Paramedic Salary in Hawaii 2026,
$81,280 Median | BLS Data by City

A median $81,280 a year, or $39.08 an hour, per BLS OEWS May 2025 — 34.1% above the national median of $60,600. The band runs $66,250 to $81,440, with the median and 75th percentile both at $81,280. Even the 10th percentile exceeds the national median, which makes Hawaii one of the strongest paramedic markets in the country on the published figures.

Because neither Urban Honolulu nor Kahului-Wailuku clears the BLS disclosure threshold for this occupation on its own. With about 140 paramedics in the entire state, the metro-level samples are too small to publish, so only the statewide row of $81,280 is available. That is a limitation of the data rather than a gap in the profession — every island has county emergency medical service coverage.

Complete an accredited paramedic programme and obtain national certification, then apply to the Hawaii Department of Health's Emergency Medical Services and Injury Prevention System Branch for state certification. The department oversees the state EMS system and its protocols. Employment then runs through county emergency medical service recruitment, which is competitive: with about 140 posts statewide and roughly 10 openings a year, vacancies are rare.

The employment model. Hawaii delivers emergency medical services through county-operated public departments with state oversight, so paramedics are public employees on published pay scales with public benefits — rather than employees of the private ambulance contractors that set paramedic pay near the local floor in most states. The median, 75th and 90th percentiles all resolving to about the same figure is the direct evidence of a pay scale at work.

Not much within the published band, and it is worth being honest about that. The median and 75th percentile are both $81,280 and the 90th is $81,440 — a span of about a hundred and sixty dollars across the entire upper half. Progression here runs through supervisory, training officer and EMS administration roles rather than through the paramedic pay scale itself, and with about 140 paramedics statewide those positions are correspondingly few.

That the wage is administered rather than negotiated. When a survey finds the median, 75th and 90th percentiles of an occupation within a couple of hundred dollars of one another, it has found a group of people on the same published pay schedule. Hawaii's county emergency medical services employ paramedics as public employees on defined steps, and once a paramedic reaches the top of that scale there is nowhere further to go within the classification. The upside is transparency and security: pay is known in advance, benefits are substantial, and there is no rate negotiation. The downside is that ambition has to be expressed as a change of role rather than as a change of pay.

The sample is about 140 people, which is very small — small enough that percentile estimates carry real uncertainty and that no metro figures could be published at all. The figure reports wages as paid, so overtime, which in a small EMS workforce covering island terrain is substantial, sits inside it. And the premium must be read against the highest housing costs in the United States, where a 34.1% nominal advantage is materially smaller in real terms.

Getting hired first, because with about 10 openings a year the binding constraint is access rather than progression. Steps on the county pay scale second, which is the mechanism the whole distribution is built on and which is published rather than negotiated. Overtime third, and in a workforce this small covering this much terrain it is a genuine component. Beyond that, the honest answer is that the paramedic classification tops out at about $81,440 in this data, and further progression means supervisory, training or EMS administration roles rather than more paramedic experience.