Nocturnist salary
Does the night job pay more per hour?
The night offer and the day job you’d take instead: annual pay, shifts a year, hours a shift. You get each one per shift and per scheduled hour, and the night premium on both.
How the calculation worksCalculator · Your numbers
Your day and night offers
Cash pay only, benefits excluded, for both jobs.
Per hour first, then per shift
Compare on the hourly, because the two schedules won’t match in shift length or shift count. Per shift is the rate extra shifts and moonlighting are quoted at, so look at it second.
What the hourly leaves out
Two jobs at the same hourly can be very different jobs. One has an APP with you and a closed ICU. The other has you alone in house, admitting and cross-covering the whole hospital. The hourly also runs on scheduled hours: a day doc who’s out by five beats the schedule, and a nocturnist can’t leave until the day team shows up. Before you compare rates, write down what each job actually is:
- Admits a night, whether there’s a cap, and how big the cross-cover census is.
- Open or closed ICU, and whether the intensivist is in house or on the phone.
- Codes, rapids, transfer calls, and the handoff and charting that run past the scheduled hours.
If nights also pay a wRVU bonus
Routine cross-cover bills nothing under your name. Your admits do, and so does critical care when a rapid or a code turns into 99291. Count those, not your census, before you decide whether a threshold copied from the day team’s production is one you’ll reach. Work the bonus out first, then add it to the night job’s annual pay above and leave the shifts and hours alone. An unreachable bonus counts as zero.
Calculate the wRVU bonus firstCommon questions
How can nights pay more per shift but the same per hour?
The longer shift absorbs the extra shift pay. Two more hours on a ten-hour day at the same hourly is 20% more per shift and nothing more per hour.
What does a negative night premium mean?
The night job pays less on that measure. Negative per shift with a positive per hour means the night shifts are shorter than the days, and the hourly is the number to take into the negotiation.
Can I include extra shifts or a signing bonus?
Yes. Put the extra-shift pay in and add the shifts and hours that earn it, or the hourly comes out wrong. Spread a signing bonus over the years of the commitment it comes with and add one year’s share to annual pay.
How the calculation works
Pay and premium
- Pay per shift
- equals annual cash pay ÷ annual shifts
- Pay per scheduled hour
- equals pay per shift ÷ average scheduled hours
- Night premium
- equals (night rate - day rate) ÷ day rate × 100
Benefits stay out of both sides: an employed job with full benefits and a 1099 job at a higher rate are different jobs, and this number won’t tell them apart.
Also from Aclera
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More calculators
wRVU target
See what your wRVU target means per shift.
Enter a month of wRVUs and shifts, the shifts you plan to work, and your annual target. You get the year at that pace and the gap to the target per shift.
RVU bonus
See what your RVU bonus would pay.
Enter base, threshold, bonus rate, and the wRVUs you expect this year. You get the bonus, the year’s pay, and the effective $/wRVU.
wRVUs per shift
See your wRVUs per shift and per scheduled hour.
Enter the wRVUs, shifts, and shift length from one period of your report. You get wRVUs per shift and per scheduled hour.
Work RVUs by code
See the work RVU for the E/M codes you bill on the wards.
Work RVU, total RVU, and the Medicare national rate for the hospital E/M, critical care, prolonged care and advance care planning codes, from the current CMS fee schedule file.
Medicare data
See what Medicare paid for hospitalist care in 2024.
Medians and quartiles for Original Medicare payments, services and patients per hospitalist in 2024, nationally and by state. Payment for billed care, not salary.