Step-down nurses occupy a valuable position in the hospital hierarchy – managing higher acuity than general floor nurses while remaining distinct from fully critical care staff. That positioning generally translates to stronger compensation than med-surg nursing, with pay that trends toward the lower end of ICU nurse ranges at most hospitals.
This guide breaks down step-down nurse salary by state, experience level, employer type, and specialty focus, using BLS OEWS May 2025 data alongside current market sources.
Note on data: The Bureau of Labor Statistics does not publish step-down or PCU-specific wage data. BLS classifies all bedside RNs under SOC 29-1141 (Registered Nurses). The state-by-state table below uses all-RN BLS OEWS May 2025 figures as a benchmark. Step-down nurses typically earn a premium above facility med-surg baselines at the same hospital, but be aware that no national dataset measures that premium – BLS does not stratify SOC 29-1141 by unit type, and the $3,000–$8,000 figure quoted across nursing salary content is an employer-level estimate rather than a measured national gap.
A note on mean versus median. Older versions of this guide, and much of the third-party nursing salary content online, quote a “mean” figure and a “median” figure interchangeably. They are not the same measurement. For registered nurses nationally in May 2025, the median was $97,550 and the mean was $101,420 – the mean sits higher because a relatively small number of very high earners in California, Hawaii, and travel contracts pull the average up. The median is the more useful number when you are checking whether a specific offer is reasonable, because it describes the midpoint nurse rather than the arithmetic average.
Average step-down nurse salary
National estimates for step-down nurse compensation from current market data:
| Source | Annual or hourly estimate |
|---|---|
| BLS OEWS May 2025 (all-RN median, SOC 29-1141) | $97,550/year |
| BLS OEWS May 2025 (all-RN mean, SOC 29-1141) | $101,420/year |
| Vivian Health (PCU staff, current) | ~$45/hr |
| Glassdoor (RN step-down) | ~$118,777/year (includes total comp) |
| Nursa salary range | $77,000–$106,000/year |
The spread in reported numbers reflects the difference in data sources: BLS surveys employers and captures all of them, including lower-paying rural facilities, while platforms like Glassdoor and ZipRecruiter rely on self-reported or advertised figures that skew toward urban hospitals and toward total compensation rather than base pay. Treat BLS as the floor-to-midpoint reference and the aggregators as an upper-bound signal. The realistic range for most full-time step-down nurses with 2+ years of experience is $90,000–$110,000 per year in most non-coastal states, and $120,000–$160,000+ in California, Hawaii, Oregon, and Washington.
Step-down nurse salary by state
The table below uses BLS OEWS May 2025 annual median wages for all registered nurses (SOC 29-1141). BLS does not publish step-down-specific state data. These figures represent the all-RN baseline; step-down nurses at acute care hospitals typically earn at or above these state medians.
| State | Annual median wage (all RNs, BLS OEWS May 2025) |
|---|---|
| Alabama | $77,080 |
| Alaska | $109,480 |
| Arizona | $99,500 |
| Arkansas | $78,940 |
| California | $140,270 |
| Colorado | $100,260 |
| Connecticut | $102,740 |
| Delaware | $99,520 |
| District of Columbia | $102,540 |
| Florida | $84,190 |
| Georgia | $93,550 |
| Hawaii | $136,320 |
| Idaho | $92,460 |
| Illinois | $95,990 |
| Indiana | $83,500 |
| Iowa | $78,630 |
| Kansas | $79,320 |
| Kentucky | $81,040 |
| Louisiana | $80,230 |
| Maine | $86,990 |
| Maryland | $99,790 |
| Massachusetts | $104,550 |
| Michigan | $94,300 |
| Minnesota | $101,510 |
| Mississippi | $77,090 |
| Missouri | $81,780 |
| Montana | $85,280 |
| Nebraska | $84,730 |
| Nevada | $103,670 |
| New Hampshire | $99,700 |
| New Jersey | $106,500 |
| New Mexico | $94,340 |
| New York | $109,440 |
| North Carolina | $84,350 |
| North Dakota | $80,730 |
| Ohio | $82,510 |
| Oklahoma | $82,920 |
| Oregon | $129,010 |
| Pennsylvania | $96,430 |
| Rhode Island | $100,640 |
| South Carolina | $82,360 |
| South Dakota | $78,060 |
| Tennessee | $81,500 |
| Texas | $95,970 |
| Utah | $84,600 |
| Vermont | $97,460 |
| Virginia | $93,600 |
| Washington | $124,200 |
| West Virginia | $80,130 |
| Wisconsin | $95,530 |
| Wyoming | $83,760 |
Source: Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025, SOC 29-1141 (Registered Nurses), accessed via O*NET state wage data. Figures represent annual median wages for all registered nurses, not step-down nurses specifically. BLS does not publish specialty-specific wage data by state.
