Physicians with supervisory duties earned 15.2% to 20.7% more total compensation than physicians without them in 2025, according to the 2026 MGMA DataDive Provider Compensation and Productivity report. The premium was 18.7% in primary care, 15.2% for surgical specialists, and 20.7% for nonsurgical specialists.
MGMA published the figures in an August 19, 2026 Stat article that draws on data for more than 245,900 physicians and advanced practice providers (APPs). APPs are nurse practitioners (NPs) and physician assistants (PAs). The numbers matter to any practice that is writing a compensation plan for a team that now includes more of them.
The supervision premium by specialty group
MGMA reports the premium as a percentage of total compensation, not as a dollar amount. Nonsurgical specialists show the largest gap at 20.7%. Surgical specialists show the smallest at 15.2%. Primary care sits between them at 18.7%.
| Specialty group | Supervision premium, total compensation | Source |
|---|---|---|
| Primary care | 18.7% | MGMA DataDive, 2026 report |
| Surgical specialties | 15.2% | MGMA DataDive, 2026 report |
| Nonsurgical specialties | 20.7% | MGMA DataDive, 2026 report |
Source: MGMA Stat, August 19, 2026, based on 2025 compensation data. The base is physicians with supervisory duties compared with physicians in the same group without them.
The comparison covers supervisory duties in general. MGMA does not break out how much of the premium comes from supervising NPs and PAs specifically. A practice that adds APPs can still use the range as a starting point when it prices the time a physician spends on oversight. MGMA does not state the premium in dollars in the article.
Physician pay rose while output fell
MGMA's 2026 provider compensation report found that median total compensation kept climbing across 23 common specialties in 2025, though modestly. Work RVUs (wRVUs) fell in 16 of those 23 specialties. Total encounters fell in all 23. MGMA described the split as pay going up while measured output came down.
The pattern is not new. In MGMA data for physician-owned practices in 2023 and 2024, primary care physicians posted 7.8% more total encounters but 10.2% fewer wRVUs. Nonsurgical specialists posted 20.5% more encounters and 7.7% fewer wRVUs. In both groups, visit counts rose while measured work per physician dropped.
Practice leaders see it in their own numbers. In an MGMA Stat poll on March 3, 2026, with 200 applicable responses, 37.0% of groups said clinician productivity in 2025 was on target and 23.0% said it exceeded goals. The other 40.0% said it fell below. A February 2025 poll had 45.0% on target, 24.0% above, and 30.0% below, so the share meeting or beating goals dropped from 69.0% to 60.0%.
What APPs earn and produce
Compensation and output rose together for APPs in 2025, which is the reverse of the physician pattern. The figures below come from the same MGMA DataDive dataset.
APP output moved the other way. In 2025, primary care NPs raised wRVUs by about 8.8% and primary care PAs by about 8.7%, MGMA reported. APP wRVU gains over five years ran between 34% and 55%.
Pay followed output. Over one year, compensation for primary care PAs grew 2.1%, for nonsurgical NPs 8.5%, and for nonsurgical PAs 7.4%. MGMA compared those rates with a 2.7% rise in consumer prices. Over five years, primary care NP compensation rose about 22%, primary care PA compensation about 27%, and primary care physician compensation about 15%.
The Bureau of Labor Statistics gives a national pay benchmark for both roles, using May 2025 data and a page updated August 27, 2026:
| Role | Median annual pay | Jobs, 2025 | Projected growth, 2025 to 2035 | Openings per year |
|---|---|---|---|---|
| Nurse practitioners, nurse midwives, and nurse anesthetists | $134,920 | 399,000 | 36.0% | 32,200 |
| Physician assistants | $135,880 | 168,900 | 21.0% | 11,500 |
Source: U.S. Bureau of Labor Statistics, Occupational Outlook Handbook. The NP line combines three advanced nursing roles, so it is a broader group than NPs alone.
The five-year figures put the pay gap in plain terms. PA compensation in primary care grew about 27% and NP compensation about 22%, against about 15% for primary care physicians. BLS projects 21.0% job growth for PAs through 2035 and says PAs deliver many of the same services as physicians.
Practices measuring APP output separately
MGMA data on physician-owned practices in 2023 and 2024 shows how much APPs contribute where they are used heavily. Median APP total encounters rose 39.3% and median APP wRVUs rose 21.9% over the period. MGMA also reported that APPs in physician-owned practices produced 124.5% more in collections, 82.0% more in encounters, and 65.7% more in wRVUs than APPs in hospital-owned groups.
Those comparisons are a reason to report APP output on its own line. When APP and physician wRVUs are blended, a rise in APP work can hide a fall in physician work, and the reverse. A monthly report with separate encounters, wRVUs, and collections per clinician type shows which side is moving.
Hiring is still rising. In an MGMA Stat poll with 288 applicable responses, 51.0% of practices added net-new APP positions in the past 12 months. Another 45.0% did not, 1.0% were unsure, and 2.0% employ no APPs. Staffing supply points the same direction: MGMA cites projections that the NP supply will grow 66.0% and the PA supply 37.0% from 2024 to 2034.
Sources
- MGMA, Beyond backfills: More than half of practices adding net-new APP roles, August 19, 2026
- MGMA, Keeping your clinician productivity on track throughout 2026, March 4, 2026
- MGMA, 2026 Provider Compensation and Productivity Data Report, 2026
- U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners, updated August 27, 2026
- U.S. Bureau of Labor Statistics, Physician Assistants, updated August 27, 2026
Talk to us
Fifteen minutes about your practice and the systems you run.