Registered Nurse vs Physician Assistant: Which Pays More?

Side-by-Side Pay Comparison

All figures below come from the U.S. Bureau of Labor Statistics Occupational Employment and Wage Statistics release for May 2025 unless marked otherwise.

Both bonus cells read "none" because the May 2025 wage release reports hourly and annual wage estimates rather than bonuses — not because nothing is paid. RN work is more often scheduled and paid by the hour from that $46.90 median, with extra shifts and night or weekend differentials added by the employer or, in a unionized hospital, by contract. PA work is more often salaried against the $135,880 annual median, with any call or productivity bonus written into the individual offer. Ask for the differential, call rate and bonus formula in dollars before you compare two offers.

PA wage estimates are published for 51 of 51 areas — the 50 states and the District of Columbia — in the May 2025 release (Prospyr, 2025), so you can check your own state instead of relying on the national median.

Why the Gap Exists

Two structural factors account for most of the $38,330 difference between the $135,880 PA median and the $97,550 RN median.

Training length and a credential you have to renew. Typical entry-level education for an RN is a bachelor's degree, and three routes exist: a BSN of about four years, an associate's degree, or a hospital diploma program usually taking two to three years (U.S. Bureau of Labor Statistics, 2025). RNs then need a license issued by the state where they work, which means graduating from an approved program and passing a qualifying exam. PA entry sits a level above: a master's degree, with programs usually running at least two years of postbaccalaureate study including classroom, lab and supervised clinical training in specialties such as family medicine, internal medicine and emergency medicine (U.S. Bureau of Labor Statistics, 2025). All states license PAs; passing the qualifying exam allows use of the PA-C credential, and keeping it requires continuing education and a recertification exam. That longer, renewable pipeline shows up at the bottom of the range — the lowest-paid 10 percent of PAs still earn more than $99,380 a year, above the $97,550 RN median.

Workforce size and demand. There were 3,465,400 RN jobs in 2025 against 168,900 PA jobs (U.S. Bureau of Labor Statistics, 2025), and projected employment growth over 2025–35 is 6 percent for RNs against 21 percent for PAs. An employer filling a nursing roster recruits from a far larger national pool than one filling a PA vacancy.

Industry mix is not the explanation. Within government excluding state/local education and hospitals, the May 2025 medians were $110,780 for RNs and $157,040 for PAs, so the gap survives inside a single employer type. The ranges do overlap, though: the top 10 percent of RNs earn more than $137,470 a year, above the $135,880 PA median.

Where Each Role Pays Best

Median annual wages by state, May 2025 (Prospyr, 2025).

California is the top-paying state for registered nurses at $140,270, and New Jersey is the top-paying state for physician assistants at $165,690, narrowly ahead of California at $165,650.

Where the usual order reverses:

• California's $140,270 RN median is above the $135,880 national PA median.
• The RN medians in California ($140,270), Hawaii ($136,320) and Oregon ($129,010) all exceed the $104,960 PA median in Alabama.

Inside any one state the PA median stays ahead: $165,650 against $140,270 in California, $164,360 against $124,200 in Washington, $104,960 against $77,080 in Alabama.

Which Path Fits You

• You want to start earning in two to three years. Registered nursing — an associate's degree or hospital diploma program usually takes two to three years (U.S. Bureau of Labor Statistics, 2025), against a bachelor's degree plus at least two years of postbaccalaureate study for a PA. The RN median is $97,550 a year, or $46.90 an hour.
• You want the higher ceiling and accept longer schooling. Physician assistant. The top 10 percent earn more than $190,280 a year, against more than $137,470 for the top 10 percent of RNs.
• You want the highest floor. Physician assistant. The lowest-paid 10 percent earn less than $99,380 a year, against less than $68,940 for RNs — the PA floor sits above the $97,550 RN median.
• You want hour-by-hour control over earnings. Registered nursing, where the $46.90 median hourly rate is the base for extra shifts and differentials, rather than a salary set against the $135,880 PA median.
• You are staying in a lower-paying state. Weigh a move before a degree: Alabama medians are $77,080 for RNs and $104,960 for PAs, while California's RN median is $140,270 (Prospyr, 2025).
• You want the fastest-growing field. Physician assistant, projected to grow 21 percent over 2025–35 from 168,900 jobs, against 6 percent from 3,465,400 RN jobs.
• You would rather not work under a supervising-physician agreement. Registered nursing. Most states require PAs to hold such an agreement (U.S. Bureau of Labor Statistics, 2025).