Highest Paying Nurse Practitioner Careers

Nurse practitioners (NPs) rank among the highest-paid nursing roles. As of May 2024, registered nurses earned a median wage of $93,600 while NPs earned a median of $129,210, per the U.S. Bureau of Labor Statistics (BLS). RNs can enter the field with an associate or bachelor's degree, but NPs need a master of science in nursing (MSN) and specialty certification. Here are the highest-paid NP specialties, with average salaries drawn from aggregated job-market data. Earning potential ultimately depends on employer, location, experience, and certifications.

Ten Highest-Paying Nurse Practitioner Specialties

1. Aesthetic NP, about $139,152. Focuses on cosmetic procedures: counseling on treatments like laser hair removal, administering injections such as Botox, and managing recovery. Requires an MSN and state APRN authorization; certifications (dermatology certified NP, plastic surgery certified nurse, aesthetic nurse specialist) are recommended but not required. With cosmetic procedures growing in popularity, demand is strong. Common settings: dermatology and plastic surgery offices, cosmetic surgery centers, private practices, hospitals, and medical spas.

2. Neonatal NP, about $138,396. Cares for newborns who are premature or born with complications, collaborating with physicians, ordering and interpreting tests, prescribing, and recommending treatment. Requires an MSN, RN license, state APRN authorization, and neonatal NP certification. Hospitals are expanding NICUs and the National Association of Neonatal Nurse Practitioners notes a wave of expected retirements, so demand is high. Settings: delivery rooms, neonatal units, physicians' offices.

3. Emergency Room NP, about $134,456. Treats acute and critical illness: assessment, diagnosis, ordering diagnostics, emergency interventions, and treatment planning. Requires an advanced nursing degree, RN licensure, and APRN credentials; the American Academy of Nurse Practitioners Certification Board offers an emergency NP certification. Overcrowding and rising patient volumes keep demand up. Settings: emergency departments, trauma centers, urgent care, mobile units, and medical transport.

4. Orthopedic NP, about $126,193. Cares for patients with musculoskeletal conditions like arthritis, osteoporosis, scoliosis, and fractures, including post-surgical mobility and patient education. Requires an MSN, state APRN authorization, at least 2,000 hours of APRN practice, and certification from the Orthopedic Nurses Certification Board. Specialty-specific projections are limited, but orthopedic NPs should track the broader 40% NP growth, amplified by an aging population. Settings: physicians' offices, bone and joint clinics, rehab facilities, and inpatient and outpatient practices.

5. Oncology NP, about $125,923. Specializes in cancer care: assisting in procedures, building care plans with physicians, ordering and analyzing tests, and educating patients and families. Requires an MSN, APRN licensure, an Oncology Nursing Certification Corporation exam, two years of RN experience, and 2,000 oncology practice hours. With the National Cancer Institute projecting more than 2 million new cancer cases in 2024 and roughly 40% of adults facing a diagnosis in their lifetime, demand should rise. Settings: hospitals, clinics, physicians' offices, and hospice.

6. Cardiology NP, about $123,657. Works with physicians to treat heart, blood vessel, and circulatory disease across adults and children, running and interpreting tests and educating families. Requires an MSN and state APRN authorization; after 2,000 hours of cardiovascular practice, NPs can earn the ANCC cardiac vascular nursing certification or a cardiovascular nursing certification from the American Board of Cardiovascular Medicine. With heart disease the leading cause of death among U.S. adults (CDC), demand should expand. Settings: emergency rooms, cardiac clinics, nursing care facilities, and private practices.

7. Family NP, about $122,355. Provides primary care and manages acute and chronic conditions for patients of all ages, independently or under physician supervision depending on the state. Requires an active RN license and an MSN or doctoral degree from an accredited family NP program; the AANP and ANCC offer certification. Primary care physician shortages keep demand high. Settings: hospitals, clinics, outpatient facilities, schools, and community centers.

8. Surgical NP, about $121,349. Handles preoperative assessments, assists in operations, runs postoperative assessments, supports recovery, and manages admission and discharge paperwork. After an MSN, surgical nurses can pursue specialty certifications in intensive care, adult cardiac surgery, and plastic surgery. The Association of periOperative Registered Nurses anticipates a shortage as nurses retire and fewer students enter the specialty. Settings: hospitals, ambulatory surgical centers, VA medical centers, specialty clinics, and physicians' offices.

9. Psychiatric Mental Health NP, about $119,576. Evaluates, diagnoses, and treats mental health conditions for individuals, families, and groups, sometimes under physician supervision and often supervising RNs and assistants. Requires an MSN or doctoral degree, training in at least two psychotherapeutic modalities, ANCC certification, and state authorization. With 1 in 5 U.S. adults living with mental illness and fewer than half receiving treatment, demand is climbing. Settings: hospitals, schools, mental health clinics, private practices, social service agencies, correctional facilities, and public health departments.

10. Pediatric NP, about $119,253. Cares for infants, children, and adolescents through age 21: diagnosing and treating conditions, tracking growth and development, prescribing, ordering tests, and educating families. Requires Pediatric Nursing Certification Board credentials in primary or acute care, an MSN, an RN license, and 500 supervised clinical hours. Demand outpaces supply, since fewer than 3% of NPs certify in pediatric primary care and under 1% in acute care. Settings: hospitals, outpatient clinics, specialty offices, school clinics, urgent care, and community health.

Pay by Location and Setting

NP pay varies widely across the country, with the highest-paying jobs generally on the West Coast. Setting matters too, so look beyond hospitals and physicians' offices when comparing offers.

Frequently Asked Questions

Which NP specialty pays the most? Aesthetic NPs lead the field, though location and facility type swing pay even within a single specialty.

What do NPs earn overall? The NP median wage is $129,210 (BLS, May 2024). NP-specific figures put the lowest 10% near $97,960 and the top 10% around $169,950, varying by location, facility, specialty, education, certification, and experience.

Do NPs earn more than RNs? Usually. The NP median runs roughly $35,000 above the RN median, and NP jobs are growing far faster, 40% from 2024 to 2034 versus 5% for RNs.

Which specialties are in highest demand? Family, gerontology, and psychiatric-mental health NPs, driven by gaps in primary care and mental healthcare.