We’re sharing the latest pay and productivity data from our survey!
While year-over-year pay increases are moderating for APPs, compensation growth for anesthesiology and leadership roles continues at a faster rate.
Total Cash Compensation
Pay increases are slowing
Median total compensation (TCC) is up double digits since 2023 across every core specialty group, and yet year-over-year gains have moderated from the highs of 2024–2025.
TCC figures exclude premium pay (shift differentials, call pay, extra shifts) unless otherwise noted.
HOSPITAL-BASED
$71.96/hr TCC, 2026 | Up 12% since 2023
MEDICAL
$69.71/hr TCC, 2026 | Up 11% since 2023
SURGICAL
$71.26/hr TCC, 2026 | Up 12% since 2023
PRIMARY CARE
$70.76/hr TCC, 2026 | Up 13% since 2023
Anesthesiology Providers
CRNAs and CAAs are outrunning the broader market
As the demand for these providers remains high, CAA pay is climbing fastest as organizations are working to close the gap with CRNA compensation.
CRNA
$125.00/hr TCC, 2026
Up 19.3% since 2023
CAA
$118.99/hr TCC, 2026
Narrowing the gap with CRNA pay
Up 30.2% since 2023
Pediatric CRNA
$125.44/hr TCC, 2026
0.4% above general CRNA pay
Up 19.7% since 2023
Incentive Compensation
Primary care is where incentives are growing fast
Just over half (52%) of organizations use incentive pay for at least some APPs — and primary care’s median incentive amount jumped from $10,000 to more than $12,500 this year.
Leadership Compensation
APP leadership is formalizing fast
Dedicated executive-level APP roles have roughly tripled in three years, and pay premiums scale with the size of the leadership seat.
- 3.1x more incumbents held Top APP Executive roles in 2025 compared to 2023.
- 2.7x more incumbents held Head of APP roles in 2026 compared to 2023.
Retention and Mobility
Turnover keeps trending down
External turnover among NPs and PAs has fallen every year since 2023, even as sign-on bonus practices have held steady.
- Internal turnover was only 4% in 2026, holding steady with 2025
- 79.8% of organizations offer sign-on bonuses – median is $7,500
- 51.9% offer retention bonuses – median is $5,000
Key Takeaways
Total rewards win talent
Base salary, incentives, and premium pay each play a distinct role in attracting and retaining APP talent. Organizations that lean on only one lever are competing with one hand tied.
Incentives are gaining ground
Pay for APPs remains competitive overall, and incentives are playing a growing role in total cash compensation. Primary care APPs in particular are seeing outsized incentive growth.
Anesthesiology demand hasn’t slowed
CRNAs and CAAs remain in high demand, and organizations are pulling multiple levers, including sign-on bonuses, retention bonuses, and shift differentials, to attract and retain them.
Leadership is formalizing
APP leadership structures are becoming more formal and strategic, with expanded, dedicated roles like the Top APP Executive position becoming more common.
