The median annual salary for an adult-gerontology nurse practitioner (AGNP) is approximately $119,000–$128,000, based on AANP 2024 Compensation Survey specialty data and BLS Occupational Employment and Wage Statistics (SOC 29-1171, May 2024). The all-NP national median is $128,490 — AGNPs typically land slightly below that benchmark in primary care settings and slightly above it in acute care. Most AGNPs earn between $105,000 and $145,000, with the highest salaries concentrated in California, New Jersey, New York, and Oregon.
Here is how those numbers break down by state, setting, and career stage.
| Metric | Value | Source |
|---|---|---|
| NP national median (all specialties) | $128,490 | BLS OEWS, May 2024 |
| NP national mean (all specialties) | $132,050 | BLS OEWS, May 2024 |
| AGNP primary care estimated median | ~$119,000 | AANP 2024 Compensation Survey |
| AGNP acute care estimated median | ~$125,000 | AANP 2024 Compensation Survey |
| AGNP 25th percentile | ~$99,000 | NPHub / aggregated survey data |
| AGNP 75th percentile | ~$126,000 | NPHub / aggregated survey data |
| AGNP entry-level (new grad) | ~$89,500–$95,000 | NPHub / PayScale 2025 |
| AGNP top earners (senior, high-cost state) | $145,000–$165,000+ | AANP / Nurse.org |
National AGNP salary overview
The BLS reports salary data for all nurse practitioners under a single occupational code (SOC 29-1171) — it does not break out AGNPs as a separate subcategory. The national NP median is $128,490 and the mean is $132,050 (BLS OEWS, May 2024). AGNP-specific data comes from the AANP annual compensation survey, which consistently shows primary care AGNPs earning around $119,000 and acute care AGNPs around $125,000.
AGNPs tend to earn less than the all-NP median for a straightforward reason: a significant portion of AGNPs practice in primary care, outpatient clinics, and long-term care facilities, which pay less than the hospital-based acute care and procedural settings that pull the all-specialty mean upward. Acute care AGNPs — those working in hospital medicine, ICU step-down, and hospitalist-support roles — close most of that gap and often exceed the NP median.
The 10th–90th percentile spread for AGNPs runs roughly $80,000 to $155,000. That $75,000 spread reflects geographic variation, employer type, practice authority, and subspecialty.
AGNP salary by state
The table below uses BLS OEWS May 2024 state-level data for all nurse practitioners (SOC 29-1171). Because BLS does not report AGNP-specific state figures, these represent the NP baseline from which AGNP salaries are derived — adjust approximately $5,000–$10,000 downward for primary care AGNP roles and $0–$5,000 upward for acute care AGNP roles in each state.
| State | NP annual mean (BLS, May 2024) | AGNP primary care est. | Data basis |
|---|---|---|---|
| Alabama | $110,020 | ~$100,000–$106,000 | BLS OEWS confirmed |
| Alaska | $126,170 | ~$116,000–$122,000 | BLS OEWS confirmed |
| Arizona | $132,560 | ~$122,000–$128,000 | BLS OEWS confirmed |
| Arkansas | $113,410 | ~$103,000–$109,000 | BLS OEWS confirmed |
| California | $161,540 | ~$148,000–$156,000 | BLS OEWS confirmed |
| Colorado | $121,990 | ~$112,000–$118,000 | BLS OEWS confirmed |
| Connecticut | $136,980 | ~$126,000–$133,000 | BLS OEWS confirmed |
| Delaware | $131,110 | ~$121,000–$127,000 | BLS OEWS confirmed |
| District of Columbia | $134,850 | ~$124,000–$130,000 | BLS OEWS confirmed |
| Florida | $119,710 | ~$110,000–$116,000 | BLS OEWS confirmed |
| Georgia | $121,150 | ~$111,000–$117,000 | BLS OEWS confirmed |
| Hawaii | $132,610 | ~$122,000–$128,000 | BLS OEWS confirmed |
| Idaho | $124,550 | ~$114,000–$120,000 | BLS OEWS confirmed |
| Illinois | $126,900 | ~$116,000–$123,000 | BLS OEWS confirmed |
| Indiana | $123,320 | ~$113,000–$119,000 | BLS OEWS confirmed |
| Iowa | $130,820 | ~$120,000–$126,000 | BLS OEWS confirmed |
| Kansas | $119,270 | ~$109,000–$115,000 | BLS OEWS confirmed |
| Kentucky | $110,370 | ~$101,000–$107,000 | BLS OEWS confirmed |
| Louisiana | $118,670 | ~$109,000–$115,000 | BLS OEWS confirmed |
| Maine | $122,940 | ~$113,000–$119,000 | BLS OEWS confirmed |
| Maryland | $127,990 | ~$118,000–$124,000 | BLS OEWS confirmed |
| Massachusetts | $144,010 | ~$133,000–$140,000 | BLS OEWS confirmed |
| Michigan | $120,680 | ~$111,000–$117,000 | BLS OEWS confirmed |
| Minnesota | $135,010 | ~$124,000–$131,000 | BLS OEWS confirmed |
