Nurse practitioner salary: what NPs earn by state, setting and specialty

If you are weighing an NP offer, planning a move, or deciding whether the jump from RN is worth it, the number to anchor on is $132,300. That was the median annual wage for nurse practitioners in the Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics (OEWS) data for May 2025, the latest release available, and this guide shows you how far above or below it your own pay is likely to land by state, setting and pay structure.

All wage figures below are BLS OEWS May 2025 unless a different year is named. BLS publishes a new OEWS round once a year, so check whether a newer one is out before you quote these in a negotiation.

Quick reference: nurse practitioner pay, May 2025

The percentile figures come from the BLS national data file for May 2025, which the Virginia Open Data Portal republishes in full as a downloadable spreadsheet. The median, mean and employment count also appear in the BLS OEWS news release.

What the median and percentiles mean for your offer

• Median (50th percentile): half of NPs earned more than this, half earned less. It is the "middle" NP, and it is usually a better guide than the average because a few very high earners pull the average up. That is why the NP mean ($137,300) sits above the median ($132,300).
• 10th percentile ($101,340): only 1 in 10 NPs earned less than this. Think of it as the floor of the normal range.
• 25th percentile ($117,990): a quarter of NPs earned less. Many new graduates and NPs in lower-paying regions sit around here.
• 75th percentile ($156,700): three quarters of NPs earned less. Getting here usually takes some combination of experience, a higher-paying location or setting, and pay on top of base.
• 90th percentile ($174,420): only 1 in 10 NPs earned more.

BLS itself makes the same point in its guide to using OEWS data in salary negotiations: someone new to a field may expect pay near the 10th or 25th percentile, while experienced workers can expect to sit nearer the 75th or 90th. Location and industry move you around inside that range too.

One practical detail: OEWS annual figures for salaried occupations like NP are the hourly rate multiplied by 2,080 hours, a standard full-time year, according to the May 2025 technical notes. If an offer is quoted hourly, multiply by 2,080 to compare it fairly. If you will work fewer hours, scale the comparison down rather than assuming the annual figure applies.

Base salary vs total compensation

The OEWS technical notes say the survey counts straight-time gross pay, including base rate, guaranteed pay, cost-of-living allowances and incentive pay such as production bonuses. It excludes overtime, shift differentials, nonproduction bonuses (a sign-on bonus is a typical example), and the cost of benefits.

What that means for NP pay in practice:

• Productivity and RVU bonuses. Many practices pay NPs a bonus tied to work RVUs (relative value units, the points assigned to each billed service) or to visit volume. In principle, production bonuses fall inside the OEWS wage definition. In practice, the survey asks employers for a wage rate, and a bonus that is paid quarterly or annually, varies a lot from person to person, or is settled after the survey period may not be fully reflected. Treat the OEWS figure as a base-heavy number, and value productivity pay separately.
• Call pay. Being on call, or getting called in, is usually paid as a premium or a separate stipend. Premium pay is excluded from OEWS wages, so call pay will generally not show up in the figures above.
• Overtime and shift differentials. Excluded. If you work nights or weekends in a hospital or urgent care setting, your real earnings can run above what OEWS suggests for your setting.
• Sign-on and retention bonuses. Excluded as nonproduction bonuses.
• Benefits. Excluded entirely. Health insurance, retirement match, paid time off, a continuing education allowance, license and DEA renewal fees, and malpractice coverage can be worth a lot, and they differ widely between employers. BLS does not publish NP-specific figures for these.

Example (hypothetical): two offers show the same base salary. Offer A adds a quarterly RVU bonus and a stipend for one weekend of call a month. Offer B has no bonus but includes a larger retirement match and pays for tail malpractice coverage if you leave. OEWS cannot tell you which is better; only the contract can. Price out each piece in dollars before you compare.

NP pay by work setting

BLS publishes industry breakdowns in its Occupational Outlook Handbook for the combined group of nurse anesthetists, nurse midwives and nurse practitioners. NPs make up most of that group (336,300 of 399,000 jobs in 2025, per the Occupational Outlook Handbook), but the much higher-paid nurse anesthetists are included, so treat these as a guide to how settings rank rather than exact NP figures.

