Cardiac nurses working on step-down, progressive care, and telemetry units earn a specialty premium over general medical-surgical nurses, with national salary estimates ranging from approximately $79,000 to $98,000 depending on setting, experience, and geography. BLS data for registered nurses (SOC 29-1141, May 2024) puts the national median RN salary at $86,070 — cardiac step-down nurses generally land at or slightly above that median, with experienced PCU and telemetry nurses often reaching $90,000–$100,000 in mid-range states and substantially more in California, Hawaii, and the Pacific Northwest.
At a glance:
| Variable | Estimate |
|---|---|
| National median (cardiac step-down/PCU, estimated) | $83,000–$95,000 |
| Entry level (0–2 years) | $68,000–$78,000 |
| Mid-career (3–7 years) | $82,000–$96,000 |
| Senior/experienced (8+ years) | $92,000–$108,000 |
| CMSRN certified premium | +$3,000–$7,000/year |
| Travel cardiac RN (13-week contract) | $100,000–$150,000+ annualized |
| Top-paying states (CA, HI, OR, WA) | $105,000–$140,000+ |
Note: BLS does not report cardiac step-down nursing as a separate occupational category. Salary figures for cardiac nurses are derived from BLS SOC 29-1141 state and national data combined with specialty estimates from Salary.com, ZipRecruiter, and Glassdoor (2024–2025 data). Treat ranges as estimates, not precise benchmarks.
National average salary for cardiac nurses
The BLS reports RN salaries under a single occupational code (SOC 29-1141) without specialty breakdowns. This means there is no official government figure specifically for cardiac step-down nursing — published specialty estimates come from aggregator sites that collect self-reported or employer-reported data.
What the aggregators report for cardiac RN/cardiac step-down nurses (2024–2025):
| Source | Reported median | Range |
|---|---|---|
| Salary.com (cardiac RN) | ~$88,000 | $75,000–$104,000 |
| ZipRecruiter (cardiac nurse) | ~$87,000 | $65,000–$118,000 |
| Glassdoor (cardiac RN) | ~$84,000 | $63,000–$110,000 |
| Indeed (cardiac step-down RN) | ~$82,000 | $62,000–$108,000 |
The BLS national RN median of $86,070 is a reasonable anchor point. Cardiac step-down and PCU nurses typically earn slightly above the all-RN median — the specialty’s telemetry requirement and pharmacology complexity command a modest premium over general medical-surgical floors, which pull the all-RN average down.
Salary by unit setting
Not all cardiac nursing roles pay the same. The acuity level of the unit is the primary driver of setting-based pay differences.
| Setting | Typical salary range | Notes |
|---|---|---|
| Cardiac telemetry floor | $75,000–$88,000 | Entry-level cardiac nursing; lower acuity, higher patient ratios |
| Cardiac step-down / intermediate care | $80,000–$96,000 | Most common cardiac nursing setting; telemetry plus IV drip management |
| Progressive care unit (PCU) | $82,000–$98,000 | Similar to step-down; some facilities pay a slight PCU designation premium |
| Cardiovascular ICU (CVICU) | $90,000–$115,000 | ICU-level pay; CCRN rather than CMSRN; post-cardiac surgery population |
The CVICU is a separate career track with ICU-level compensation to match. If you’re comparing cardiac step-down to CVICU compensation, expect a $10,000–$20,000 gap in most markets. See our complete guide to becoming a CVICU nurse for the CVICU career path.
Salary by experience level
Experience is one of the most consistent predictors of cardiac nursing pay. Hospitals use step-increase schedules tied to years of service, and experienced nurses also qualify for charge, lead, and preceptor differentials.
| Experience level | Estimated salary range | What’s driving the range |
|---|---|---|
| Entry (0–2 years) | $68,000–$78,000 | New grad or recent specialty transition; base rate only |
| Mid-career (3–7 years) | $82,000–$96,000 | Step increases, specialty certifications, shift differential accumulation |
| Senior (8+ years) | $92,000–$108,000 | Top of the step scale, charge/lead differentials, union contracts at ceiling |
| Charge/lead nurse | Add $3–6/hour | Charge differentials typically paid per shift, not always permanent increase |
| Preceptor/educator | Add $1–3/hour | Varies widely by hospital; some pay per precepted shift, others are flat stipend |
The steepest salary growth in cardiac nursing happens in the first 5–7 years. After that, most step scales plateau without a deliberate move — to a higher-acuity unit, a travel contract, a leadership role, or advanced practice.