| Mississippi | $117,490 | ~$108,000–$114,000 | BLS OEWS confirmed |
| Missouri | $116,680 | ~$107,000–$113,000 | BLS OEWS confirmed |
| Montana | $124,640 | ~$114,000–$120,000 | BLS OEWS confirmed |
| Nebraska | $121,680 | ~$111,000–$118,000 | BLS OEWS confirmed |
| Nevada | $148,670 | ~$136,000–$144,000 | BLS OEWS confirmed |
| New Hampshire | $130,740 | ~$120,000–$126,000 | BLS OEWS confirmed |
| New Jersey | $145,030 | ~$133,000–$141,000 | BLS OEWS confirmed |
| New Mexico | $136,770 | ~$126,000–$133,000 | BLS OEWS confirmed |
| New York | $142,830 | ~$131,000–$138,000 | BLS OEWS confirmed |
| North Carolina | $121,590 | ~$111,000–$118,000 | BLS OEWS confirmed |
| North Dakota | $127,760 | ~$117,000–$124,000 | BLS OEWS confirmed |
| Ohio | $122,870 | ~$113,000–$119,000 | BLS OEWS confirmed |
| Oklahoma | $124,330 | ~$114,000–$120,000 | BLS OEWS confirmed |
| Oregon | $144,950 | ~$133,000–$140,000 | BLS OEWS confirmed |
| Pennsylvania | $127,450 | ~$117,000–$123,000 | BLS OEWS confirmed |
| Rhode Island | $133,460 | ~$123,000–$129,000 | BLS OEWS confirmed |
| South Carolina | $116,940 | ~$107,000–$113,000 | BLS OEWS confirmed |
| South Dakota | $120,980 | ~$111,000–$117,000 | BLS OEWS confirmed |
| Tennessee | $103,720 | ~$94,000–$100,000 | BLS OEWS confirmed |
| Texas | $130,010 | ~$119,000–$126,000 | BLS OEWS confirmed |
| Utah | $127,820 | ~$117,000–$124,000 | BLS OEWS confirmed |
| Vermont | $126,100 | ~$116,000–$122,000 | BLS OEWS confirmed |
| Virginia | $120,870 | ~$111,000–$117,000 | BLS OEWS confirmed |
| Washington | $140,220 | ~$129,000–$136,000 | BLS OEWS confirmed |
| West Virginia | $113,450 | ~$103,000–$110,000 | BLS OEWS confirmed |
| Wisconsin | $128,330 | ~$118,000–$124,000 | BLS OEWS confirmed |
| Wyoming | $123,560 | ~$113,000–$119,000 | BLS OEWS confirmed |
Notes on state data: BLS OEWS state figures are for all NPs (SOC 29-1171, May 2024), released April 2025. AGNP primary care estimates apply an approximate $7,000–$10,000 specialty discount based on AANP survey data. Acute care AGNPs in the same state typically earn 5–8% more than the primary care estimate shown. Nevada data was unavailable in some prior releases but confirmed in the April 2025 BLS publication.
The highest-paying states cluster along the coasts and in the Mountain West. California stands alone at the top — at $161,540 for all NPs, the AGNP differential barely matters. Tennessee is the lowest-paying state for NPs at $103,720, which translates to an AGNP primary care range that can dip below $100,000.
AGNP salary by work setting
Setting is one of the largest single variables in AGNP compensation. Acute care hospital roles pay materially more than outpatient primary care or long-term care positions, though non-monetary factors — schedule, call burden, patient acuity — can offset the wage gap in either direction.
| Work setting | Estimated AGNP annual salary range | Notes |
|---|---|---|
| Inpatient hospital (acute care AGNP) | $130,000–$165,000 | Highest base pay; shift differentials and call add further |
| Hospitalist / hospital medicine group | $125,000–$155,000 | Often includes productivity bonus; 7-on/7-off common |
| Outpatient primary care clinic | $110,000–$130,000 | Most common AGNP setting; hours more predictable |
| Long-term care / skilled nursing facility (SNF) | $105,000–$125,000 | High demand, lower base; loan repayment often available |
| Home health / house calls | $110,000–$130,000 | Per-visit models vary; full-time salaried roles increasing |
| Telehealth (chronic care, geriatric management) | $115,000–$145,000 | Strong growth area; scope depends on state practice law |
| VA / federal government | $118,000–$148,000 | GS pay scale plus locality pay; strong benefits package |
| Academic medical center | $115,000–$135,000 | May include teaching release time; below private-practice peak |
| Community health center (FQHC) | $105,000–$120,000 | Eligible for NHSC loan repayment up to $55,000 over 2 years |
| Palliative care / hospice | $110,000–$135,000 | Growing subspecialty; AGNP background well-matched |
Acute care hospital roles dominate on raw salary, but telehealth and VA roles close the gap when total compensation is factored in. FQHCs and SNFs consistently offer the lowest base pay — but access to National Health Service Corps (NHSC) loan repayment at $55,000 per two-year service period makes them worth considering for AGNPs carrying graduate school debt.
