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 $90,000 to $112,000 depending on setting, experience, and geography. BLS data for registered nurses (SOC 29-1141, May 2025) puts the national median RN salary at $97,550 – cardiac step-down nurses generally land at or slightly above that median, with experienced PCU and telemetry nurses often reaching $105,000–$115,000 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) | $94,000–$108,000 |
| Entry level (0–2 years) | $77,000–$88,000 |
| Mid-career (3–7 years) | $93,000–$109,000 |
| Senior/experienced (8+ years) | $104,000–$122,000 |
| 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) | $130,000–$160,000+ |
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 (May 2025, released May 2026) combined with specialty estimates from Salary.com, Indeed, Glassdoor, and ZipRecruiter, all rechecked August 2026. 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 (checked August 2026):
| Source | Reported average | Range | Data as of |
|---|---|---|---|
| Salary.com (cardiac nurse) | $96,429 ($46/hour) | $73,675 (P10) – $112,904 (P90) | 1 Aug 2026 |
| Indeed (cardiac nurse) | $50.65/hour (~$105,400) | $29.77–$86.15/hour | 2 Aug 2026 |
| Glassdoor (cardiac RN) | $93,631 base | $80,580 (P25) – $109,695 (P75) | 2026 |
| ZipRecruiter (cardiac nurse) | $80,898 | $62,500 (P25) – $82,500 (P75) | Jul 2026 |
These are averages rather than medians, and the spread between them is the point worth taking away. ZipRecruiter’s $80,898 sits nearly $25,000 below Indeed’s implied annual figure because the two platforms sample different things: ZipRecruiter indexes posted job ads across all settings and experience levels, while Indeed’s figure comes from self-reported salaries weighted toward incumbents. Treat the cluster, not any single number, as the signal.
The BLS national RN median of $97,550 remains the most defensible anchor point, and the aggregator cluster brackets it. 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 | $85,000–$100,000 | Entry-level cardiac nursing; lower acuity, higher patient ratios |
| Cardiac step-down / intermediate care | $91,000–$109,000 | Most common cardiac nursing setting; telemetry plus IV drip management |
| Progressive care unit (PCU) | $93,000–$111,000 | Similar to step-down; some facilities pay a slight PCU designation premium |
| Cardiovascular ICU (CVICU) | $92,000–$125,000 | ICU-level pay; CCRN rather than CMSRN; post-cardiac surgery population |
The CVICU is a separate career track, and the pay difference is narrower at the entry end than most cardiac nurses expect. Against the $91,000–$111,000 step-down and PCU band used throughout this guide, the step-down-to-CVICU gap runs about $1,000 at the floor and roughly $14,000 at the ceiling, a midpoint difference near $7,500. The CVICU band is wide because the specialty’s four aggregator sources disagree sharply: Salary.com’s CVICU-specific model puts the average at $92,225 (1 August 2026) while ZipRecruiter reports $124,358, with Vivian’s staff rate of $48.06/hour (about $99,965 annualized) sitting between them. A nurse moving from step-down into a CVICU role at the same hospital should expect the increase to come from the ICU differential and the shift to 1:1 and 1:2 assignments rather than from a step change in base rate. See our CVICU nurse salary guide for the full source breakdown and our complete guide to becoming a CVICU nurse for the 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) | $77,000–$88,000 | New grad or recent specialty transition; base rate only |
| Mid-career (3–7 years) | $93,000–$109,000 | Step increases, specialty certifications, shift differential accumulation |
| Senior (8+ years) | $104,000–$122,000 | 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 Certified Medical-Surgical 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 2025) 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 2025) | Cardiac step-down estimate |
|---|---|---|
| California | $140,270 | $147,000–$154,000+ |
| Hawaii | $136,320 | $143,000–$150,000 |
| Oregon | $129,010 | $135,000–$142,000 |
| Washington | $124,200 | $130,000–$137,000 |
| Alaska | $109,480 | $115,000–$120,000 |
| New York | $109,440 | $115,000–$120,000 |
| New Jersey | $106,500 | $112,000–$117,000 |
| Massachusetts | $104,550 | $110,000–$115,000 |
| Nevada | $103,670 | $109,000–$114,000 |
| Connecticut | $102,740 | $108,000–$113,000 |
| Minnesota | $101,510 | $107,000–$112,000 |
| Colorado | $100,260 | $105,000–$110,000 |
| Maryland | $99,790 | $105,000–$110,000 |
| Delaware | $99,520 | $104,000–$109,000 |
| Arizona | $99,500 | $104,000–$109,000 |
| Pennsylvania | $96,430 | $101,000–$106,000 |
| Illinois | $95,990 | $101,000–$106,000 |
| Texas | $95,970 | $101,000–$106,000 |
| Michigan | $94,300 | $99,000–$104,000 |
| Virginia | $93,600 | $98,000–$103,000 |
| Georgia | $93,550 | $98,000–$103,000 |
| North Carolina | $84,350 | $89,000–$93,000 |
| Florida | $84,190 | $88,000–$93,000 |
| Ohio | $82,510 | $87,000–$91,000 |
Source: BLS OEWS May 2025 (SOC 29-1141), released May 2026. 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, and Washington follow closely. One consequence of the May 2025 vintage is worth flagging, because most salary content has not caught up with it: Oregon ($129,010) and Washington ($124,200) now sit clearly above New York ($109,440) and Massachusetts ($104,550), reversing the Northeast-over-Pacific-Northwest ordering that older guides assert. If you are comparing offers against an article written on May 2024 data, the rank order it gives you is out of date. Alaska, New York, and New Jersey round out the upper tier.
