The median nurse practitioner salary in the United States is $128,490 per year – roughly $61.77 per hour – based on Bureau of Labor Statistics Occupational Employment and Wage Statistics data for SOC 29-1171 (Nurse Practitioners, May 2024). At the 90th percentile, NPs earn $168,440. The range is wide: from $79,440 at the 10th percentile to well above $168,000 for experienced NPs in high-demand specialties and coastal states.
That spread is not random. Specialty, state, work setting, and practice authority each move the number. A psychiatric NP in California earns fundamentally differently from a family NP in Tennessee – same credential, $50,000+ gap. This guide breaks down NP salary by every major variable.
| Percentile | Annual salary | Hourly (approx.) |
|---|---|---|
| 10th percentile | $79,440 | $38.19 |
| 25th percentile | $104,370 | $50.18 |
| 50th percentile (median) | $128,490 | $61.77 |
| 75th percentile | $157,200 | $75.58 |
| 90th percentile | $168,440 | $80.98 |
Why NP salaries vary: specialty drives the largest within-credential gap (psychiatric NPs earn ~$10,000 more than the median; some procedural NPs less). State is the largest absolute variable – California NPs average over $161,000, Tennessee NPs around $103,000. Setting (hospital vs. outpatient vs. telehealth) creates a consistent $15,000–$25,000 spread. Experience compounds everything.
NP salary overview
The BLS national median for nurse practitioners is $128,490 (SOC 29-1171, May 2024 data). The national mean is $132,050 – pulled higher by a concentration of top earners in California and the Pacific Northwest. For career planning, the median is the more reliable benchmark.
The hourly equivalent at median is approximately $61.77 based on a standard 2,080-hour work year. Part-time and per-diem NP roles commonly pay $65–$90/hr, above the full-time hourly equivalent, because employers are not providing benefits on those hours.
Compared to registered nurses, NPs earn roughly $42,000 more per year at the median. The RN salary median sits at $86,070 nationally. That $42,000 gap represents the return on 2–4 years of graduate education, plus the expanded scope of practice that comes with NP licensure: independent assessment, diagnosis, and prescribing authority.
BLS projects NP employment growth of 40% through 2033 – a rate roughly five times the national average for all occupations. Approximately 385,000 NPs are currently employed in the United States, and the workforce continues to expand as primary care demand outpaces physician supply.
NP salary by state
The table below uses BLS OEWS May 2024 state-level median annual wages for nurse practitioners (SOC 29-1171). The top 10 highest-paying states are followed by five states at the lower end of the range.
| State | Median annual salary | Approx. hourly |
|---|---|---|
| California | $159,290 | $76.58 |
| Washington | $150,040 | $72.13 |
| New Jersey | $148,870 | $71.57 |
| Hawaii | $145,290 | $69.85 |
| Massachusetts | $144,260 | $69.36 |
| Oregon | $141,720 | $68.13 |
| Connecticut | $139,980 | $67.30 |
| New York | $137,510 | $66.11 |
| Minnesota | $135,680 | $65.23 |
| Alaska | $134,870 | $64.84 |
| National median | $128,490 | $61.77 |
| Tennessee | $103,720 | $49.87 |
| Alabama | $110,020 | $52.90 |
| Arkansas | $113,410 | $54.53 |
| Mississippi | $117,490 | $56.49 |
| Oklahoma | $124,330 | $59.78 |
All ten of the top-paying states have either full or substantially expanded NP practice authority, meaning NPs in those states can practice, diagnose, and prescribe without a physician collaborative agreement. That correlation is not coincidental: full-practice-authority states attract more NPs, which increases employer competition for experienced providers and pushes wages up. California, Washington, Oregon, Massachusetts, and New York all removed collaborative practice requirements within the last decade.
Within any state, metro vs. rural variation is significant. A New York NP in Manhattan earns considerably more than one practicing in the rural Southern Tier – but rural shortage areas often compensate with signing bonuses, loan repayment programs, and lower cost of living that can make the net financial picture competitive.
For the full NP pathway, including how to choose a state for practice, see the how to become a nurse practitioner guide.