What changed in this vintage. The May 2025 estimates compressed the gap between high-wage and low-wage states considerably, and several rankings moved. The bottom of the table rose far faster than the top: Alabama now sits at $77,080 and South Dakota at $78,060, while California moved only about 5%, from $133,340 to $140,270. New Hampshire ($99,700) and Rhode Island ($100,640) jumped from the bottom third of the table into the top quarter. If you are comparing this table against a salary guide that still shows California paying roughly twice what Alabama pays, that guide is running an older vintage – the real gap at the median is now about 82%.
Step-down vs med-surg vs ICU salary comparison
The table below uses national salary estimates from current market data. Figures represent typical ranges for experienced nurses (2–5 years) at acute care hospitals.
| Specialty | Typical annual salary range | Nurse-to-patient ratio | Monitoring requirement |
|---|---|---|---|
| Medical-surgical (floor) | $84,000–$98,000 | 1:4 to 1:6 | Intermittent / none |
| Step-down / PCU | $95,000–$115,000 | 1:3 to 1:4 | Continuous telemetry |
| ICU / critical care | $100,000–$125,000+ | 1:1 to 1:2 | Continuous bedside |
The nurse-to-patient ratios in the table above are typical staffing practice, not a national legal requirement. Only California sets ratios in regulation. Under California Code of Regulations Title 22, section 70217, the licensed nurse-to-patient ratio in a step-down unit has been 1:3 or fewer at all times since January 1, 2008; telemetry units are 1:4, critical care 1:2, and medical/surgical 1:5 (tightened from 1:6 on January 1, 2005). Oregon’s HB 2697 sets ratios by a different mechanism, and most other states either require a staffing committee and written plan or regulate nothing at all.
The step-down premium over med-surg typically reflects:
- Mandatory ACLS certification requirement
- Continuous telemetry monitoring responsibility
- Vasoactive medication management
- Higher overall skill requirement for arrhythmia recognition and hemodynamic assessment
For context on ICU nursing pay, see our ICU nurse salary guide. For med-surg salary comparisons, see our med-surg nurse salary guide.
PCCN certification salary premium
The Progressive Care Certified Nurse (PCCN) credential from the American Association of Critical-Care Nurses (AACN) typically adds to base pay through two mechanisms:
Per-hour differential: The most common structure. Hospitals offer $1.00–$3.00 per hour for active PCCN certification, which equates to approximately $2,080–$6,240 per year on a full-time schedule.
Annual lump-sum bonus: Some employers pay a one-time annual bonus of $1,500–$3,000 for holding an active specialty certification.
Magnet-designated hospitals and large academic medical centers tend to offer higher certification differentials. In California, where base wages are already elevated, the PCCN differential adds meaningfully to an already high salary floor.
AACN offers two eligibility routes for the PCCN (Adult), and guides commonly quote only the first. The two-year option requires 1,750 hours in the direct care of acutely ill adult patients during the previous two years, with 875 of those hours accrued in the most recent year. The five-year option requires a minimum of 2,000 hours over five years, with only 144 hours in the most recent year – which is the route that works for nurses who have moved into education, management, or part-time practice and would fail the recency test on the two-year path. For more on the certification pathway, see the step-down nurse career guide.
Salary by years of experience
Step-down nurse compensation scales significantly with experience, driven by automatic merit increases, unit-specific pay scales, and eligibility for charge nurse and preceptor differentials.
| Experience level | Estimated annual salary range |
|---|---|
| New graduate / less than 1 year | $70,000–$85,000 |
| 1–2 years | $80,000–$95,000 |
| 3–5 years | $92,000–$108,000 |
| 5–10 years | $102,000–$122,000 |
| 10+ years | $112,000–$140,000+ |
These bands are planning estimates derived from the national percentile spread for SOC 29-1141, not a measured national dataset – BLS publishes percentiles for registered nurses as a whole and does not break them out by years of experience or by unit type. Roughly, new graduates map to the 10th–25th percentile of the RN distribution, experienced staff nurses to the median-to-75th percentile band, and senior specialty nurses to the 75th–90th.
Ranges vary substantially by state. A 5-year step-down nurse in California may earn $140,000–$165,000+; the same nurse in Alabama or South Dakota may earn $82,000–$98,000.
