The national mean salary for med-surg nurses is approximately $94,480 per year ($44/hour), based on BLS occupational employment data and med-surg-specific figures from Vivian Health. This sits modestly below the overall RN average of $98,430, which reflects the reality that med-surg is often an entry-level placement before nurses move into higher-paying specialty units. With experience, CMSRN certification, and strategic location choices, med-surg nurses can push well past $100,000 annually — and travel med-surg nurses regularly earn $2,000+ per week.
Quick answer:
- National average:
$94,480/year ($44/hour) - New grad range: $60,000–$75,000 (most states); $85,000+ in California
- Experienced (5+ years): $85,000–$110,000+
- Travel med-surg: $2,000–$2,500+/week
- Highest-paying state: California ($148,330 mean for all RNs; $82/hour med-surg specific per Vivian Health)
Med-surg nurse salary overview
Med-surg nurses are compensated within the general RN pay structure — there is no universally separate salary band for med-surg versus other floor nursing specialties at most hospital systems. Pay is determined primarily by:
- Geographic location (state and metro area) — the dominant factor
- Years of RN experience — most systems use step-based pay scales that increase annually
- Employer type — large academic medical centers and union hospitals generally pay more than community hospitals
- Certifications — CMSRN and BSN completion typically unlock pay differentials
- Shift differential — nights and weekends add $3–$8/hour at most facilities
The BLS reports a national mean wage for registered nurses of $98,430 (May 2024). Med-surg-specific salary data from Vivian Health puts the med-surg average at $45.35/hour ($94,480 annually) — approximately 6% below the overall RN mean. That gap reflects the mix of new graduates and mid-career nurses on med-surg floors versus the higher concentration of senior nurses in specialty units.
Note: BLS does not publish salary breakdowns by nursing specialty. All state and metro figures in this guide are for registered nurses broadly. The note “BLS data reflects all registered nurses, not med-surg-specific, as no specialty breakdown is published” applies to all state and metro tables below.
Med-surg nurse salary by state
All data from BLS OES May 2024 (released 2025). Reflects mean annual wages for all registered nurses. Sorted by annual mean wage, descending. Colorado data was not published by BLS for this cycle due to state reporting issues.
| State | Hourly mean | Annual mean |
|---|---|---|
| California | $71.31 | $148,330 |
| Oregon | $57.92 | $120,470 |
| Hawaii | $59.48 | $123,720 |
| Washington | $55.64 | $115,740 |
| Massachusetts | $54.14 | $112,610 |
| Alaska | $53.86 | $112,040 |
| District of Columbia | $52.52 | $109,240 |
| New Jersey | $51.44 | $106,990 |
| New York | $53.12 | $110,490 |
| Connecticut | $49.84 | $103,670 |
| Nevada | $49.17 | $102,280 |
| Rhode Island | $47.96 | $99,770 |
| Minnesota | $47.82 | $99,460 |
| Maryland | $46.46 | $96,650 |
| Colorado | — | — (data not published) |
| Delaware | $45.89 | $95,450 |
| Arizona | $45.79 | $95,230 |
| New Hampshire | $45.49 | $94,620 |
| New Mexico | $45.37 | $94,360 |
| Vermont | $44.57 | $92,710 |
| Georgia | $44.21 | $91,960 |
| Texas | $44.08 | $91,690 |
| Illinois | $43.81 | $91,130 |
| Pennsylvania | $43.67 | $90,830 |
| Virginia | $43.72 | $90,930 |
| Michigan | $43.55 | $90,580 |
| Wisconsin | $43.48 | $90,450 |
| Idaho | $43.16 | $89,770 |
| Florida | $42.40 | $88,200 |
| Utah | $42.42 | $88,240 |
| Montana | $42.54 | $88,480 |
| Wyoming | $42.32 | $88,020 |
| Maine | $42.04 | $87,440 |
| North Carolina | $41.48 | $86,270 |
| Ohio | $41.40 | $86,110 |
| Indiana | $41.27 | $85,850 |
| Oklahoma | $41.25 | $85,800 |
| South Carolina | $40.83 | $84,930 |
| Louisiana | $40.44 | $84,110 |
| Kentucky | $40.34 | $83,900 |
| Nebraska | $39.85 | $82,890 |
| Tennessee | $39.43 | $82,010 |
| Missouri | $39.40 | $81,950 |
| West Virginia | $38.77 | $80,650 |
| Kansas | $38.19 | $79,430 |
| Mississippi | $38.21 | $79,470 |
| North Dakota | $39.38 | $81,900 |
| Iowa | $37.39 | $77,780 |
| Arkansas | $37.36 | $77,720 |
| Alabama | $36.04 | $74,970 |
| South Dakota | $34.72 | $72,210 |
Source: BLS OES May 2024. Data reflects all registered nurses. No specialty-level breakdown is available for med-surg specifically.