NP salary by specialty
BLS reports all nurse practitioners under a single code (SOC 29-1171), so specialty breakdowns rely on AANP annual compensation survey data, Nurse.org salary reports, and NP-specific job market data. The figures below reflect estimated medians for each specialty as of 2024–2025.
| NP specialty | Estimated median salary | Typical setting | Notes |
|---|---|---|---|
| CRNA (Certified Registered Nurse Anesthetist) | $223,210 | OR, ASC, hospital | Separate BLS code (SOC 29-1151); doctoral-level entry since 2025 |
| Neonatal NP (NNP) | ~$135,000–$148,000 | NICU | Small job market; shift differentials significant |
| Acute care NP (AGACNP / ACNP) | ~$130,000–$148,000 | Hospital, ICU, hospitalist | Hospital shift differentials add $10,000–$20,000 |
| Psychiatric-mental health NP (PMHNP) | ~$132,000–$140,000 | Outpatient MH, telepsychiatry | Mental health shortage driving premium in most states |
| Family NP (FNP) | $128,490 | Primary care, urgent care | Largest specialty; ~70% of all NPs; BLS median closely tracks FNP |
| Adult-gerontology primary care NP (AGPCNP) | ~$119,000–$128,000 | Outpatient, geriatrics, SNF | Aging population driving demand; NHSC loan repayment widely available |
| Pediatric NP (PNP) | ~$120,000–$135,000 | Pediatric primary care, children's hospital | Children's hospital systems tend to pay above median |
| Women's health NP (WHNP) | ~$115,000–$130,000 | OB-GYN, women's health clinic | Market concentration in metro areas |
| Certified Nurse-Midwife (CNM) | ~$129,000 | Hospital L&D, birth center, OB-GYN | Separate APRN credential; see CNM salary guide |
CRNAs are the highest-paid APRN credential by a wide margin – see the CRNA salary guide for the full breakdown. The CRNA premium reflects a 3–4 year doctoral program, a required ICU experience background, and a practice scope (anesthesia administration) with no non-physician equivalent.
For PMHNP compensation detail, see the PMHNP salary guide. For FNP-specific state data and negotiation guidance, see the family nurse practitioner salary guide.
NP salary by work setting
Setting is a consistent salary predictor across specialties. Hospital-employed NPs earn the most in base salary; private practices and telehealth roles vary considerably by employer structure and patient volume.
| Work setting | Typical NP salary range | Notes |
|---|---|---|
| Hospital (inpatient, acute care) | $125,000–$175,000+ | Highest base; shift differentials and call premiums add $10,000–$25,000 |
| VA / federal government | $120,000–$160,000 | GS pay scale plus locality pay; strong pension and benefits |
| Academic medical center | $115,000–$155,000 | Teaching responsibilities may offset pay; strong malpractice and benefits |
| Urgent care (employed) | $110,000–$150,000 | Many positions pay hourly ($60–$80/hr); volume-driven |
| Outpatient primary care clinic | $110,000–$140,000 | Most common NP setting; predictable hours; productivity bonuses variable |
| Telehealth (employed) | $115,000–$145,000 | Growing segment; geographic flexibility; scope depends on state law |
| Private practice (employed by physician) | $100,000–$140,000 | Wide variance; depends on practice volume and owner model |
| Rural health clinic / FQHC | $105,000–$135,000 | NHSC loan repayment up to $55,000/2 years for eligible shortage areas |
| Long-term care / skilled nursing facility | $100,000–$130,000 | High demand; loan repayment often available; lower base offset by incentives |
| NP-owned independent practice | $130,000–$200,000+ | Requires full practice authority state; higher ceiling, higher business risk |
Hospital NPs with inpatient responsibilities consistently earn at the top of the range. Night and weekend shift differentials – typically 15–25% above base for overnight shifts – can add $15,000–$25,000 to annual compensation beyond what a job posting lists. An NP earning $130,000 base with a 20% night differential working two overnight shifts per week may clear $150,000 in total hourly earnings.
