Senior Physician Assistant Salary in San Francisco, CA: $245,881 (2026)
Quick Answer:The top tier of physician assistants working in San Francisco, CA — those at or above the 90th percentile — pull in $245,881/year or more for 2026, based on BLS OEWS 2025 estimates for SOC 29-1071. Strip back San Francisco's price premium (BEA RPP 115.6, 16% above national) and that top-decile pay carries the same buying power as $212,676 in average-cost America. The 29% spread above city median typically rewards 7+ years of practice or specialty credentials.
Official BLS data · View source
In 2026, experienced physician assistants in San Francisco can anticipate a median annual salary of $190,501, with top-tier earners making as much as $245,881. The robust salary potential at the 90th percentile significantly showcases the earning power of seasoned professionals in this region, placing San Francisco above the national market, where top physician assistant salaries reach $140,391. To attain such elevated compensation, senior physician assistants typically require over seven years of experience, along with specialized training and credentials. Specializing in high-demand areas such as surgical assistance, emergency medicine, and critical care positions professionals to capitalize on the significant wage gaps between the median salaries and those at the top of the pay scale.
2026 Salary Percentile Distribution in San Francisco
Experienced physician assistants at the top of the pay scale in San Francisco earn between $226,488 and $245,881 per year (2026 est.). This $136,207 range from 10th to 90th percentile reflects significant earnings potential growth over a career. The San Francisco median of $190,501 sits 35.69% above the US median.
Top PA Salary Comparison
| Level | San Francisco | National |
|---|---|---|
| Median (P50) | $190,501 | $140,391 |
| 75th Percentile | $226,488 | $169,424 |
| 90th Percentile (Top 10%) | $245,881 | $196,597 |
In San Francisco, experienced physician assistants (P90) earn 29.07% more than the local median — reflecting the significant value of specialization and tenure in this market.
What Drives Top Physician Assistant Pay in San Francisco
Advanced Certifications in California
CA physician assistants with additional specialty certifications within the physician assistant field earn significantly above the $190,501 median. Expanded-scope credentials are increasingly valued by San Francisco employers.
Specialty Focus
Physician Assistants focusing on high-acuity or specialty areas within the physician assistant field in San Francisco command premium compensation, often reaching the $226,488–$245,881 range.
Large Health-System & Multi-Site Experience
Large hospital systems and multi-site employers in the San Francisco metro area, which is a large PA employment market, often pay above-market rates for experienced physician assistants who demonstrate efficiency and leadership.
Employer Loyalty & Patient Relationships
Long-tenured physician assistants in San Francisco with established relationships have strong negotiating leverage. In this competitive market, retention bonuses and annual raises are common for top performers.
Continuing Education & Leadership
Physician Assistants in California who pursue advanced degrees, mentor junior staff, or lead clinical education programs position themselves for the highest compensation tiers and management roles.
Physician Assistant Career & Wage Growth Path in San Francisco
Clinical Physician Assistant
0-5 yearsSenior/Lead Physician Assistant
5-10 yearsPhysician Assistant Department Manager
10+ yearsEducator / Specialty Leadership
AdvancedSan Francisco ranks #39 of 158 California cities for top earner physician assistant salary (90th percentile: $245,881).
Top 10% physician assistant compensation in San Francisco ($245,881) is 3.26% above the California average P90 ($238,110).
2019 BLS Actual
$187,050
2025 BLS Actual
$237,980
2026 Current Est.
$245,881
2019–2027 Growth
+35.8%
Salary Trajectory for Physician Assistants in San Francisco (2019–2027)
2019–2025: actual BLS OEWS data for this metro area. 2026+: CAGR 3.32% projection.
| Year | Annual Salary | Status |
|---|---|---|
| 2019 | $187,050 | Actual |
| 2020 | $200,870 | Actual |
| 2021 | $205,887 | Actual |
| 2022 | $219,940 | Actual |
| 2023 | $229,900 | Actual |
| 2024 | $220,310 | Actual |
| 2025 | $237,980 | Actual |
| 2026(current) | $245,881 | Estimated |
| 2027 | $254,044 | Projected |
Top-earning physician assistants (90th percentile) in San Francisco saw their compensation grow 27.2% from $187,050 in 2019 to $237,980 in 2025, based on 7 years of BLS OEWS data for this metropolitan area. At a 3.32% annual growth rate, senior-level pay is projected to reach $254,044 by 2027, reflecting continued demand for clinical expertise and expanded-function credentials.
Note: Historical values (2019–2025) are actual BLS OEWS figures for the San Francisco metropolitan area, sourced from annual Occupational Employment and Wage Statistics surveys. 2026–2026 figures are current estimates, and 2027 values are projections, calculated using a 3.32% CAGR derived from 7-year BLS historical data. Actual salaries may vary based on employer, experience, certifications, and local market conditions.
Maximizing Your Physician Assistant Earnings in San Francisco
For those in senior physician assistant roles in CA, specific specializations often yield enhanced pay—particularly in fields like orthopedics, cardiothoracic and neurosurgery, and emergency medicine. Compensation structures can vary widely depending on the type of employment; for instance, PAs in hospital systems or surgical specialty practices tend to earn more than those in primary care settings or urgent care chains. Career advancement offers pathways to leadership roles, such as becoming a lead PA or faculty in PA education programs. Additionally, obtaining advanced credentials—like a Master's degree and the NCCPA certification—can significantly increase earning potential. Non-salary compensation also plays a role; factors such as first-assist case volume, call coverage, and RVU productivity bonuses impact overall pay. In San Francisco, compensation strategies are increasingly competitive, reflecting the higher cost of living while still aligning with national averages for senior physician assistant pay.
More salary data for San Francisco, CA:
Frequently Asked Questions
How much do experienced physician assistants make in San Francisco in 2026?
What drives higher physician assistant pay in San Francisco?
What certifications boost physician assistant salary in San Francisco?
Can experienced physician assistants make six figures in San Francisco?
How much does physician assistant salary increase over time in San Francisco?
Related Pages
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Nearby Cities in California
Written by Jessica Tran, MPAS, PA-C
Career Analyst
Jessica has 10 years of experience as a physician assistant. Her specialty is cardiology in an outpatient setting.
Methodology & Data Source
Top-earner salary figures on this page are 2026 projections derived from the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey, May 2026 release. BLS reported a 90th percentile salary of $237,980 for physician assistants in the San Francisco metro area. A 3.32% compound annual growth rate (CAGR), calculated from 6-year national BLS wage trends, was applied to project current 2026 senior-level compensation. Individual earnings depend on certifications, specialization, practice type, and years of clinical experience.
Data Sources & Methodology
Source: BLS, OEWS, 6-year dataset (–). Per-city data from annual BLS metropolitan area surveys.
2026 figures are projected from 2025 BLS data using a compound annual growth rate (CAGR) of 3.32%, derived from historical BLS wage trends for physician assistants (SOC 29-1071).
Compiled and verified by Jessica Tran, MPAS, PA-C, a licensed physician assistant with 10+ years of clinical experience. · View source data at BLS.gov