Key observations:
- California’s mean ($148,330) is nearly double South Dakota’s ($72,210). The geographic spread in nursing compensation is wider than almost any other profession requiring similar education.
- The Pacific Northwest consistently outperforms expectations relative to cost of living. Oregon ($120,470) and Washington ($115,740) are strong alternatives for nurses who want high pay without California’s competition and costs.
- The South and Midwest generally pay $75,000–$90,000, which reads as lower in absolute terms but often corresponds to substantially lower housing costs.
Salary by city and metro area
Top-paying metropolitan areas for registered nurses, based on BLS OES 2024 data. California dominates the list — 22 of the top 25 highest-paying metros for RNs are in California.
| Metro area | Annual mean |
|---|---|
| San Jose-Sunnyvale-Santa Clara, CA | $189,880 |
| San Francisco-Oakland-Fremont, CA | $178,450 |
| Vallejo, CA | $175,620 |
| Los Angeles-Long Beach-Anaheim, CA | ~$155,000 |
| Sacramento-Roseville, CA | ~$145,000 |
| Seattle-Tacoma-Bellevue, WA | $105,540 |
| Boston-Cambridge-Nashua, MA-NH | $106,980 |
| New York-Newark-Jersey City, NY-NJ | ~$108,000 |
| Providence-Warwick, RI | ~$100,000 |
| Minneapolis-St. Paul, MN | ~$99,000 |
Note: Metro figures marked ”~” are estimates based on available BLS state and metro data; exact 2024 metro figures for some areas had not been published at time of writing. San Jose, San Francisco, and Seattle figures are from BLS OES 2024 published data.
For med-surg nurses specifically, the highest-paying metros tracked by Vivian Health are California-based, with hourly rates up to $100/hour for experienced staff nurses in the Bay Area and Southern California.
Salary by experience level
Med-surg salaries follow a steep curve in the first 3 years, then a more gradual increase as nurses reach mid-career.
| Experience level | Approximate annual salary range | Notes |
|---|---|---|
| New graduate (0–1 year) | $60,000–$75,000 | Most states; $85,000+ in California |
| Early career (1–3 years) | $70,000–$85,000 | Step increases begin compounding |
| Mid-career (3–5 years) | $80,000–$95,000 | CMSRN eligible; charge nurse potential |
| Experienced (5–10 years) | $90,000–$110,000 | Leadership differentials available |
| Senior (10+ years) | $95,000–$120,000+ | Geographic and employer variation significant |
Ranges are national estimates. California figures are consistently $15,000–$30,000 higher at equivalent experience levels.
Most hospital systems use step-based pay scales that automatically increment salary annually for the first 10–15 years. The difference between a year-1 and year-5 nurse at the same facility on the same floor is often $8,000–$15,000 — even without a promotion or specialty transfer.
Salary by employer type
The type of facility significantly affects what med-surg nurses earn. From highest to lowest:
Large academic medical centers and Magnet hospitals — $85,000–$110,000+ nationally. These facilities offer higher base pay, stronger benefits, and more robust certification reimbursement programs. Competition for positions is higher.
