Orthopedic Nurse Practitioner (ONP) Salary by State
Compare Orthopedic Nurse Practitioner salaries across all 19 states. Select a state below for detailed percentile breakdowns, cost-of-living adjustments, and specialty comparisons.
Our nursing salary data is sourced from the U.S. Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics program.
Data
reviewed by 
sirI, MSN, APRN, NP
on April 2026
for accuracy.
Orthopedic Nurse Practitioner Salary Rankings — All States
Key Insights: The Cost of Living Reality
While California offers the highest raw salary for ONPs at $172,253, it is crucial to factor in the state's cost of living (COL index of 142.2). When salaries are adjusted for actual purchasing power, the landscape shifts dramatically.
For example, a ONP in Kansas making a raw median salary of $125,927 enjoys a COL index of 87.4, effectively giving them a purchasing power of $144,081 compared to the national baseline. States in the South and Midwest often provide a better ratio of income to living expenses, despite appearing lower on the raw salary rankings.
| Rank | State | Median Hourly | Median Annual | COL Adjusted | vs National |
|---|---|---|---|---|---|
| #1 | California | $81.54 | $172,253 | $121,134 | +32% |
| #2 | Washington | $73.40 | $148,092 | $128,664 | +14% |
| #3 | Delaware | $66.18 | $136,773 | $132,532 | +5% |
| #4 | Hawaii | $66.95 | $135,618 | $70,634 | +4% |
| #5 | Rhode Island | $67.37 | $135,156 | $119,607 | +4% |
| #6 | Pennsylvania | $64.33 | $132,447 | $134,875 | +2% |
| #7 | Vermont | $63.65 | $130,116 | $113,243 | Avg |
| #8 | Ohio | $62.02 | $129,875 | $141,475 | Avg |
| #9 | Utah | $64.52 | $129,360 | $126,205 | -1% |
| #10 | Maine | $62.07 | $129,297 | $115,961 | -1% |
| #11 | Idaho | $62.87 | $128,793 | $129,440 | -1% |
| #12 | Nebraska | $61.43 | $128,531 | $139,102 | -1% |
| #13 | Florida | $60.43 | $126,389 | $122,946 | -3% |
| #14 | Kansas | $60.21 | $125,927 | $144,081 | -3% |
| #15 | Georgia | $61.16 | $125,465 | $140,655 | -4% |
| #16 | Louisiana | $59.91 | $124,772 | $135,621 | -4% |
| #17 | South Carolina | $59.03 | $118,136 | $125,276 | -9% |
| #18 | Tennessee | $52.35 | $110,691 | $122,717 | -15% |
| #19 | Alabama | $55.53 | $109,022 | $123,747 | -16% |
What is an Orthopedic Nurse Practitioner (ONP)?
An Orthopedic Nurse Practitioner (ONP) is an advanced practice registered nurse who specializes in the assessment, diagnosis, and treatment of musculoskeletal diseases and injuries. Functioning as the "central nervous system" of the orthopedic team, an ONP bridges the gap between surgical intervention and long-term functional recovery. In the trenches of a busy bone and joint clinic or a trauma unit, the clinical weight of this role is felt in your ability to restore a patient’s mobility and quality of life. You aren't just treating a fracture or a degenerative disc; you are navigating the complex intersection of mechanical function and systemic health, ensuring that every patient—from the elite athlete to the geriatric fall victim—regains the independence they deserve.
The path to the ONP credential requires a dedicated academic climb, typically involving a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) with a focus on family or adult-gerontology practice. To demonstrate specialty mastery, most of us pursue the Orthopedic Nurse Practitioner Certified (ONPC) credential through the Orthopaedic Nurses Certification Board (ONCB). In 2026, our profession is at the forefront of high-tech musculoskeletal care; we are now utilizing AI-driven gait analysis and 3D-bioprinted orthopedic templates to personalize surgical recovery plans. This modern landscape allows us to be more proactive, using advanced diagnostics and regenerative medicine to manage musculoskeletal health with surgical precision and nursing compassion.
An ONP license is a true professional "passport," offering incredible flexibility across the entire healthcare continuum. Whether your passion lies in the high-stakes environment of an orthopedic trauma center, the precision of an outpatient sports medicine clinic, or the strategic world of geriatric fracture liaison services, your expertise is the currency of the industry. This role allows you to pivot between assisting in the operating room, managing independent clinics, or leading clinical research in joint replacement outcomes. Because the demand for providers who can master the complexities of human movement is universal, this career gives you the autonomy to build a professional life that has a tangible, life-changing impact every single shift.
Frequently Asked Questions
What is the median Orthopedic Nurse Practitioner salary in the US?
The national median salary for a Orthopedic Nurse Practitioner (ONP) is $130,353 per year, or approximately $63.42 per hour based on 2023 BLS data.
Which state pays Orthopedic Nurse Practitioners the most?
California offers the highest Orthopedic Nurse Practitioner salary at $172,252 per year, while Alabama is the lowest at $109,021.
What is the starting salary for a Orthopedic Nurse Practitioner?
Entry-level Orthopedic Nurse Practitioners in the US typically start around the 10th percentile, earning a national median of $99,081. With significant experience, top earners in the 90th percentile can make upwards of $167,653 annually.
Does the highest paying state for ONPs offer the best standard of living?
Not necessarily. While California offers the highest raw salary at $172,252, its high cost of living means your purchasing power is lower. When adjusted for cost of living, states like Kansas and Ohio often provide a better financial return for ONPs.
How much does a Orthopedic Nurse Practitioner make an hour?
On a national level, a Orthopedic Nurse Practitioner makes a median of $63.42 per hour. However, depending on the state and facility, this can range from $47.64 for new graduates up to $80.60 for highly experienced directors or specialists.
Does a Orthopedic Nurse Practitioner make more than a standard Registered Nurse?
Yes, significantly more. While the national median for a standard Registered Nurse is roughly $93,600, a Orthopedic Nurse Practitioner averages $130,353. This premium compensation reflects the advanced MSN or DNP degree and specialized clinical training required for the role.