CMSRN certification pay premium
The Cardiac Medicine Certified Registered Nurse (CMSRN), issued by the Medical-Surgical Nursing Certification Board (MSNCB), is the primary specialty credential for cardiac step-down and PCU nurses. Certification affects pay in two ways: direct pay differentials and indirect effects on advancement.
Direct pay differential:
Most hospitals that recognize specialty certifications offer a pay differential for nurses holding relevant credentials. Common structures include:
- Per-hour differential: $1.00–$3.00/hour added to base rate while holding the certification
- Annual lump sum: $1,500–$4,000/year paid as a bonus for certified nurses
- Step increase: Some systems advance certified nurses one additional step on the pay scale, which can be worth $2,000–$5,000/year
Across a full-time schedule, a $2/hour differential adds approximately $4,160/year. A $3/hour differential adds $6,240/year.
Indirect effects:
CMSRN holders are more competitive for charge nurse, educator, and lead positions — roles that carry their own differentials. Certification also strengthens applications to higher-acuity units (CVICU transition programs sometimes prefer or require CMSRN holders from step-down). The credential’s salary impact compounds over time.
Whether your current hospital pays a direct differential or not, checking your union contract or HR compensation policy is worth the effort — many nurses don’t know this benefit exists until they ask.
Cardiac nurse salary by state
The table below uses BLS SOC 29-1141 state-level median annual wages (May 2024) as the benchmark for cardiac RN pay in each state. Because BLS does not break out cardiac nursing separately, these figures represent the all-RN median for each state — cardiac step-down nurses at mid-career in each state typically earn somewhat above the all-RN median shown.
| State | RN median annual (BLS May 2024) | Cardiac step-down estimate |
|---|---|---|
| California | $133,340 | $115,000–$150,000+ |
| Hawaii | $113,220 | $98,000–$128,000 |
| Oregon | $106,610 | $92,000–$118,000 |
| Washington | $102,700 | $88,000–$115,000 |
| Alaska | $101,360 | $88,000–$112,000 |
| Massachusetts | $100,400 | $87,000–$112,000 |
| Nevada | $97,770 | $84,000–$108,000 |
| New York | $97,470 | $84,000–$108,000 |
| Connecticut | $93,580 | $80,000–$104,000 |
| New Jersey | $92,100 | $79,000–$102,000 |
| Minnesota | $90,160 | $78,000–$100,000 |
| Arizona | $89,040 | $77,000–$99,000 |
| Colorado | $88,920 | $77,000–$99,000 |
| Maryland | $87,870 | $76,000–$97,000 |
| Delaware | $85,220 | $74,000–$94,000 |
| Illinois | $84,730 | $73,000–$94,000 |
| Texas | $82,750 | $72,000–$92,000 |
| Florida | $81,440 | $71,000–$91,000 |
| Georgia | $80,960 | $70,000–$90,000 |
| Michigan | $80,730 | $70,000–$90,000 |
| Virginia | $80,200 | $70,000–$89,000 |
| Pennsylvania | $79,830 | $69,000–$89,000 |
| Ohio | $78,950 | $68,000–$88,000 |
| North Carolina | $78,400 | $68,000–$87,000 |
Source: BLS OES May 2024 (SOC 29-1141). Cardiac step-down estimates apply a 5–10% specialty premium range over the state RN median. Estimates are approximate and vary by employer, union status, experience, and setting.
Top-paying states for cardiac nurses: California stands well above the rest, driven by mandatory nurse-to-patient ratio laws (which restrict float and overtime), strong union contracts (SEIU-UHW and NNU), and tight labor market dynamics in major metro areas. Hawaii, Oregon, Washington, Alaska, and Massachusetts round out the top six. Pacific Coast and New England states dominate the upper salary band.
