Survey also shows continued utilization of APP incentives and premium pay as a recruitment and retention tool.

• Median total cash compensation (TCC) for hospital-based nurse practitioners (NPs) and physician assistants (PAs) rose about 2% from 2025 to 2026, compared with more than 5% the prior year.
• Median TCC increased 6.3% for certified registered nurse anesthetists (CRNAs) and 8.2% for certified anesthesiologist assistants (CAAs).
• More than half (52%) of surveyed organizations use incentive pay for at least some advanced practice providers (APPs).

SullivanCotter, the nation’s leading independent consulting firm in the assessment and development of total rewards programs, workforce solutions, and data products for health care and not-for-profits, released its 2026 Advanced Practice Provider Compensation and Productivity Survey Report, which shows differing pay trends across APP roles.

This survey is the industry's largest compensation dataset for evaluating APP compensation and productivity across U.S. hospitals and health systems. It draws on data from 892 organizations, covers more than 160,900 individual APPs and 6,200 APP leaders, and includes work relative value unit (wRVU) data from more than 42,400 APPs – which represents approximately 25% of all practicing APPs in the country.

APP Compensation and Productivity Trends

While the APP workforce remains in high demand, compensation growth for NPs and PAs continues at a more measured pace than in recent years. Productivity trends also vary by specialty and practice model.

• Median TCC for hospital-based specialties increased approximately 2% from 2025 to 2026, compared with more than 5% growth the previous year.
• Primary care and surgical specialties both posted roughly 3% year-over-year increases in median TCC. These figures exclude premium pay, such as shift differentials, call pay and extra shift pay.
• Median personally performed wRVUs for primary care NPs and PAs increased from 4,316 in 2025 to 4,450 in 2026, continuing a pattern of annual growth.

Other specialty groups have experienced greater year-over-year variability, underscoring the importance of interpreting benchmarks in the context of clinical responsibilities and care delivery models.

“Benchmarks are most useful when they reflect how APPs actually practice,” said Zach Hartsell, Principal and APP Workforce Practice Leader, SullivanCotter. “A primary care APP managing a patient panel has different responsibilities from an APP supporting a surgical team. Productivity expectations should account for those differences and be evaluated alongside quality and access outcomes.”

CRNA and CAA Compensation Growth

Demand for anesthesia providers continues to place upward pressure on compensation for CRNAs and CAAs.

• From 2025 to 2026, median TCC increased by 6.3% for CRNAs and 8.2% for CAAs, compared to the respective growth of 5.2% and 6.4% reported in last year’s survey.
• Over the longer term, median TCC grew by 19.3% for CRNAs and 30.2% for CAAs from 2023 to 2026.

Compensation growth for anesthesia providers continues to outpace the increases across most NP and PA specialties, reflecting sustained competition for anesthesia talent. CAA pay levels are also moving closer to those of CRNAs.

APP Incentive Compensation and Premium Pay

Changing APP expectations around schedule flexibility, professional development, and career advancement are also prompting organizations to evaluate recruitment and retention strategies beyond compensation alone. Shift differentials and extra shift pay remain common tools for meeting coverage needs.

• In 2026, 52% of organizations reported using incentive pay for at least some of their APPs.
• Among APPs with a base salary plus an incentive plan, primary care had the largest median incentive payment at $12,500, with incentive pay representing 9.3% of base salary. This compares with $10,000 and 7.6% respectively in 2025. Incentives for medical, surgical, and hospital-based specialties represented 5% of base salary.
• 67% of organizations provide shift differentials to some or all departments, with median hourly premiums ranging from $5.00 to $14.58, and 82% provide extra shift pay for at least some APPs. Organizations using a flat-dollar approach reported a median rate of $80 per hour, while those using a percentage-based approach reported a median premium of 27.5% of base pay.

Base salary remains important, but it is only one factor APPs consider when deciding whether to join or stay with an organization. Incentive opportunities, work schedules, and career development also shape the overall employment experience. Organizations need to consider these elements together when evaluating their compensation and workforce strategies.

APP Leadership Compensation

APP leadership structures continue to formalize as health systems recognize the strategic importance of this workforce. Dedicated executive roles carry responsibility for APP strategy and infrastructure across multiple entities, while clinical-level leaders often maintain substantial patient care responsibilities.

Compensation practices reflect these differences:

• Separate leadership salary grades are used by 81% of organizations for top APP executive roles, compared to 41% for clinical-level leaders.
• Premium pay eligibility also declines as leadership responsibilities become more administrative and strategic, with 63% of organizations reporting eligibility for clinical-level leaders compared to 12% for top APP executives.
• Incentive eligibility becomes more common as leadership responsibility increases, with 89% of organizations reporting eligibility for top APP executives compared to 53% for clinical-level leaders.
• Senior leaders are more likely to participate in management incentive programs, while clinical-level leaders often remain in the same incentive programs offered to staff APPs.

“As APP leadership responsibilities expand, compensation programs should reflect the scope and accountability of each role,” said Hadley Powless, Principal, SullivanCotter. “Senior leaders are increasingly responsible for workforce strategy and infrastructure. Their incentive programs should support those priorities rather than rely primarily on measures of clinical productivity.”

About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improves outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights, expertise, and data products to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision, and values.

For more information on SullivanCotter’s surveys, please visit our website at www.sullivancotter.com, or contact us via email or by phone at 888.739.7039.

Note to media: Additional data and interviews are available on request.

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