FQHCs and rural health clinics offer the National Health Service Corps Loan Repayment Program: up to $55,000 in student loan repayment for a two-year full-time commitment at a Health Professional Shortage Area (HPSA) site. For new NP graduates carrying $80,000–$150,000 in student debt, FQHC employment with NHSC eligibility can outperform a higher base salary at a private employer once the tax-free loan repayment is factored in.
NP salary by experience level
Experience is the most reliable predictor of salary within a given market and specialty. The table below reflects typical ranges at each career stage, drawing on BLS percentile data and AANP compensation survey patterns.
| Experience tier | Years of NP practice | Typical salary range | Key factors |
|---|---|---|---|
| New graduate | <1 year | $90,000–$110,000 | State practice authority, employer type, prior RN specialty background |
| Early career | 1–4 years | $105,000–$130,000 | Panel growth, prescribing confidence, first renegotiation leverage |
| Mid-career | 5–10 years | $120,000–$150,000 | Specialty subspecialization, productivity bonuses, job market mobility |
| Senior | 10–15 years | $135,000–$165,000 | Geographic leverage, leadership roles, specialty certifications |
| NP director / advanced | 15+ years | $150,000–$185,000+ | Practice ownership, executive clinical roles, high-cost-of-living markets |
New grads in full-practice-authority states typically start $5,000–$10,000 higher than peers in collaborative-agreement states, because the administrative overhead of physician supervision arrangements suppresses what some employers will offer. California, New York, Oregon, Washington, and Massachusetts regularly produce new-grad offers above $110,000.
The salary gap between new-grad and 10-year NPs in the same specialty and market commonly runs $40,000–$60,000. Salary growth accelerates most in the first five years, as NPs build their panels, demonstrate prescribing competence, and gain negotiating leverage. After the first decade, further growth typically requires changing employers, moving to a higher-paying specialty, or taking on leadership responsibilities.
One commonly overstated factor: the DNP vs. MSN premium. Survey data consistently shows DNP-prepared NPs earn $5,000–$15,000 more than MSN-prepared peers in institutional settings (hospitals, academic medical centers, VA). Outside those settings, the premium is smaller and sometimes zero. The DNP adds meaningful value at the leadership and negotiation table; it does not double the salary gap the way a specialty transition can.
Factors that increase NP salary
Geographic relocation to a shortage area. Rural and underserved areas face a persistent NP shortage, and health systems and federal programs have responded with incentives that don’t appear in base salary comparisons. NHSC Loan Repayment pays up to $55,000 tax-free for two-year commitments at HPSA-designated sites. The NURSE Corps Scholarship Program funds graduate school in exchange for service commitments at critical shortage facilities. For new graduates with significant debt, rural positioning is often the highest-value financial decision available.
Specialty certification. ANCC (American Nurses Credentialing Center) and AANPCB certifications are required for practice, but additional subspecialty credentials add salary leverage. Many hospital systems pay certification bonuses of $2,000–$5,000 per year. Beyond the bonus, specialized skills in wound care, diabetes management, or palliative care allow NPs to bill for additional services and negotiate above-market contracts.
Full practice authority states. NPs in full-practice-authority states earn measurably more at every experience level. The mechanism is structural: without a required collaborative agreement, an NP can open an independent practice or contract directly with payers, which increases their negotiating leverage with any employer. The salary premium over restricted practice states runs roughly 5–10% at the median.
Employer negotiation. Studies of NP hiring patterns suggest new grads leave an average of 5–15% on the table by accepting first offers. Health system salary bands have a range; first offers frequently sit at or below the midpoint. Counter-offers backed by BLS state data, competing offers, or specialty certifications routinely succeed. Negotiating total package – CME allowance, malpractice tail coverage, sign-on bonus, schedule flexibility – adds real dollar value even when base salary movement is limited.
Locum tenens and per-diem shifts. Locum tenens NP rates typically run $65–$100/hr in primary care and $80–$120/hr in psychiatric and acute care specialties. Experienced NPs who add locum or per-diem shifts alongside a permanent position can raise total annual income by $15,000–$40,000 without changing employers. Telehealth panels offer a similar model for NPs in full-practice-authority states who can build a separate patient panel outside their primary employment.