What the table suggests:

• Physician offices employ the most and pay around the middle. Nearly half of the group works there, and the median sits close to the overall NP median. These roles are also where RVU-based productivity pay is most common, which the base figure will not fully capture.
• Hospitals and outpatient centers pay more at the median. Part of that reflects shift work, acuity and the hours involved. Remember that overtime and shift differentials come on top and are not in these numbers.
• Settings overlap a lot. A strong physician-office offer can beat a weak hospital one.

NP pay by state, and what changes once you adjust for prices

State medians for NPs ranged widely in May 2025. These figures come from the BLS state data file, republished by the Virginia Open Data Portal as a downloadable spreadsheet.

Highest and lowest median pay by state

The states with the most NPs on payroll were Texas (25,970, median $131,670), California, New York and Florida (21,790, median $129,510). Big NP markets are not always the best-paid ones.

Adjusting for prices with BEA regional price parities

A higher salary only helps if it buys more. The Bureau of Economic Analysis (BEA) publishes regional price parities (RPPs), which compare price levels in each state with the national average, set at 100. An RPP of 110 means prices about 10% above the national level. BEA says housing rents are often the main driver of the differences.

The newest RPPs are for 2024, published February 19, 2026, and BEA lists the next release for December 10, 2026. For 2024, California had the highest state RPP at 110.7, followed by Hawaii (110.0) and New Jersey (108.8), with the District of Columbia at 109.9. The lowest were Arkansas (86.9), Mississippi (87.0), and Iowa and Oklahoma (both 87.8).

To adjust, divide the pay figure by the RPP and multiply by 100.

Worked example (illustration only): California's May 2025 NP median was $168,520. Divide by 110.7 and multiply by 100, and you get about $152,200 in national-average prices. Oklahoma's median was $133,390; divided by 87.8 and multiplied by 100, that is about $151,900. A gap of more than $35,000 on paper shrinks to a few hundred dollars once prices are taken into account.

Here is the same calculation for the states with the highest and lowest 2024 RPPs:

Two cautions before you pack the car:

• The years do not match exactly. The wage data is May 2025 and the price data is 2024. That is fine for comparing states, less so for precise budgeting.
• RPPs are statewide averages. Prices inside a state vary a lot. BEA also publishes metro-area RPPs, which are a better match if you know the city.

Metro areas where NP pay is highest and lowest

OEWS publishes estimates for approximately 530 metropolitan and nonmetropolitan areas, according to the technical notes, though not every area will have a published NP figure. Those metro figures live in BLS's interactive profile and map tools, so this guide does not reprint a metro ranking. Here is what the state data already tells you, and how to check your own area.

• Spread inside a state can be as big as the gap between states. In California, the 10th percentile NP earned $120,340 and the 90th percentile earned $240,830. In Arkansas, the median was $125,660 but the 90th percentile reached $205,810. Some of that spread is location within the state, some is setting and pay structure.
• Big metros tend to pay more. BLS notes that wages for the same job are generally higher in large metro areas, where a higher cost of living pushes pay up.
• Rural and nonmetro roles can surprise you. Hard-to-fill rural jobs sometimes pay above the state median, often through bonuses or loan repayment that OEWS does not count. Ask.

To look up your metro, start from the BLS OEWS negotiation guide, which links to the occupation profiles and the wage map. Pick "Nurse Practitioners" and switch the map to the median or a percentile. Note the number of NPs in the area too: a metro estimate based on only a handful of jobs is less reliable than a statewide one.

What moves you up the range

Specialty: the data is thin

OEWS does not split nurse practitioners by specialty. Family, adult-gerontology, psychiatric-mental health, acute care, pediatric and women's health NPs are all counted together under one occupation code. So there is no official national median for, say, psychiatric NPs.

Professional associations and private salary surveys do publish specialty figures. If you use them, check who was surveyed, how many people answered, and whether the figure is base pay or total pay. Self-reported surveys with small samples can swing a lot from year to year. Treat specialty claims as rough signals, and lean on job postings and offers in your own market.