Mid-range states: Texas, Illinois, Pennsylvania, Michigan, and Virginia cluster near $98,000–$106,000 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 $88,000/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) | $91,000–$111,000 | Inpatient, floor/intermediate | CMSRN |
| Cardiac cath lab | $100,000–$122,000 | Procedural/interventional | RCIS, CV-BC |
| Cardiovascular ICU (CVICU) | $92,000–$125,000 | Intensive care | CCRN, CMC, CSC |
| Cardiac rehab | $82,000–$100,000 | Outpatient recovery | CCRP |
Cath lab and CVICU nursing pay more than cardiac step-down at the top of their bands, and both require higher acuity experience and carry specialized procedure or critical care skill sets. Read the floors alongside the ceilings, though: the cath lab band starts $9,000 above step-down while the CVICU band starts within $1,000 of it. The CVICU premium is concentrated in experienced nurses at high-volume surgical programs, so a first CVICU offer can land close to what a senior step-down nurse already earns. 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.
Get the eligibility rule right, because it is widely misstated. MSNCB requires an unencumbered RN license plus 2,000 practice hours within the past three years in a medical-surgical setting – practice as a clinical nurse, manager, or educator all count. The commonly quoted “two years of experience” is MSNCB’s recommendation, not the requirement; the 2,000 hours is the binding test, and a part-time nurse can pass the two-year mark and still fall short. Cardiac step-down, PCU, and telemetry practice falls inside MSNCB’s definition of a medical-surgical setting, so those hours count toward the total. The initial exam fee is $267 for AMSN members and $394 standard, both inclusive of a $90 non-refundable processing fee. 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. A cardiac nurse working three 12-hour night shifts per week logs about 1,872 differential-eligible hours a year, so that adds roughly $9,400–$18,700 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 roughly $1,000–$14,000 more than cardiac step-down nurses, a midpoint difference near $7,500. 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. Weigh that against the other levers on this list before committing: a single travel contract or a move to a higher-paying state moves total compensation further and faster than the CVICU transition does. Where the CVICU earns its place is the ceiling and what sits beyond it – the band tops out $14,000 higher than step-down, and CVICU experience is the preferred background for CRNA programs (median $236,590) and for cardiac surgery NP roles, both of which clear inpatient staff pay by a wide margin. Treat it as the entry point to the highest-paying cardiac career tracks rather than as a large immediate raise.
7. Move to a higher-paying state
The $63,000 gap between Alabama (median $77,080) and California (median $140,270) is the largest compensation lever available – but it’s also the most disruptive. A more targeted strategy: identify states in the $100,000–$125,000 band (Washington, New York, New Jersey, Minnesota, Colorado) 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 $44–$53 per hour at staff positions in most states. That range is the $91,000–$111,000 step-down band in this guide divided by 2,080 full-time hours, and it brackets the national all-RN median hourly rate of $46.90 ($97,550 ÷ 2,080, BLS SOC 29-1141, May 2025). California cardiac nurses earn roughly $71–$74/hour, derived the same way from the state estimate of $147,000–$154,000 – the state’s all-RN median alone is $67.44/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) has the highest ceiling, typically $92,000–$125,000 for staff positions, with cardiac cath lab nursing ($100,000–$122,000) close behind and paying more at the entry end. Cardiac step-down and PCU nurses earn $91,000–$111,000, and cardiac rehab nurses (outpatient) earn the least among the cardiac specialties, typically $82,000–$100,000. The CVICU band overlaps the step-down band substantially at the floor, so the premium is real for experienced nurses at high-volume surgical programs rather than automatic on transfer.
