Single-specialty practices with 0.41 or more advanced practice providers (APPs) per physician reported median revenue of $896,721 per physician in 2025, which is 47% above the $608,117 at practices with no APPs, according to MGMA's 2026 DataDive Financials and Operations data. The gap in operating spread was much smaller: $259,594 against $245,881, a difference of about 6%.
The figures come from MGMA's 2026 APP, Staffing and Access Data Report. It uses 2025 medians from nearly 4,000 medical groups and practices. Each number below names its source, and the comparisons are between different practices, not before-and-after results from one practice that changed its staffing.
How many practices use APPs, and how many per physician
APP use is split at the ends. MGMA found that 37% of single-specialty practices in 2025 reported no physician and APP mix. Another 4% had 0.20 or fewer APPs per physician, 8% had 0.21 to 0.40, and 51% had 0.41 or more.
Among practices that do employ APPs, the median ratio runs from 0.71 in multispecialty groups to 0.99 in surgical practices. A primary care group at the 75th percentile employs 1.39 APPs for each physician FTE, while one at the 25th percentile employs 0.44.
| Practice type | 25th percentile | Median | 75th percentile |
|---|---|---|---|
| Primary care | 0.44 | 0.80 | 1.39 |
| Single specialty | 0.49 | 0.87 | 1.34 |
| Surgical | 0.53 | 0.99 | 1.49 |
| Multispecialty | 0.36 | 0.71 | 1.07 |
APPs per FTE physician, practices reporting APPs, 2025. Source: MGMA, 2026 DataDive Financials and Operations.
Revenue per physician rises faster than what is left over
Revenue per physician counts every dollar the practice collects around one physician, including the dollars APPs produce. Operating spread is revenue left after operating expenses and before provider pay. MGMA's single-specialty medians show the two measures moving apart as the APP ratio climbs.
Practices with 0.41 or more APPs per physician had $78,973 left per physician after paying APPs. Practices with no APPs had $245,881 of spread and no APP cost. The after-APP figure is 68% lower, though it still comes before physician pay and is not net income.
MGMA also divides revenue across every provider, physicians and APPs together. That view shows lower numbers in the high-ratio groups.
| Specialty group | Revenue per provider, lowest mixed-team APP band | Revenue per provider, highest APP band |
|---|---|---|
| Primary care | $555,333 | $489,016 |
| Single specialty | $512,465 | $432,788 |
Median revenue per provider, 2025. Source: MGMA, 2026 APP, Staffing and Access Data Report.
The primary care gap is $66,317 per provider, and the single-specialty gap is $79,677. A practice can raise the first number while it lowers the second.
More than half of groups are adding APP jobs
In an MGMA Stat poll on August 18, 2026, 51% of respondents said they had added APP positions beyond backfills in the prior 12 months. Another 45% said no, 1% were unsure, and 2% did not employ APPs. The poll had 288 applicable responses.
Growth was the most common reason, including new service lines, more patients, new locations and longer hours. Groups that did not add roles most often named enough current capacity or budget limits. MGMA's November 2025 poll asked a different question and found that 48% of groups had shifted their ratio toward APPs, 40% held it steady and 11% moved toward physicians. MGMA says the two polls should not be compared directly.
Pay is rising with demand. MGMA's 2026 Provider Compensation and Productivity report, built on 2025 data from more than 245,900 physicians and APPs, found one-year APP pay growth above the 2.7% rise in consumer prices in every grouping except primary care physician assistants, at 2.10%. Over five years, primary care nurse practitioner pay rose about 22% and physician assistant pay about 27%, against about 15% for primary care physicians. In primary care, NP work RVUs rose about 8.8% in 2025 and PA work RVUs about 8.7%.
Support staff and access around the new hire
An APP needs exam rooms, schedule space and support staff. Median support staff per physician FTE in 2025 was 4.42 in primary care, 3.50 in single-specialty practices and 3.05 in surgical practices. The Financials and Operations report puts support staff cost at $300,700 per physician in primary care, $227,700 in single specialty and $200,800 in surgical practices, roughly 30% to 34% of revenue at the median.
Access numbers give a way to test whether a new hire helped. Median third next available appointment in 2025 was 8.0 days for established primary care patients and 13.7 days for new ones. Primary care no-show rates had a median of 6.0%, and 11.0% of primary care visits were same-day.
MGMA's July 2026 poll found that 46% of groups saw new-patient waits unchanged, 28% saw them lengthen and 22% saw them shorten. Many groups in all three answers had added providers, hours or schedule changes. In August, 32% of groups reported higher no-show rates, 58% the same and 10% lower.
MGMA's report suggests setting one target before a role is posted. The target can be days to the third next available appointment, revenue per provider or the amount left after APP pay.
Sources
- MGMA, 2026 APP, Staffing and Access Data Report, 2026
- MGMA Stat, Beyond backfills: More than half of practices adding net-new APP roles, August 19, 2026
- MGMA Stat, New-patient wait times largely hold flat in 2026 as some groups add providers in bid to meet demand, July 15, 2026
- MGMA Stat, About 1 in 3 medical groups see higher no-shows in 2026 as patients face higher costs, August 12, 2026
- MGMA Stat, APP utilization and how care team redesign continues into 2026, November 12, 2025
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