AGNP salary by experience level
Salary growth across an AGNP career follows a predictable arc: rapid in the first five years, steady from year five to fifteen, then plateau-dependent on advancement into leadership or specialty subspecialties.
| Career stage | Years of NP experience | Estimated salary range | Key drivers |
|---|---|---|---|
| New graduate | <1 year | $89,500–$100,000 | Employer type; full vs restricted practice state |
| Early career | 1–3 years | $100,000–$115,000 | Panel growth, prescribing confidence, employer loyalty premium |
| Mid-career | 3–7 years | $115,000–$130,000 | Productivity bonuses, specialty subspecialization |
| Experienced | 7–12 years | $125,000–$145,000 | Geographic leverage, acute care transition, DNP completion |
| Senior / advanced | 12+ years | $135,000–$165,000+ | Leadership roles, independent practice, high-cost-of-living markets |
New graduates in restrictive practice states — where a collaborative practice agreement with a supervising physician is required — tend to land toward the lower end of the new-grad range, because the administrative overhead of collaboration agreements makes some employers cautious about hiring costs. Full-practice-authority states (California, New York, Oregon, Washington, and others) remove that friction and typically show higher starting offers.
AGNP vs other NP specialties
AGNPs sit in the middle of the NP specialty salary distribution — above several primary care specialties on a per-hour basis in acute care settings, but below the highest earners in anesthesia and psychiatry.
| NP specialty | Estimated median salary | Primary certification | Typical setting |
|---|---|---|---|
| CRNA (certified registered nurse anesthetist) | $223,210 | NBCRNA (DNAP/MSN) | OR, ASC, hospital |
| Neonatal NP (NNP) | ~$135,000–$148,000 | NCC | NICU |
| PMHNP (psychiatric-mental health NP) | ~$132,000–$140,000 | ANCC PMHNP-BC | Outpatient, telepsychiatry |
| AGNP – acute care (AGACNP-BC) | ~$125,000–$135,000 | ANCC / AACN | Hospital, hospitalist |
| AGNP – primary care (AGPCNP-BC) | ~$119,000–$128,000 | ANCC / AANPCB | Outpatient, SNF, home health |
| FNP (family nurse practitioner) | ~$120,000–$130,000 | ANCC FNP-BC / AANPCB FNP-C | Primary care, urgent care |
| CNM (certified nurse midwife) | ~$120,000–$130,000 | AMCB | OB/GYN, birth center |
| Pediatric NP (PNP-BC) | ~$110,000–$125,000 | PNCB / ANCC | Pediatric primary care, hospital |
The gap between acute care and primary care AGNP roles is meaningful — roughly $6,000–$10,000 per year at the median. That gap compresses in high-cost states (California, New York) where primary care salaries are pulled up by cost-of-living pressure, and widens in lower-cost states where hospital positions attract larger premiums.
What affects AGNP pay
Certification track: AGPCNP-BC vs AGACNP-BC
The ANCC offers two separate adult-gerontology certifications. The AGPCNP-BC (Adult-Gerontology Primary Care NP Board Certified) is for outpatient and community practice. The AGACNP-BC (Adult-Gerontology Acute Care NP Board Certified) is for hospital and critical care settings. The AANPCB offers a parallel primary care credential, the AGNP-C, which is clinically equivalent to the ANCC AGPCNP-BC for most employers.
Acute care certification (AGACNP-BC) commands a salary premium because hospital-based roles typically pay more and because fewer programs offer the acute care track — supply is tighter. If your goal is maximum earning potential, the AGACNP-BC path is the higher-leverage choice.
State practice authority
Full practice authority states allow AGNPs to assess, diagnose, and prescribe without a physician collaboration agreement. Forty-six states (plus D.C.) now have full or reduced practice authority, but the distinctions matter for new graduates. States with full practice authority tend to have higher NP employment rates and competitive starting salaries because AGNPs can open independent practices or command premium placement fees from multi-specialty groups.
Employer type
Private equity-backed medical groups and large hospital systems typically offer higher base salaries than solo physician practices, FQHCs, or public health departments. However, productivity bonuses, ownership stakes, and loan repayment can invert that hierarchy. A community health AGNP earning $112,000 plus $55,000 NHSC repayment is effectively earning $127,500 in year one.