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.
References
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics: Registered Nurses,” SOC 29-1141, May 2025 OEWS national and state estimates (released May 2026) – national median $97,550, mean $101,420. https://www.bls.gov/oes/current/oes291141.htm
- O*NET OnLine, “Wages for Registered Nurses (29-1141.00),” state median annual wages and percentile spreads derived from BLS OEWS May 2025 estimates. https://www.onetonline.org/link/localwages/29-1141.00
- U.S. Bureau of Labor Statistics, “Registered Nurses,” Occupational Outlook Handbook, 2026 edition – approximately 3.39 million RNs employed, 5% projected growth 2024–2034, about 189,100 annual openings. https://www.bls.gov/ooh/healthcare/registered-nurses.htm
- Medical-Surgical Nursing Certification Board, “CMSRN Certification Handbook,” MSNCB, last updated July 2025 – eligibility requires an unencumbered RN license and 2,000 practice hours within the past three years in a medical-surgical setting; initial exam fees $267 AMSN member / $394 standard, inclusive of a $90 non-refundable processing fee. https://www.msncb.org/CMSRN/Certification
- American Association of Critical-Care Nurses, “CCRN (Adult) Certification,” AACN – critical care certification for the CVICU pathway. https://www.aacn.org/certification/get-certified/ccrn-adult
- American Nurses Credentialing Center, “Cardiac-Vascular Nursing Certification (CV-BC),” ANCC – requires two years of full-time RN practice, 2,000 hours of cardiac-vascular clinical practice in the last three years, and 30 hours of related continuing education; initial fees $295 ANA member / $395 non-member. https://www.nursingworld.org/our-certifications/cardiac-vascular-nurse/
- Tsao CW et al., “2026 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association,” Circulation, January 2026, DOI 10.1161/CIR.0000000000001412 – cardiovascular disease prevalence and burden underpinning cardiac nursing demand. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001412
- Cardiovascular Credentialing International, “Registered Cardiovascular Invasive Specialist (RCIS),” CCI – the cath lab credential referenced in the specialty comparison table. https://cci-online.org
- Salary.com, “Cardiac Nurse Salary in the United States,” data as of 1 August 2026 – average $96,429/year ($46/hour), 10th percentile $73,675, 90th percentile $112,904. https://www.salary.com/research/salary/hiring/cardiac-nurse-salary
- Indeed, “Cardiac nurse salary in United States,” data as of 2 August 2026 – average base $50.65/hour from 1.4k reported salaries, range $29.77–$86.15/hour. https://www.indeed.com/career/cardiac-nurse/salaries
- Glassdoor, “Cardiac RN: Average Salary & Pay Trends 2026” – average base $93,631/year, 25th–75th percentile $80,580–$109,695. https://www.glassdoor.com/Salaries/cardiac-rn-salary-SRCH_KO0,10.htm
- ZipRecruiter, “Cardiac Nurse Salary,” July 2026 – national average $80,898/year, 25th–75th percentile $62,500–$82,500. https://www.ziprecruiter.com/Salaries/Cardiac-Nurse-Salary
- Salary.com, “CVICU Nurse Salary in the United States,” data as of 1 August 2026 – average $92,225/year, 75th percentile $102,985. Accessed 6 August 2026. https://www.salary.com/research/salary/hiring/cvicu-nurse-salary
- Vivian Health, “Average Cardiovascular ICU Nurse Salary by State & Nationally,” staff (permanent) positions, data as of 6 August 2026 – $48.06/hour, approximately $99,965 annualized on a 2,080-hour basis. https://www.vivian.com/nursing/cvicu/salary/
- ZipRecruiter, “CVICU Nurse Salary in the United States,” June 2026 – national average $124,358/year ($59.79/hour); 25th percentile $102,000, 75th percentile $143,500, 90th percentile $163,500. Accessed 6 August 2026. https://www.ziprecruiter.com/Salaries/Cvicu-Nurse-Salary
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics: Nurse Anesthetists,” SOC 29-1151, May 2025 OEWS national estimates – median $236,590, mean $248,320. https://www.bls.gov/oes/current/oes291151.htm