Physician Assistant Salary in Hawaii 2026:
$164,050 Median

A median $164,050 a year, or $78.87 an hour, per BLS OEWS May 2025 — 20.7% above the national median of $135,880. The middle half falls between $126,780 and $170,060 and the full band runs $79,280 to $178,110. The low 10th percentile reflects part-time and contingent work rather than a full-time entry rate, so the median is the right reference.

Oahu, by a considerable margin: Urban Honolulu reports $170,060 against Kahului-Wailuku on Maui at $134,960, a gap of about thirty-five thousand dollars. That reverses the neighbour-island premium other clinical roles show in this state, and it reflects where the hospital, surgical and specialty practice that pays physician assistants best is concentrated.

Through the Hawaii Medical Board at the Department of Commerce and Consumer Affairs, the same board that licenses physicians. You need a degree from an accredited physician assistant programme and NCCPA national certification, and you practise under a supervising physician arrangement with delegated prescriptive authority. On the neighbour islands that arrangement deserves particular attention, since the supervising physician may be at a distance.

Because the composition of the work differs. Physician assistant pay is driven upward by hospital, surgical, emergency and specialty practice, and those settings are concentrated in Honolulu's health systems. A neighbour-island physician assistant is more likely to be in primary care or community practice, which pays less everywhere. That is the opposite of what happens with nurse practitioners in this state, where full practice authority makes an independent rural clinician especially valuable.

Financially it is among the better ones, with a median 20.7% above the national figure and a Honolulu metro figure of $170,060 — a premium large enough to survive a serious cost-of-living adjustment, which is not true of most Hawaii occupations. The constraints are the small number of posts, about 530 statewide with roughly 40 openings a year, and the supervising physician requirement, which is a real practical consideration on the neighbour islands.

Because Hawaii grants nurse practitioners full practice authority and requires physician assistants to practise under a supervising physician. On a neighbour island with few physicians, a nurse practitioner can deliver primary care independently — which makes them extremely valuable and produces the large Maui premium on the nurse practitioner page. A physician assistant in the same community needs a supervising physician arrangement, which is precisely what is scarce there, so the role concentrates instead in Honolulu's hospitals and specialty practices where supervision is readily available and the pay is highest. The two professions' pay geographies invert for a purely regulatory reason.

The 10th percentile of $79,280 sits far below the 25th at $126,780, so the bottom of this band is part-time and contingent work rather than entry-level full-time practice, and anyone reading it as a career ladder will misjudge the starting point. With about 530 physician assistants the sample is small. The code covers primary care, emergency, surgical and specialty practice at different rates. And the figure excludes call stipends and productivity arrangements.

Full-time clinical status first, given the gap between the $79,280 tenth percentile and the $126,780 twenty-fifth. Location second, and in this state it points to Honolulu — $170,060 against $134,960 on Maui, about thirty-five thousand dollars. Specialty third: surgical first assisting, emergency medicine and procedural practice, which along with lead advanced practice provider roles is what the $178,110 ninetieth percentile describes. The supervising physician arrangement matters too, since what it delegates determines what you can be paid for.