Additional pay layers that accumulate with experience:
- PCCN certification differential (eligible after 1,750 hours): +$2,000–$6,000/year
- Charge nurse differential: +$3–$6/hour when acting as charge
- Preceptor differential: +$1–$3/hour when orienting a new nurse
- Night shift differential: +15–25% above base at most hospitals
- Weekend differential: +$3–$8/hour (or a flat per-shift premium)
Salary by employer type
Where you work affects your step-down salary significantly, independent of state or city.
| Employer type | Typical salary range | Notes |
|---|---|---|
| Academic medical center | $95,000–$140,000 | Highest base wages; Magnet certification common; strong certification differentials |
| Large community hospital | $88,000–$110,000 | Competitive with AMCs in high-cost states; wider variation in smaller markets |
| VA hospital (federal) | $85,000–$115,000 | Federal pay scale; excellent benefits and pension; predictable progression |
| Travel agency (contract) | $95,000–$175,000+ (gross annual) | Weekly rates $2,000–$3,600+; lower benefits and no paid time off |
| Skilled nursing facility (SNF) | $70,000–$85,000 | Rare for true step-down; typically lower pay than acute care |
Federal VA hospitals offer compensation through the Office of Personnel Management pay scale, which is transparent, predictable, and includes a federal pension – an increasingly rare benefit. Pay levels are lower than California union rates but competitive in most other states.
Top-paying metros for step-down nurses
Metropolitan area matters as much as state. The highest-earning step-down nurses work in these markets:
San Jose–Sunnyvale–Santa Clara, CA: The highest-paying metro area for registered nurses in BLS data, driven by Silicon Valley cost of living and strong union presence. Step-down nurses at Santa Clara Valley Medical Center and Stanford Health Care facilities in this corridor earn among the highest wages in the country.
San Francisco Bay Area, CA: Closely behind San Jose. UCSF Medical Center, Kaiser Permanente Northern California, and Dignity Health facilities compete aggressively for PCU nurses. California’s Title 22 mandatory 1:3 step-down ratio adds to the per-nurse labor cost – and therefore to salaries.
Seattle, WA: Washington State has no income tax, strong union density, and among the highest RN wages outside California – a statewide median of $124,200 in May 2025. UW Medicine and Virginia Mason Franciscan Health are the major academic employers. Step-down nurses in Seattle typically earn $125,000–$145,000.
Boston, MA: Massachusetts General Hospital, Brigham and Women’s, and the Beth Israel Lahey Health system anchor one of the strongest nursing job markets in the Northeast. Strong union contracts at MGH and BWH support high base wages.
New York City, NY: NYC hospitals pay above the New York State mean. NYSNA union contracts at large NYC health systems set strong wage floors. Cost of living offsets some of the gain, but nurses in Manhattan and surrounding boroughs consistently earn above $110,000.
Portland, OR: Oregon’s RN median wage of $129,010 (BLS OEWS May 2025) reflects a strong union environment and relatively high cost of living, and now ranks third in the country behind only California and Hawaii. OHSU and Legacy Health are the major PCU employers. Oregon’s HB 2697, signed in August 2023, phased in nurse-to-patient ratios from June 2024, with the general medical-surgical ratio tightening from 1:5 to 1:4 on June 1, 2026.
Travel step-down nursing pay
Travel step-down contracts offer the highest short-term earnings in the specialty. Current data from Vivian Health (2025):
- National average: ~$2,125/week
- California: $2,400–$3,440/week
- Washington, DC: ~$2,207/week
Weekly travel packages typically include:
- Taxable base wage: Varies by state; typically $500–$700/week
- Non-taxable housing stipend: $1,000–$1,500/week (requires maintaining a permanent tax home)
- Non-taxable meals and incidentals: $400–$600/week
- Completion bonus: Some contracts include a $500–$1,500 bonus at the end of the 13-week assignment
The total package is the number agencies advertise. Nurses who maintain a permanent tax home (required by the IRS for non-taxable stipends) keep more of that gross pay than staff nurses earning an equivalent wage.
To qualify for travel step-down contracts, most agencies require:
- Minimum 1 year of recent step-down or PCU staff experience
- Current ACLS and BLS certification
- PCCN certification is preferred but not always required
For more on the travel nursing pathway, see our travel nurse salary guide.
States with the highest travel step-down contract volume include California, Texas, Florida, New York, and Washington – markets where high patient volume and staffing shortages create consistent contract demand.
How to increase your step-down salary
Earn the PCCN certification. The most direct pay increase available to step-down nurses. After meeting the practice-hour requirement, the PCCN adds roughly $2,000–$6,000 per year at employers that pay a certification differential. The exam costs $260 for AACN members and $375 for non-members, so joining AACN is usually worth doing before you apply.
