Physician Assistant Salary in Iowa 2026,
$134,770 Median | BLS Data by City

Iowa physician assistants earn a median $134,770 a year, or $64.79 an hour, per BLS OEWS May 2025, with a band from $102,330 at the 10th percentile to $182,940 at the 90th. That is only 0.8% below the national median of $135,880 — effectively the national rate. Iowa is buying a scarce, nationally certified credential and paying what the national market asks for it.

Davenport-Moline-Rock Island, at $137,420, though the margin is small: Iowa City publishes $134,770, Des Moines-West Des Moines $133,830, Waterloo-Cedar Falls $132,880 and Sioux City $130,970 — all within about sixty-five hundred dollars of each other. Note that the Davenport-Moline-Rock Island metro crosses into Illinois, so it is not a pure Iowa figure. The practical conclusion is that specialty choice, not city, determines a PA's earnings in Iowa.

The Iowa Board of Physician Assistants — a standalone board rather than a division of the medical board, which is unusual. Licensure requires graduation from an ARC-PA accredited programme and certification by the National Commission on Certification of Physician Assistants, with continuing certification maintained thereafter.

Iowa has moved away from requiring every PA to be tied to a named supervising physician, in favour of practice governed at the level of the health care facility or practice group and defined by the PA's own education, training and competence. In practice this means an Iowa PA's scope is set by their employer's clinical governance rather than by a state-mandated one-to-one pairing — which is one reason PAs are deployable across rural critical access hospitals where a dedicated supervising physician would be hard to designate.

On the numbers, yes — arguably the best combination in this unit. A median within 0.8% of the national figure, a flat 3.8% state income tax, and housing costs far below the national average. The caveats are scale and specialty: Iowa employs only 1,200 PAs at a location quotient of 0.74, so the number of narrow subspecialty posts is limited and concentrated around Iowa City and Des Moines. High property taxes are the other item to model.

It means Iowa is short of physician assistants and is paying to fix it. A low location quotient with low pay would suggest a state that does not use the profession; a low location quotient with pay at 0.8% of the national median suggests a state that wants the profession and cannot recruit enough of it. Iowa's health system is dispersed across many small rural hospitals and clinics where a PA is exactly the right credential — generalist, procedurally capable, deployable without a dedicated on-site specialist — and the state's regulatory framework has moved to make that deployment easier. For a PA weighing a move, that is a demand signal, not a warning.

It pools specialties that pay very differently, and it excludes call. The $102,330-to-$182,940 range on this row is almost entirely a specialty spread: an outpatient primary care PA and a surgical first assistant with a heavy call rota hold the same licence and appear on the same OEWS line. The figure also excludes call pay, productivity incentives and, in rural Iowa, recruitment and loan repayment arrangements — all normal parts of the package here and none of them captured in a wage survey.

Specialty, call and rurality. Specialty is the largest, moving a PA between the median and the $159,950 upper quartile. Call is second and often underestimated — in a state with many small hospitals, coverage arrangements are compensated separately and can add materially to the base. Rurality is the third and is specific to Iowa: critical access hospitals and rural clinics that struggle to recruit will pay above their metropolitan counterparts and may add loan repayment or housing support, which is why Sioux City's $130,970 metro figure understates what a genuinely rural Iowa post may offer.