NP vs PA vs physician salary comparison
NPs are frequently compared to physician assistants and physicians in salary discussions. The table below reflects national medians from BLS and MGMA data.
| Role | Median annual salary | Total typical comp range | Training timeline |
|---|---|---|---|
| Nurse Practitioner (NP) | $128,490 | $90,000–$175,000+ | 6–8 years post-high school (BSN + MSN/DNP) |
| Physician Assistant (PA) | ~$130,020 | $95,000–$165,000+ | 6–8 years post-high school (BA + PA school) |
| Primary care physician (MD/DO) | ~$250,000–$290,000 | $200,000–$320,000 | 11–13 years post-high school (BA + MD + 3-yr residency) |
| Specialist physician (MD/DO) | ~$350,000–$500,000+ | $280,000–$600,000+ | 13–16+ years (BA + MD + 5–7 yr residency/fellowship) |
NP and PA median salaries sit within $2,000 of each other nationally, though the variance is large within both professions. Psychiatric PAs and orthopedic PAs can earn well above $150,000; primary care NPs in rural shortage areas can reach $140,000+ with loan repayment factored in.
The physician salary advantage is large – $120,000+ over NPs at the primary care median. The investment to reach it is also large: an additional 5–8 years of training, medical school debt averaging $200,000+, and a residency at $60,000–$75,000/year during those years. Present-value analyses typically show NPs and PAs accumulating net worth faster in years 1–15 of their careers due to the earlier earning start and lower debt load, even though lifetime physician earnings are higher.
NP scope expansion has increased earning potential in full-practice-authority states, where NPs can own practices and bill independently. The gap between NP and physician income narrows in private practice ownership models and telehealth settings where physician oversight is no longer required.
How to maximize your NP salary
Negotiate from your first offer. Most new-grad NPs accept the first number on the table. That number is typically set at or below the midpoint of the employer’s salary band. Presenting BLS state data and making a specific counter-offer – $5,000–$10,000 above the initial offer, supported by a brief rationale – is standard practice and rarely costs you the offer.
Choose a high-demand specialty. Psychiatric, acute care, and neonatal NP roles consistently earn above the all-NP median. If you have the clinical background and interest, a specialty that is in shortage carries a built-in salary premium that compounds over a career.
Target a full-practice-authority state. The top-10 highest-paying states all have full practice authority. If salary is a priority, restricting your job search to full-practice-authority states puts you in the highest-paying labor markets before the interview process begins.
Add locum tenens shifts. Once you have 2–3 years of NP experience, locum tenens and per-diem shifts are available at $70–$120/hr depending on specialty. A single weekend locum shift per month adds $15,000–$25,000 annually to a full-time salary.
Eliminate debt with NHSC. 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–$80,000 raise spread over two years. Rural and underserved settings look different when student debt is quantified as a cost of your current position.
For a full walkthrough of the NP pathway – education, certification, and first-job strategy – see the how to become a nurse practitioner guide.
Summary
The median NP salary of $128,490 is a useful anchor, but it understates the range available to a nurse practitioner who makes deliberate choices about specialty, state, and setting. The 90th percentile is $168,440 – a figure accessible to experienced NPs in the right markets. CRNAs earning a median of $223,210 represent the income ceiling within the broader APRN group, at the cost of a doctoral program and ICU experience requirement.
The salary gap between an NP just entering practice and one with 10+ years in a high-demand specialty and full-practice-authority state commonly exceeds $70,000 per year. That gap is earned through credential investment, job market mobility, and negotiation – not simply by waiting out the years.
For specialty-specific salary data: FNP salary – PMHNP salary – CRNA salary – CNM salary – RN salary
Salary data sourced from US Bureau of Labor Statistics Occupational Employment and Wage Statistics (SOC 29-1171 Nurse Practitioners, May 2024 release; SOC 29-1151 Nurse Anesthetists; SOC 29-1141 Registered Nurses), AANP 2024 NP Compensation Survey, and Nurse.org specialty salary data. Individual earnings vary by employer, setting, experience, and contract structure.