Move to California. If geography is flexible, California’s mandatory 1:3 step-down ratio and strong union environment push wages to $140,000–$170,000+ for experienced nurses. The state income tax is significant, but the wage floor is substantially higher: California’s 10th percentile for registered nurses is $101,260, which is above the national median.
Negotiate shift differentials. A night differential of 15–25% on a full-time schedule adds roughly $12,000–$22,000 per year at a national-median base rate, and weekend differentials stack on top of that. Nurses willing to work night shift consistently have substantially higher annual earnings than their day-shift colleagues at the same base rate.
Take charge nurse shifts. Most facilities pay a per-shift or per-hour differential when you act as charge nurse. Even occasional charge shifts add meaningfully over a year.
Pursue a travel contract after 1–2 years on staff. Travel contracts in step-down typically yield $25,000–$50,000 more per year than equivalent staff positions, though you trade job security and benefits for the premium.
Look for float pool or per diem positions. Hospital float pools and per diem positions typically pay higher hourly rates (10–20% above base) in exchange for schedule flexibility. For step-down nurses with broad competencies, float pool work is a straightforward way to increase hourly earnings without leaving the facility.
Obtain a BSN if you have an ADN. Many hospitals offer a BSN completion differential of $1–$2/hour, and some step-down units require a BSN for staff positions or limit career advancement without one. BSN completion programs at many community colleges and online universities cost far less than the career differential they unlock.
Consider academic medical centers over community hospitals. AMCs and Magnet-designated hospitals typically offer higher base wages, stronger certification differentials, and more structured merit increase schedules than community hospitals in the same market.
Frequently asked questions
How much do step-down nurses make an hour? National estimates for step-down nurses range from $43–$57/hour for staff positions, depending on state, facility, and experience. California step-down nurses at major medical centers earn $70–$85+/hour. BLS OEWS May 2025 reports a national all-RN annual median of $97,550, which is roughly $46.90/hour at 2,080 hours.
Do step-down nurses make more than ICU nurses? Generally no. ICU nurses typically earn $5,000–$15,000 more per year than step-down nurses at the same facility, reflecting the higher acuity and greater skill requirements of critical care. The gap varies: at some hospitals with uniform RN pay scales, step-down and ICU nurses earn the same base rate with differences only in certification differentials.
What is the starting salary for a step-down nurse? New graduate step-down nurses (in markets where hospitals offer direct step-down residency programs) typically start at $70,000–$85,000 nationally. California new grads in PCU programs start at $100,000–$120,000 or higher at large academic medical centers, reflecting a state 10th-percentile RN wage of $101,260.
Does working nights increase step-down pay significantly? Yes. Night shift differentials of 15–25% above base are standard, adding $12,000–$22,000 per year for most nurses. Combined with weekend differentials, a night/weekend step-down nurse can significantly out-earn a day/weekday nurse at the same base rate.
How does step-down pay compare to the ICU nurse salary? ICU nurses earn approximately $5,000–$15,000 more per year than step-down nurses nationally. That figure is an employer-level pattern rather than a measured national statistic – BLS reports a single wage distribution for all registered nurses and does not separate critical care from progressive care. For nurses considering the ICU path, read our full ICU nurse career guide for the progression steps and salary data.
References
- US Bureau of Labor Statistics, “Occupational Employment and Wage Statistics, May 2025: 29-1141 Registered Nurses,” released 2026. National median annual wage $97,550; mean $101,420.
- US Bureau of Labor Statistics, “Occupational Outlook Handbook: Registered Nurses,” employment projections 2024–2034 (5% growth, approximately 189,100 annual openings).
- O*NET OnLine, “Summary Report for 29-1141.00 – Registered Nurses,” and state wage detail pages (
onetonline.org/link/localwages/29-1141.00), National Center for O*NET Development, 2026. - American Association of Critical-Care Nurses, “PCCN (Adult) Certification: Eligibility Requirements and Exam Fees,” aacn.org, 2026.
- California Code of Regulations, Title 22, Section 70217, “Nursing Service Staff” – licensed nurse-to-patient ratios by unit type, including the 1:3 step-down ratio effective January 1, 2008.
- Oregon Health Authority, “Hospital Nurse Staffing (HB 2697) Implementation FAQ,” Oregon Health Authority Public Health Division, 2024–2026.
- Internal Revenue Service, Publication 463, “Travel, Gift, and Car Expenses,” on the tax home requirement governing non-taxable travel stipends.
- Vivian Health, “Progressive Care (PCU) Nurse Salary Guide,” staff and travel contract rate data, 2026.
- American Nurses Credentialing Center, “Magnet Recognition Program Application Manual,” on baccalaureate and graduate degree requirements for nurse managers and nurse leaders.