Subspecialty additions
AGNPs who add training in palliative care, wound care certification (WCC), or diabetes management can bill for additional services and often command a salary adjustment at contract renewal. Palliative care is a particular growth area — demand far outstrips supply and dedicated palliative-care NP positions frequently carry salary premiums of $10,000–$20,000 over general internal medicine NP roles.
Doctoral degree premium
A DNP does not guarantee a salary bump, but it helps at the negotiating table — particularly for hospital-employed positions and academic medical centers, where administrator-to-NP salary differentials are smaller when a doctoral credential is on the table. The premium varies: research suggests a $5,000–$15,000 advantage for DNP-prepared NPs in institutional settings.
Job outlook and demand
The BLS projects employment of all nurse practitioners will grow 45% from 2023 to 2033 — roughly five times the rate for all occupations. For AGNPs specifically, the outlook is even more pointed: the AAMC estimates a shortage of over 30,000 geriatricians by 2030, and AGNPs are the primary workforce solution that health systems are reaching for to fill that gap.
The numbers behind the demand are structural, not cyclical. The U.S. population aged 65 and older will reach 80 million by 2040 — up from 54 million today. That cohort drives disproportionately high healthcare utilization: older adults account for roughly 35% of all hospital stays and 42% of all days of care. Chronic condition management — diabetes, COPD, heart failure, dementia — is the core of AGNP practice, and those conditions are growing in absolute prevalence with every passing year.
Rural areas face the most acute shortage. Many rural counties have no geriatrician within 60 miles, and AGNPs practicing with full independence are filling gaps that would otherwise go unfilled. Rural Health Information Hub data suggests rural AGNPs in primary care can leverage this shortage into above-median salaries and loan repayment packages that urban peers rarely see.
How to maximize your AGNP salary
Choose your setting strategically. Hospital-based acute care roles pay the most, but telehealth chronic care management is closing the gap quickly — without the shift-work burden. If work-life balance matters to you, a telehealth chronic disease management role can hit $130,000–$145,000 with a predictable schedule.
Target full-practice-authority states. Independent practice unlocks the ability to open your own panel or contract directly with Medicare — both routes to income above the employer-set salary ceiling. California, New York, Oregon, and Washington consistently rank as top earners for AGNPs.
Negotiate productivity bonuses. Many AGNP contracts structure base salary conservatively and attach a per-visit or panel-size bonus. Understand the RVU or panel math before you sign. A $115,000 base with a well-structured productivity bonus can clear $135,000 in year two.
Consider the NHSC for debt elimination. If you carry graduate school debt, two years at an NHSC-eligible site eliminates $55,000 tax-free — the after-tax equivalent of a $70,000 raise spread over two years. That changes the calculus on “lower-paying” FQHC and SNF roles substantially.
Complete your DNP if you’re targeting leadership. The doctoral premium is not universal, but it is consistent in hospital systems, academic medical centers, and VA settings. If those environments are your long-term target, the DNP return-on-investment math usually works.
Frequently asked questions
Is AGNP in high demand? Yes. The combination of an aging U.S. population and a persistent geriatrician shortage makes AGNPs one of the most in-demand NP specialties entering the 2030s. The AAMC projects a geriatrician shortage exceeding 30,000 by 2030. AGNPs — both primary and acute care — are the main pipeline for filling that gap, and health systems are actively competing for them.
How does AGNP salary compare to FNP salary? Primary care AGNPs and FNPs earn similar salaries — typically within $5,000–$10,000 of each other at the median. The bigger differentiator is setting: acute care AGNPs (AGACNP-BC) earn meaningfully more than FNPs because hospital-based positions carry higher base pay. An FNP in urgent care and an AGPCNP-BC in outpatient internal medicine will often land within the same band. See the FNP salary guide for a direct comparison.
How long does it take to become an AGNP? The AGPCNP-BC and AGACNP-BC credentials require completion of an accredited graduate program (MSN or DNP with an adult-gerontology focus) plus 500 hours of supervised clinical experience. Most MSN programs take 2–3 years post-BSN; DNP programs take 3–4 years. If you are already an RN, plan for 5–7 years total from BSN entry to first AGNP role. See the full NP pathway guide for step-by-step details.
Salary data sourced from BLS Occupational Employment and Wage Statistics (SOC 29-1171, May 2024, released April 2025), AANP 2024 NP Compensation Survey, and ANCC certification program data. AGNP-specific estimates apply specialty adjustments from AANP survey data to BLS state figures. Individual salaries vary by employer, negotiated contract terms, and geographic cost of living.
Related guides: PMHNP salary — CRNA salary — How to become a nurse practitioner — How to become a PMHNP