Mid-range states: Texas, Florida, Illinois, Pennsylvania, and the Mid-Atlantic states cluster near $80,000–$92,000 for cardiac step-down nurses at mid-career. These markets offer better housing affordability than California, meaningful specialty premiums, and in some metro areas (Houston, Chicago, Philadelphia), active cardiac nursing labor markets.
Travel cardiac nurse salary
Travel nursing on cardiac step-down, PCU, and telemetry units is consistently one of the more accessible and well-compensated specialties in travel nursing. Cardiac RNs with 2+ years of experience are in demand year-round, and CMSRN or ACLS certification strengthens placement options.
Typical travel cardiac RN compensation structure:
| Component | Typical range |
|---|---|
| Base taxable hourly rate | $24–$35/hour |
| Non-taxable stipends (housing + meals + incidentals) | $700–$1,400/week |
| Total weekly gross | $1,900–$3,200+ |
| Annualized (assuming 46 weeks worked) | $87,000–$147,000+ |
Travel pay structures vary by agency, state tax law, and contract type. Non-taxable stipends are available only to nurses who maintain a permanent tax home elsewhere. Rates quoted for standard 13-week contracts; crisis rates during shortage periods can be substantially higher.
Agencies most commonly used by cardiac travel nurses include Vivian Health (comparison platform), AMN Healthcare, Travel Nurse Across America (TNAA), and Aya Healthcare. Most require a minimum of 1–2 years of acute care experience in the specialty, with cardiac step-down, telemetry, or PCU experience qualifying.
Comparing staff vs. travel compensation:
A staff cardiac RN in Ohio earning $80,000/year might compare to a travel contract paying $2,400/week gross — which annualizes to approximately $110,000 for 46 working weeks. The differential is real, but travel nursing involves expenses staff positions don’t: licensing fees for multiple states (a compact RN license reduces this), potential gaps between contracts, higher health insurance costs (agency coverage tends to be more expensive), and the logistical demands of relocating every 13 weeks.
For experienced cardiac nurses with flexibility, travel nursing often represents the single highest-leverage salary move available — more immediate than waiting for a step increase and more accessible than advanced practice.
Cardiac nurse specialty comparison
Cardiac nursing salary sits in a clear band relative to neighboring cardiovascular specialties. The table below shows how cardiac step-down compensation compares to the other guides in this cluster.
| Specialty | Typical salary range | Setting | Key credential |
|---|---|---|---|
| Cardiac step-down/PCU (this guide) | $80,000–$98,000 | Inpatient, floor/intermediate | CMSRN |
| Cardiac cath lab | $88,000–$108,000 | Procedural/interventional | RCIS, CV-BC |
| Cardiovascular ICU (CVICU) | $90,000–$115,000 | Intensive care | CCRN, CMC, CSC |
| Cardiac rehab | $72,000–$88,000 | Outpatient recovery | CCRP |
Cath lab and CVICU nursing pay more than cardiac step-down in most markets — both require higher acuity experience and carry specialized procedure or critical care skill sets. Cardiac rehab nursing, an outpatient specialty, typically earns less than inpatient cardiac positions. See our guides to becoming a cardiac cath lab nurse and becoming a cardiac rehab nurse for full career path breakdowns.
How to increase your cardiac nursing salary
1. Earn your CMSRN
The CMSRN certification is the most direct lever for step-down and PCU nurses. Beyond the direct pay differential, it signals competency and strengthens your position for charge, lead, and educator roles. Most nurses reach CMSRN eligibility (2 years RN experience + 1,000 cardiac hours) within 12–18 months of starting a cardiac position. See our guide on how to become a cardiac nurse for certification details.
2. Complete your BSN
Some hospitals pay BSN nurses more than ADN nurses at equivalent experience levels — differentials of $1–3/hour are documented at several large systems. More importantly, BSN completion opens pathways to charge, educator, and leadership roles that carry their own compensation premiums.
3. Maintain current ACLS
ACLS is table stakes for cardiac nursing. Letting certification lapse can make you ineligible for certain assignments, charge positions, or float pool placements that carry differentials. Some hospitals pay a small differential for nurses holding additional certifications (NIHSS, TNCC, etc.) — check your HR policy.