Regional hospital systems (HCA, CommonSpirit, Ascension, Tenet) — $80,000–$100,000. Consistent pay scales across facilities. Travel and per diem opportunities often available within the system.
Community hospitals — $75,000–$90,000. May offer strong work-life balance and lower patient census, but base pay is typically below health system rates.
Long-term acute care (LTAC) facilities — $70,000–$85,000. LTAC hospitals serve medically complex patients who need extended acute care but don’t require full hospital resources. Med-surg skills transfer well here, though the patient population is narrower.
Skilled nursing facilities (SNF) with RN positions — $65,000–$80,000. Lower acuity than hospital med-surg, but also lower pay.
Outpatient surgical centers — $70,000–$85,000. Less weekend and holiday coverage, but typically no nights; some nurses accept the pay trade-off for schedule quality.
Union membership also affects compensation. Nurses in states with strong nursing unions (California, Massachusetts, Minnesota, Washington, Oregon, New York) generally earn more than peers in comparable non-union facilities. California’s large union contracts — particularly with National Nurses United member organizations — set wage floors significantly above the national average.
How CMSRN certification affects salary
CMSRN-certified nurses earn a measurable premium over non-certified peers. Analysis of available salary data places the certification salary impact at $5,000–$10,000 annually, though the exact figure varies by employer and whether the facility formally rewards certification with a pay differential.
How certification affects your pay in practice:
Direct pay differential: Many hospitals explicitly offer a certification premium — typically $0.50–$2.00/hour added to base pay when you provide proof of certification. At $1.00/hour, that’s approximately $2,080/year on a full-time 40-hour schedule.
Negotiation leverage: CMSRN certification strengthens your position when negotiating an annual review increase or counter-offering a job offer. Quantified credentials give you a specific, employer-verifiable data point.
Access to higher-level roles: CMSRN-certified nurses are stronger candidates for charge nurse, clinical educator, and preceptor positions — roles that carry pay differentials of $2–$5/hour above staff nurse rates.
Travel nursing premiums: Some travel staffing agencies offer higher weekly rates or more assignment options for CMSRN-certified med-surg nurses.
The total CMSRN salary impact over a career is substantial. AMSN members pay $267 for the exam; non-members pay $394. The certification recoups its cost within weeks to months at any salary premium. Check whether your employer reimburses the exam fee before applying — many do.
For full details on CMSRN eligibility, exam format, and the certification process, see our how to become a med-surg nurse guide.
Travel med-surg nurse salary
Travel med-surg nursing is a high-earning option available to nurses with 1–2 years of solid floor experience. The pay differential over staff nursing is significant.
Current travel med-surg compensation (2026):
- National average weekly rate: $2,081/week (Vivian Health data, 2026)
- Annualized full-time equivalent: approximately $108,000–$117,000/year
- Top-paying states for travel med-surg (Vivian Health): Rhode Island ($2,449/week), North Dakota ($2,372/week), Alaska ($2,354/week), New York ($2,323/week), Massachusetts ($2,319/week)
Weekly rates by experience level (approximate, ZipRecruiter/SkillGigs aggregated data):
| Experience | Typical weekly rate |
|---|---|
| Entry level (0–1 year travel experience) | $1,500–$2,000/week |
| Mid-level (3–5 years RN experience) | $2,000–$2,500/week |
| Experienced (5–7 years RN experience) | $2,400–$2,800/week |
| Senior (7+ years) | $2,800–$3,500+/week |
Travel pay packages include a combination of taxable hourly base pay and non-taxable stipends for housing and meals. The taxable/non-taxable split varies by agency and assignment location. The headline “weekly rate” figures reflect total package value.
Practical considerations for travel med-surg:
Most travel agencies require 1–2 years of recent acute care med-surg experience. A strong float pool background or experience on a high-acuity floor accelerates eligibility. Vivian Health, AMN Healthcare, and Aya Healthcare are among the largest travel nursing platforms; comparing offers across agencies on the same assignment is standard practice.
Med-surg is one of the most consistently available travel specialties — demand is year-round at most health systems. This predictability makes it easier to string together back-to-back 13-week contracts without gaps.
