional networks, training programs, or mentors with specialized knowledge ^[7]. Set up metrics to measure your progress and stay accountable.

Choose programs arranged with your specialty

The right educational path should focus entirely on your target clinical area ^[4]. This population-focused education means your time goes to the specialty where you’ll end up practicing ^[4].

Take time to research different pathways. Find programs that match both your career objectives and experience level ^[28]. Note that NP specialty programs usually take two to three years full-time. Some specialties like family practice offer accelerated options ^[28].

Think over locum tenens or travel roles to gain flexibility

Locum tenens positions give you unmatched flexibility and competitive pay—often 63% higher than permanent positions ^[29]. These temporary assignments let you control your schedule. You pick only positions that fit your lifestyle ^[30].

Healthcare practitioners love the reduced administrative work. They can focus more on clinical duties. NP Katherine Allen shares her experience: “I have never worked a weekend or on call while working a travel assignment” ^[30]. These roles also give you valuable exposure to a variety of clinical settings, which enhances your skills and marketability.

Stay current with industry trends and salary data

Professional development is vital as healthcare keeps changing ^[31]. Professional organizations, conferences, and advanced certifications will keep you current with emerging specialties and practice models ^[5].

The Bureau of Labor Statistics shows NP roles will grow 40% from 2023-2033 ^[5]. Fields like psychiatry, oncology, and geriatrics just need more specialized expertise ^[5]. Watching these trends helps you position yourself better as the digital world evolves.

Conclusion

Healthcare’s advanced practice roles are opening up amazing career paths today. In this piece, we look at the most profitable specialties for nurse practitioners and physician assistants that show incredible earning potential in any discipline. Esthetic NPs lead the pack with median yearly earnings of $141,375. Cardiovascular surgery PAs earn even more, with salaries up to $213,124 per year.

Your choice of specialty is a vital factor that shapes your financial future. Primary care providers usually earn between $115,000-$125,000. Specialists in dermatology or emergency medicine can earn double or triple these amounts. Location plays a big role too. Practitioners in the Pacific region earn substantially more than those working elsewhere.

Higher education and experience boost your earning power. NPs with doctoral degrees earn 7% above average. Those with over 10 years of experience make $152,000-$154,000 yearly, which is much higher than their newer colleagues. Your workplace matters too. Hospital jobs typically pay better than outpatient roles.

The job market looks promising. Growth projections show a 46% increase for NPs and 28% for PAs through 2033, which points to steady demand. Changing scope-of-practice laws and an aging population needing more care suggest salaries will keep rising. New practitioners should think about their specialty choice carefully. They need to balance their interests with money matters and develop career plans that maximize both job satisfaction and income potential.

FAQs

Q1. Which advanced practice role typically earns more: nurse practitioners or physician assistants? While salaries can vary based on factors like specialty and location, physician assistants generally earn slightly more on average. Recent data shows PAs with a median annual salary of $130,020, compared to $128,490 for nurse practitioners.

Q2. What is the projected job growth for nurse practitioners in the coming years? The job outlook for nurse practitioners is exceptionally strong. The Bureau of Labor Statistics projects a 46% increase in NP positions from 2023 to 2033, making it one of the fastest-growing healthcare careers.

Q3. Which nurse practitioner specialty offers the highest earning potential? While salaries vary, esthetic nurse practitioners currently lead as the highest-earning NP specialty, with median annual earnings of $141,375. Other top-paying specialties include neonatal, emergency, and psychiatric mental health nurse practitioners.

Q4. How can nurse practitioners maximize their earning potential? To maximize earnings, NPs should consider specializing in high-demand fields, pursuing advanced certifications, gaining experience, and being open to working in high-paying geographic areas. Additionally, exploring roles in hospital settings or considering locum tenens positions can boost income.

Q5. What factors most significantly impact the salaries of advanced practice providers? The most influential factors affecting NP and PA salaries include specialty choice, geographic location, years of experience, practice setting (e.g., hospital vs. outpatient), and level of education. State regulations regarding scope of practice can also play a role in earning potential.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

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