Physician Assistant.
San Francisco.
$159,000
median salary, 35% above the national average
$138,000 to $186,000. Updated for 2026.
The numbers.
Everything you need to negotiate with confidence.
The median Physician Assistant salary in San Francisco is $159,000, 35% above the national average. Entry level starts near $138,000. Experienced professionals push past $186,000. San Francisco is the epicenter of venture capital and startup innovation, consistently producing the highest tech salaries in the nation. That spread is your negotiation window.
Salary range
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How San Francisco compares
San Francisco, CA
$159,000
Cost of living: 35% above average
National Average
$118,000
San Francisco is $41,000 above
What you should know
Before you negotiate a Physician Assistant offer in San Francisco, understand the terrain. San Francisco is the epicenter of venture capital and startup innovation, consistently producing the highest tech salaries in the nation. The city's concentration of AI labs, SaaS companies, and fintech firms creates intense competition for talent. Despite remote work trends, SF still commands the steepest salary premiums for engineering and product roles. Surgical subspecialties and emergency medicine pay the highest PA salaries, often 20 to 30% above primary care. Geographic location matters significantly, with rural and underserved areas offering premium pay to attract talent. Experience in procedural skills and first-assist certification further boost compensation.
Entry-level PAs earn $95,000 to $105,000 in their first role. Mid-career PAs with specialty experience reach $120,000 to $135,000. Senior PAs in surgical specialties or leadership positions can command $145,000 to $165,000 with additional administrative responsibilities. In San Francisco, those numbers run higher. The cost of living here is 35% above average, and employers adjust to compete.
Base salary is not the full picture. PAs commonly receive productivity bonuses, CME allowances of $2,000 to $5,000 annually, malpractice insurance, and relocation assistance. Hospital systems often add shift differentials for nights, weekends, and call coverage. And on the tax side: california's top marginal state income tax rate is 13.3%, the highest in the U.S. San Francisco has no additional city income tax, but overall tax burden remains steep. When someone quotes you $159,000, ask what the total package looks like. The gap between base and total comp is where real money hides.
On negotiation: Leverage competing offers aggressively. SF employers expect candidates to shop around, and matching or beating a rival offer is standard practice here. The range for Physician Assistants in San Francisco runs from $138,000 to $186,000. That is not a narrow window. Where you land inside it depends almost entirely on whether you negotiate and how well you prepare.
Top industries in San Francisco
Negotiating in San Francisco
Leverage competing offers aggressively. SF employers expect candidates to shop around, and matching or beating a rival offer is standard practice here.