4. Move to nights or pursue differential-heavy shifts
Night shift differentials at most hospitals run $5–$10/hour above base. For a cardiac nurse working three 12-hour night shifts per week, that adds $7,800–$15,600 to annual income before overtime. Weekend differentials (often $3–$6/hour) compound this further. Nurses who are willing to work overnight and weekend hours consistently outpace day-shift peers on total compensation.
5. Pursue a travel nursing contract
As described above, travel nursing in cardiac step-down is one of the most accessible high-compensation paths for nurses with 2+ years of experience. Many nurses do 1–2 travel contracts, bank the earnings, and return to staff positions with substantial savings — or continue traveling long-term.
6. Transition to the CVICU
CVICU nurses earn $10,000–$20,000 more than cardiac step-down nurses in most markets. The transition requires an ICU-specific orientation program (typically 4–8 months for nurses coming from step-down) and a shift in credential focus from CMSRN to CCRN. For nurses whose long-term goal is maximum inpatient cardiac compensation, CVICU is the clearest path.
7. Move to a higher-paying state
The $50,000+ gap between Alabama (median $62,980) and California (median $133,340) is the largest compensation lever available — but it’s also the most disruptive. A more targeted strategy: identify states in the $95,000–$110,000 band (Hawaii, Oregon, Washington, Massachusetts) that combine meaningful salary gains with lower cost of living adjustment than California. For the full RN salary comparison by state, see the RN salary guide.
FAQs
How much do cardiac nurses make per hour?
Cardiac step-down and PCU nurses typically earn $38–$50 per hour at staff positions in most states, based on BLS SOC 29-1141 data and specialty aggregator estimates. California cardiac nurses can earn $55–$72/hour. Night shift and weekend differentials add $5–$10/hour on top of base rates. Travel cardiac nurses can reach $60–$80+/hour in total package value when stipends are included.
Do cardiac nurses make more than med-surg nurses?
Yes, typically. Cardiac step-down and PCU nurses earn a specialty premium over general medical-surgical nurses — most estimates put the differential at $3,000–$8,000 per year for equivalent experience and geography. The gap reflects the telemetry requirement, complex pharmacology, and higher acuity of cardiac units compared to general med-surg floors.
Does the CMSRN certification increase pay?
At most hospitals, yes. CMSRN certification typically earns a direct pay differential of $1–$3/hour or an annual bonus of $1,500–$4,000, depending on the employer’s certification compensation policy. Across a full-time schedule, a $2/hour differential adds approximately $4,160/year. Some hospitals also give certified nurses an additional step increase on the pay scale. Check your HR policy or union contract for the specifics at your institution.
How much do travel cardiac nurses make?
Travel cardiac nurses on 13-week step-down or PCU contracts typically earn $1,900–$3,200 per week in total gross compensation, which annualizes to approximately $87,000–$147,000 for 46 working weeks. The package combines a taxable base hourly rate with non-taxable housing, meal, and incidental stipends. Rates vary significantly by state, facility, and contract timing — high-demand periods can push crisis rates above $3,500/week.
What is the highest-paying cardiac nursing specialty?
Among cardiac nursing specialties, the cardiovascular ICU (CVICU) pays the most, typically $90,000–$115,000 for staff positions. Cardiac cath lab nursing ($88,000–$108,000) is close behind. Cardiac step-down and PCU nurses earn $80,000–$98,000, and cardiac rehab nurses (outpatient) earn the least among the cardiac specialties, typically $72,000–$88,000.
How long does it take a cardiac nurse to reach top pay?
Most hospital step scales reach their ceiling in 10–15 years of service. In practice, salary growth is steepest in the first 5–7 years — a combination of annual step increases, specialty certification differentials, and eligible shift or role differentials. After the step scale plateaus, the most effective moves to increase income are: travel nursing, transitioning to a higher-acuity unit (CVICU), pursuing advanced practice (ACNP), or relocating to a higher-paying state.
For more on building a cardiac nursing career, see our guides to how to become a cardiac nurse, becoming a CVICU nurse, cardiac cath lab nursing, and the overall RN salary guide.