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Surgical First Assistant · 2026 salary + AI outlook

Surgical First Assistant salary — and how to earn like the top 1%

$68,000median / year · about $33 an hour (BLS)

AI reads scans and guides robots, but a first assistant's hands still retract, suture, and close in 2026. Robotic-trained, certified SFAs in high-acuity specialties out-earn the rest.

Entry level
$46,000
Top earners
$95,000
Job growth
+6%
AI exposure
Low
🏆 The Top 1% Playbook

How to reach the top 1% of Surgical First Assistants

Four moves, straight from how the highest-paid in this field use AI in 2026:

1
Get CSFA certified The NBSTSA CSFA or NSAA CSA credential is the line between a scrubbed tech and a billable first assistant. Certification is what lets facilities and payers reimburse your role directly.
2
Train on the robot Da Vinci and robotic-platform experience is the fastest-growing premium in the OR. First assistants fluent in robotic docking, port placement, and bedside assist are recruited hardest.
3
Specialize high-acuity Cardiac, spine, neuro, and transplant assisting pay well above general cases. Depth in one complex service line, with the surgeon's trust, is what commands the top contracts.
4
Go RNFA or contract Nurses can pursue the RNFA path for the widest scope and pay; others go independent-contractor or travel SFA, billing per case at rates staff positions rarely match.
💡 The move that pays: The robot needs a driver and the patient needs a closer; the certified, robotic-trained assistant is both, and neither goes to a prompt.
HomeJob Salaries › Surgical First Assistant Salary

Surgical First Assistant Salary in 2026

Surgical First Assistant pay, in real terms

Per hour
$32.69
Per week
$1,308
Every 2 weeks
$2,615
Per month
$5,667

At the national median of $68,000/year, a surgical first assistant earns $5,667/month before taxes. Over a 30-year career that's roughly $2,040,000 in gross earnings — and that's before raises, promotions, or bonuses.

That puts this role about 41% above the U.S. median wage for all workers (about $48,060/year, per BLS). Using the common rule of keeping housing under 30% of gross pay, this salary supports about $1,700/month in rent or mortgage.

Figures are gross (pre-tax) estimates from the national median; use the take-home and hourly calculators on PayCrunch for your exact state and situation.

Updated June 2026 · BLS Data
How much does a Surgical First Assistant make?
$68,000per year
National median salary · $32.69/hour · $5,667/month
Hourly
$32.69
Monthly
$5,667
Weekly
$1,308
Daily
$262
Estimated take-home
$51,680/yr
Adjust Your Market Position
$68,000/yr
Entry Level · $46,000 Top Earner · $95,000
IRS.gov data
BLS.gov verified
All 50 states
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What Does a Surgical First Assistant Do?

Surgical first assistants work alongside surgeons during operations, providing exposure, hemostasis, and tissue handling.

Surgical First Assistant Salary by State

Select your state to see the adjusted surgical first assistant salary based on cost-of-living differences.

Select a state above

How to Become a Surgical First Assistant

Education: Associate's degree + surgical training

Certifications: CSFA certification

Career path: Surgical Tech → First Assistant → Senior First Assistant → Surgical Services Manager

Surgical First Assistant Salary by Experience

Entry level
$46,000
Mid-career
$68,000
Senior
$86,450

Estimates based on BLS percentile data and industry surveys. Actual salaries vary by employer, location, and individual qualifications.

Top 10 Highest-Paying States for Surgical First Assistants

#StateAnnualMonthlyHourly
1Hawaii$80,240$6,687$38.58
2California$78,200$6,517$37.60
3New York$78,200$6,517$37.60
4Massachusetts$76,160$6,347$36.62
5New Jersey$76,160$6,347$36.62
6Connecticut$74,800$6,233$35.96
7Washington$74,800$6,233$35.96
8Maryland$73,440$6,120$35.31
9Alaska$71,400$5,950$34.33
10Colorado$71,400$5,950$34.33

State salaries estimated using BLS national median adjusted by regional cost-of-living factors.