For a full breakdown of the travel nursing path, licensing requirements, and how to evaluate agencies, see our guide on how to become a travel nurse and our travel nurse salary guide.
How to increase your salary as a med-surg nurse
Several concrete strategies can move your pay meaningfully above the baseline:
1. Get CMSRN certified The lowest-cost, highest-return action available to any med-surg nurse with 2+ years of experience. The exam costs under $400. The return is $5,000–$10,000/year in most markets, plus access to higher-level roles. Many employers reimburse the fee.
2. Complete your BSN (if you hold an ADN) Many hospital systems pay an additional $1–$3/hour for BSN-prepared nurses, and BSN completion is a prerequisite for management, education, and advanced practice roles. Online RN-to-BSN programs are available for under $10,000 and can be completed in 12–18 months while working full time.
3. Move to a higher-paying state Geographic arbitrage is the single largest salary lever available to RNs. A mid-career med-surg nurse earning $85,000 in Tennessee could earn $115,000–$130,000+ in Washington or Oregon without changing specialty or employer type. If remote work isn’t an option (and for bedside nursing it isn’t), physical relocation to a high-wage state is a legitimate strategy worth modeling.
4. Travel nurse for 1–3 years Travel med-surg offers $40,000–$60,000 more per year than equivalent staff positions in most markets. After 13–26 weeks of travel, many nurses return to staff positions with substantially better offers — they’ve demonstrated mobility and negotiating leverage.
5. Transition to a specialty unit ICU, ED, cardiac cath lab, and labor and delivery positions typically pay $2–$8/hour more than general med-surg. The transition requires additional training and sometimes a pay cut during orientation, but the long-term earning ceiling is higher. See our guides on how to become an ICU nurse and ICU nurse salary.
6. Move into charge nurse or clinical educator roles Charge nurses earn shift differentials of $2–$5/hour above staff pay at most facilities. Clinical educators move off the floor but often retain a base comparable to senior staff while gaining schedule control. Both roles require CMSRN or equivalent credentialing and a track record of mentoring peers.
7. Pursue nurse practitioner training NP programs take 2–3 years and require clinical hours, but the salary jump is significant: the median NP salary is $126,000+, with Adult-Gerontology PCNPs (the NP path most aligned with med-surg experience) typically earning $105,000–$130,000. Med-surg experience is strong preparation for adult-focused NP practice. See our guide on how to become a nurse practitioner.
FAQ
What is the starting salary for a med-surg nurse?
New graduate med-surg nurses typically earn between $60,000 and $75,000 annually in most states, with significant variation by geography. In California, new grads on med-surg floors can start above $85,000 due to the state’s strong union contracts and mandatory staffing laws. The national average for all RNs (the closest BLS proxy for med-surg) was $98,430 as of May 2024 — but this blends all experience levels. Entry-level positions skew well below that figure.
Do med-surg nurses make less than ICU nurses?
Generally yes, though the gap is smaller than most nurses expect. ICU nurses earn a modest premium over med-surg nurses at most hospital systems — typically $2–$5 more per hour. The larger differentials come from experience, certifications, and geography rather than from the unit type alone. A CMSRN-certified med-surg nurse with five years of experience will often out-earn a new ICU nurse.
Is CMSRN worth the salary increase?
The data suggests yes. CMSRN-certified nurses typically earn $5,000–$10,000 more annually than non-certified med-surg nurses in comparable roles. The AMSN member exam fee is $267, non-member $394. Many hospitals reimburse the exam fee entirely. Even without reimbursement, the certification pays for itself within the first month of any salary premium.
What is the highest-paying state for med-surg nurses?
California. BLS May 2024 data shows California RNs earn a mean of $148,330 annually — far above the second-highest state. Vivian Health data specifically for med-surg nurses shows California hourly rates averaging $82/hour with top earners reaching $100/hour. The combination of California’s mandatory staffing ratios (which require more nurses per shift), high cost of living, and strong union contracts drives this premium.