Highest Paying States for Surgical Technologists (2026): Where Surg Techs Earn the Most
The highest paying state for surgical technologists is Hawaii at $88,941 average median salary in 2026, based on BLS OEWS data across 52 states and 1677+ metro areas. Surg tech pay varies from Puerto Rico ($31,933) to Hawaii ($88,941) — driven by CST cert, specialty (CV / Ortho / Neuro), and trauma center density.
Best States for Surgical Tech Salary: 2026 Rankings
Surgical technologist pay variance is driven by CST (Certified Surgical Technologist) cert, specialty (CV / Ortho / Neuro), trauma center density, COL, state income tax, and travel surg tech market. Hawaii leads at $88,941, while Puerto Rico sits at $31,933.
Top-Tier States
- California ($75,000-$92,000) — SF Bay Area / LA / San Diego academic + Kaiser premium.
- Alaska ($72,000-$85,000) — chronic shortage + no state income tax + IHS premium.
- Massachusetts ($72,000-$85,000) — Boston academic centers.
- Connecticut ($68,000-$80,000) — Yale + Fairfield.
- New York ($65,000-$82,000) — NYC academic centers + Long Island.
- Hawaii ($65,000-$78,000) — shortage + high COL.
- Washington ($65,000-$78,000) — Seattle + no state income tax.
Mid-Tier Markets
- Nevada ($60,000-$72,000) — Las Vegas + no state income tax.
- Oregon ($60,000-$72,000) — Portland.
- New Jersey ($60,000-$72,000) — Bergen / Morris.
- Minnesota ($58,000-$70,000) — Mayo Rochester premium.
- Texas ($55,000-$70,000) — Houston Medical Center + no state income tax.
- Florida ($50,000-$65,000) — Miami / Tampa + no state income tax.
Specialty Premium Markets
- Cardiovascular (CV) surg tech — premier specialty $75,000-$95,000+.
- Orthopedic surg tech — premium specialty.
- Neurosurgery surg tech — premium specialty.
- Trauma center surg tech — premium acute care.
- Robotics (da Vinci) surg tech — premium emerging.
- Travel surg tech contracts — $1,800-$3,200/week premium.
- Per-diem (PRN) supplemental — $35-$55/hour senior CSTs.
- Federal VA / DoD — pension + PSLF.
2026 State Ranking Methodology
Rankings reflect 2026 projected median from BLS OEWS 2025. Trauma center concentration + CV / ortho specialty materially shift ceiling.
2019 BLS
$48,300
2025 BLS
$64,650
2026 Current Est.
$68,141
2019–2027 Growth
+48.7%
National Average for Context
2019–2025: BLS OEWS actual data. 2026+: CAGR 5.40% projection.
| Year | Median Annual Salary | Status |
|---|---|---|
| 2019 | $48,300 | Actual |
| 2020 | $49,710 | Actual |
| 2021 | $48,530 | Actual |
| 2022 | $55,960 | Actual |
| 2023 | $60,610 | Actual |
| 2024 | $62,830 | Actual |
| 2025 | $64,650 | Actual |
| 2026(current) | $68,141 | Estimated |
| 2027 | $71,821 | Projected |
Understanding the national salary trend helps contextualize state-level differences. The national median provides a baseline for comparing how each state's surgical technologist pay stacks up.
Note: BLS actual data is sourced from the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey. Estimated and projected values are calculated using a 5.40% historical CAGR. Actual compensation may vary based on employer, experience, certifications, and local market conditions.
Top 10 Highest Paying States for Surgical Technologists
What Drives State-Level Surgical Tech Pay Differences
Five primary factors explain surg tech state-level pay variance.
1. Cost of Living (30-40%)
- HCOL markets command premium.
- RPP from BEA — CA 113, MS 86.
- COL-adjusted real income — Texas / Tennessee net often beat California.
2. Specialty + Trauma Center Density (20-30%)
- Cardiovascular (CV) surg tech — premier specialty.
- Orthopedic surg tech — premium.
- Neurosurgery surg tech — premium.
- Level 1 trauma center — premium acute care.
- Robotics (da Vinci) surg tech — premium emerging.
- Pediatric surgery (children's hospital) — premium niche.
- Transplant surg tech — premium specialty.