Compare to Related Jobs

Job TitleMedian SalaryHourlyDifference
Surgical First Assistant$68,000$32.69
Public Health Nurse$68,000$32.69
Dietitian$66,450$31.95$-1,550
Nutritionist$66,450$31.95$-1,550
Occupational Therapy Assistant$64,250$30.89$-3,750
Organ Transplant Coordinator$72,000$34.62+$4,000
Acupuncturist$72,000$34.62+$4,000

Job Outlook

The BLS projects +6% growth for surgical first assistants through 2032, which is faster than average compared to the average for all occupations (3%).

🆕 New & Trending AI Tools for Surgical First AssistantReviewed July 2026

We track new AI-tool launches every week and refresh this list — here’s what’s gaining traction for Surgical First Assistant work right now.

AbridgeNEWEnterprise / see site

Ambient AI scribe that turns a patient conversation into structured clinical notes.

How a Surgical First Assistant uses it: document a visit automatically instead of charting after your shift

Microsoft Dragon CopilotNEWEnterprise / see site

Voice AI that dictates and drafts clinical documentation (successor to Nuance DAX).

How a Surgical First Assistant uses it: speak your notes and have the chart written and filed for you

Heidi HealthNEWFree / paid tiers

AI documentation tool built around clinician and nurse workflows.

How a Surgical First Assistant uses it: handle shift notes and handovers without manual write-ups

OpenEvidenceNEWFree for verified clinicians

AI that answers clinical questions from current medical evidence, with citations.

How a Surgical First Assistant uses it: check the latest evidence at the point of care in seconds

NotebookLMNEWFree / $7.99 mo

Google tool that answers questions grounded only in the documents you give it — with citations.

How a Surgical First Assistant uses it: load your own manuals, policies, or PDFs and ask questions that stay accurate to the source

SukiEnterprise / see site

AI voice assistant for clinical notes and coding.

How a Surgical First Assistant uses it: dictate notes hands-free and cut charting time sharply

NablaFree tier / see site

Ambient AI assistant that generates notes from the patient encounter.

How a Surgical First Assistant uses it: capture the visit and get a ready-to-review note in seconds

ChatGPTFree / $20 mo

The most-used AI assistant — writing, analysis, research, and images from a plain-language chat.

How a Surgical First Assistant uses it: draft emails and documents, summarize long files, and get instant answers to on-the-job questions

ClaudeFree / $20 mo

AI assistant known for careful writing, long-document analysis, and coding.

How a Surgical First Assistant uses it: analyze big reports or spreadsheets and turn messy notes into clean, finished writing

Frequently Asked Questions

How much does a surgical first assistant make?
The national median salary for a surgical first assistant is $68,000 per year, or $32.69 per hour. Entry-level positions start around $46,000 while top earners make $95,000 or more.
What education do you need to become a surgical first assistant?
Most surgical first assistant positions require associate's degree + surgical training. Additional certifications or experience may increase earning potential.
What is the job outlook for surgical first assistants?
Employment of surgical first assistants is projected to grow 6% over the next decade, which is faster than average compared to the average for all occupations.
What are the highest paying states for surgical first assistants?
The highest paying states include Hawaii, California, New York, Massachusetts, and New Jersey, where cost of living adjustments push salaries above the national median.
Can you make six figures as a surgical first assistant?
While the median salary is below six figures, top earners in high-paying states and with significant experience can approach or exceed $100,000.
Methodology and data sources

Salary data is based on the Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics (OES) program. National median, 10th percentile, and 90th percentile figures are sourced from the most recent BLS OES release. State-level salary estimates are calculated by applying regional price parity adjustments from the Bureau of Economic Analysis (BEA) to the national median. Job growth projections are from the BLS Employment Projections program. Education and certification requirements are based on BLS Occupational Outlook Handbook descriptions. All figures are approximate and updated periodically.

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