Experience and growth in the field

BLS links experience to where you sit in the distribution, and the field itself has grown fast. The NP median was $111,680 in May 2020, according to the BLS May 2020 NP profile, against $132,300 in May 2025. Those are nominal figures, not adjusted for inflation. NP employment in the survey grew from 211,280 to 323,040 over the same years, and BLS projects NP employment to grow 41% from 2025 to 2035.

Call, productivity and extra shifts

Often the biggest levers for an individual NP, and the least visible in official data.

• Call pay: ask whether call is paid as a flat stipend per shift, an hourly rate when called in, or both, and how often you will carry it.
• RVU or productivity bonuses: ask what threshold triggers the bonus, the dollar rate per RVU or visit above it, how often it pays out, and whether it can be clawed back.
• Extra shifts and differentials: nights, weekends and holidays often carry a differential in hospital settings.

Scope of practice and billing

How much revenue you are credited with can affect productivity pay. Visits billed under a physician's number, under "incident-to" rules, or under the NP's own number may be credited differently in your employer's formula, and Medicare generally pays a reduced rate when services are billed under an NP's own number. Practice rules also vary by state, which shapes what work you can do independently. If a formula depends on billing, ask how your work is attributed.

How NP pay compares with nearby roles

National medians, May 2025, from the BLS Occupational Outlook Handbook:

Physician assistants often work alongside NPs, and their median ran slightly above the NP median in May 2025. If a practice employs both, ask whether they share a pay scale and productivity formula.

How to use these numbers when you are offered a job

Start by placing the offer against your state's distribution, not just the national median.

Example (hypothetical): you are offered $128,000 base for an outpatient role in Ohio. Ohio's May 2025 NP median was $124,870 and the 75th percentile was $134,750. The offer is above the middle, short of the top quarter. If you bring several years of experience, asking to move toward the 75th percentile is a reasonable, data-backed request.

Example (hypothetical): a new graduate gets a $110,000 offer in Texas. The Texas 10th percentile was $96,880 and the 25th was $113,840, so the offer sits in the lower quarter, which is common for a first NP role. A modest counter toward the 25th percentile, plus a guaranteed review at 12 months, is a realistic ask.

Scripts you can use

To ask how productivity pay works:

"Thanks, I'm excited about the role. Before I compare offers, can you walk me through how the productivity bonus is calculated? What's the RVU or visit threshold, what's the rate above it, how often does it pay out, and what did NPs in this role actually earn from it last year?"

To counter on base:

"Based on BLS data for nurse practitioners in this state, the median is around [state median] and the 75th percentile is around [state 75th]. Given my experience in [area], I was hoping for a base closer to [your number]. Is there flexibility there?"

To pin down call:

"How is call scheduled and paid? Is it a stipend per shift, pay per callback, or both, and how many call shifts a month should I expect?"

Checklist before you sign

• Base salary, written as both annual and hourly, with expected weekly hours.
• Productivity formula in writing: threshold, rate, payout schedule, and any clawback.
• Call schedule and how each type of call is paid.
• Sign-on bonus terms, including any repayment if you leave early.
• Malpractice coverage type, and who pays for tail coverage.
• Benefits: health plan, retirement match, PTO, continuing education allowance and license fees.
• Non-compete or non-solicitation terms. Rules vary by state, so if the clause is broad, a lawyer who reviews healthcare employment contracts can tell you what it means where you work.

What to do next

• Look up your state's 25th, median and 75th percentile NP wages from the May 2025 data, and write down where your current pay or offer falls.
• If you are comparing states, run the RPP calculation above for each one, using metro RPPs if you know the city.
• Before any offer conversation, list every pay element (base, productivity, call, bonuses, benefits) and put a dollar value on each.
• Ask for the productivity formula and last year's actual payouts in writing.
• Check for a newer OEWS release each spring and new RPPs each December, and update your numbers.

For more pay guides by job, browse our salaries by role section, and see negotiation for more scripts.