3. CST Cert + State Licensure (10-15%)
- NBSTSA CST certification — universal credential.
- State licensure (NJ, NY, IL, MA, OR, TX, IN) — required in some states.
- State endorsement — varies.
- CFA (Certified First Assistant) — premium credential.
- SA-C (Surgical Assistant Certified) — premium specialty.
- Specialty certifications — premium.
4. State Income Tax (5-10% take-home)
- No state income tax — AK, WA, TX, FL, TN, NV, SD, WY, NH.
- High state income tax — CA, NY, OR, NJ, MN, HI.
- NYC + Philadelphia local — additional.
- Property + sales tax — TX, NJ tradeoff.
5. Travel + Per-Diem Premium (10-15%)
- Travel surg tech contracts — $1,800-$3,200/week premium.
- Per-diem (PRN) supplemental — $35-$55/hour senior CSTs.
- Locum tenens surg tech — premium contract.
- Hospital union vs non-union — 10-15% premium union.
- Federal VA / DoD — pension + PSLF.
Where Do Surgical Technologists Get Paid the Most?
Complete ranking of all 52 states by average surgical technologist salary. Click any state to see city-level breakdowns and detailed data.
| Rank | State | Avg Salary |
|---|---|---|
| 1 | Hawaii | $88,941 |
| 2 | California | $87,393 |
| 3 | New York | $84,697 |
| 4 | Massachusetts | $84,301 |
| 5 | Alaska | $83,623 |
| 6 | District of Columbia | $83,003 |
| 7 | Oregon | $82,371 |
| 8 | Connecticut | $81,351 |
| 9 | Minnesota | $80,931 |
| 10 | Washington | $80,826 |
| 11 | Colorado | $80,130 |
| 12 | Rhode Island | $78,153 |
| 13 | Nevada | $77,803 |
| 14 | Arizona | $77,482 |
| 15 | Wisconsin | $76,868 |
| 16 | New Jersey | $76,463 |
| 17 | New Hampshire | $75,362 |
| 18 | Idaho | $74,569 |
| 19 | Texas | $71,796 |
| 20 | Maryland | $71,654 |
| 21 | Pennsylvania | $69,141 |
| 22 | Illinois | $68,316 |
| 23 | Georgia | $68,134 |
| 24 | Michigan | $67,853 |
| 25 | Virginia | $67,574 |
| 26 | Nebraska | $67,482 |
| 27 | Utah | $67,475 |
| 28 | Indiana | $67,298 |
| 29 | Maine | $67,177 |
| 30 | Ohio | $65,880 |
| 31 | Florida | $65,743 |
| 32 | Kentucky | $65,301 |
| 33 | North Carolina | $65,180 |
| 34 | Oklahoma | $64,940 |
| 35 | North Dakota | $64,809 |
| 36 | Vermont | $64,612 |
| 37 | Missouri | $64,562 |
| 38 | South Carolina | $63,989 |
| 39 | Tennessee | $63,602 |
| 40 | Iowa | $63,469 |
| 41 | Montana | $63,215 |
| 42 | Arkansas | $62,745 |
| 43 | Delaware | $61,866 |
| 44 | Louisiana | $60,156 |
| 45 | Wyoming | $59,165 |
| 46 | South Dakota | $59,064 |
| 47 | Kansas | $59,056 |
| 48 | Mississippi | $57,463 |
| 49 | New Mexico | $57,203 |
| 50 | West Virginia | $52,881 |
| 51 | Alabama | $52,804 |
| 52 | Puerto Rico | $31,933 |
Lowest Paying States for Surgical Technologists
Even the lowest-paying states offer surgical technologist salaries well above the national average for all occupations. Here are the 5 lowest-paying states:
Top Earner Potential by State
The 90th percentile represents what experienced, highly-skilled surgical technologists earn in each state. These are the 10 states with the highest earning ceilings:
| # | State | Top Earner (P90) |
|---|---|---|
| 1 | Massachusetts | $118,051 |
| 2 | California | $117,791 |
| 3 | Connecticut | $113,392 |
| 4 | New Jersey | $110,426 |
| 5 | Nevada | $109,851 |
| 6 | Washington | $109,132 |
| 7 | New York | $108,923 |
| 8 | District of Columbia | $107,951 |
| 9 | Hawaii | $107,415 |
| 10 | Alaska | $106,675 |
How to Move to a Higher-Paying State for Surgical Tech Work
Relocating for surg tech pay requires balancing nominal salary against specialty, state tax, COL, and CST cert.
1. Verify CST + State License
- NBSTSA CST certification — universal credential.
- CAAHEP-accredited surg tech program — required.
- State licensure (NJ, NY, IL, MA, OR, TX, IN) — verify requirement.
- State endorsement — 4-12 weeks.
- BLS + ACLS certifications — required.
- Specialty cert (CV, ortho, neuro) — premium.
- CFA / SA-C credentials — premium first assist.
- Background check + fingerprint — typical.
2. Calculate Real Take-Home, Not Nominal
- COL-adjusted income — Texas CST at $62,000 may exceed California CST at $85,000 net.
- State + local income tax — effective rate.
- Property + sales tax — TX, NJ tradeoff.
- Childcare cost spread — major.
- Health + benefits — academic vs community hospital.
- 401(k) match + pension — federal + university.
- Shift differential (call, night) — 10-25% premium.
3. Target CV / Ortho / Neuro Specialty
- Cardiovascular (CV) surg tech (premier) — $75,000-$95,000+.
- Orthopedic surg tech — premium specialty.
- Neurosurgery surg tech — premium.
- Trauma center surg tech — premium acute care.
- Robotics (da Vinci) surg tech — premium emerging.
- Pediatric surgery (children's hospital) — premium niche.
- Transplant surg tech — premium specialty.
- Travel surg tech (15-30% premium hourly) — premium.
4. Negotiate Sign-On + Loan Forgiveness
- Sign-on bonus ($5,000-$15,000) — common at shortage.
- Relocation assistance ($3,000-$10,000) — standard.
- HRSA NHSC loan forgiveness — limited but available.
- PSLF stack (501(c)(3) + government) — 10-year forgiveness.
- Tuition reimbursement (CFA, SA-C, BSN) — premium.
- Call pay (premium for trauma/CV) — significant supplemental.
- Shift differential (night, weekend) — 10-25% premium.
- Specialty stipend (CV, ortho) — premium.
5. Choose Setting Based on Career Plan
- Cardiovascular OR (premier specialty) — top pay.
- Orthopedic OR (specialty) — premium.
- Neurosurgery OR (specialty) — premium.
- Trauma center (Level 1) — premium acute.
- Robotics (da Vinci) specialist — premium emerging.
- Academic medical center — premium benefits + PSLF.
- Federal VA / DoD — pension + PSLF.
- Travel surg tech / per-diem — premium hourly.
- First assistant (CFA, SA-C) pivot — premium career advancement.
- OR Manager / Educator track — admin path.
Additional Geographic + Lifestyle Considerations
- Climate fit + lifestyle preference — extreme heat (TX, FL, AZ) vs winter (MN, ME, AK) — major lifestyle differential beyond paycheck.
- School district quality (for families with children) — major hidden cost. Top suburban districts in NJ / NY / MA / CA add significant value.
- Healthcare access + cost-of-living index — verify metro-specific data on BLS / BEA.
- Spousal employment market — coordinate timing with partner career.
- Aging parent proximity — major life consideration.
- Network + alumni density (professional + social) — major.
- Recreation + outdoor access — varies dramatically by state.
- State + local political climate fit — major lifestyle differential.
More Salary Resources
Frequently Asked Questions
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Written by Jessica Thompson, BA, CST
Career Analyst
Jessica has over 10 years of experience as a surgical technologist. She specializes in orthopedic surgical procedures. Jessica works at a community hospital.
Methodology & Data Source
State salary rankings on this page are 2026 projections based on the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey, May 2026 release. A 5.40% compound annual growth rate (CAGR), derived from 6-year national BLS wage trends, was applied to each state's average salary. Cost-of-living adjustments use BEA Regional Price Parity data. Individual pay varies by city, employer, certifications, and experience.
Data Sources & Methodology
Source: BLS, OEWS , released .
Compiled and verified by Jessica Thompson, BA, CST, a licensed surgical technologist with 10+ years of clinical experience. · View source data at BLS.gov