Certified registered nurse anesthetists now earn an average of $288,441 annually, up from $181,000 in 2019, according to Marit Health peer-reported salary data and AANA’s 2026 compensation report.
This 59% increase has outpaced anesthesiologist pay growth at nearly twice the rate. In major metro markets the figure runs higher, with $310,000 in Chicago, $329,000 in New York.
Here’s what’s driving the increase, according to Marit Health:
1. Anesthesia demand has expanded well beyond the OR
Surgical volumes were already climbing before the COVID-19 pandemic and accelerated sharply as elective procedures resumed. An aging population requiring more joint replacements, cardiac procedures and cancer surgeries drove operating room volumes past previous baselines.
A more significant shift is that anesthesia is no longer confined to the OR, according to Marit Health. Endoscopy suites, cardiac catheterization labs, office-based procedures, interventional radiology and MRI units now require the same coverage the OR has. Non-operating room anesthesia is projected to account for more than 50% of all anesthetics delivered by 2030, according to AANA data.
2. CRNA graduates are largely offsetting retirements, not growing the workforce
Approximately 2,400 CRNAs graduate annually from 155 accredited programs nationwide, according to the AANA. However, roughly 31% of the current CRNA workforce is 55 or older, meaning retirements are accelerating at the same pace as demand. Annual graduates are replacing departures, not adding net capacity.
As of 2025, all newly graduating CRNAs are required to hold doctoral degrees, which is a change that raises training standards but extends the path to practice and constrains how quickly new programs can scale. The AANA projects a shortage of about 12,500 anesthesia providers by 2033, representing nearly 22% of the current workforce.
3. The anesthesiologist workforce is contracting in parallel
About 30% of practicing anesthesiologists are projected to exit clinical practice by 2033, equating to roughly 2,000 retirements or departures per year against approximately 1,700 annual residency positions available nationwide, according to data from Stout. About 57% of active anesthesiologists are 55 or older, and more than 17% are approaching retirement age. As the physician anesthesiologist pipeline contracts, ASCs and hospitals are leaning harder on CRNAs to fill the gap, which is increasing demand for a workforce that is itself supply-constrained.
4. The economics of CRNA staffing are shifting
The average physician anesthesiologist earns approximately $565,000 annually, nearly twice the CRNA average. That cost differential has made CRNA-heavy care team models financially attractive for ASCs and hospitals managing tight margins.
However, the gap is compressing. CRNA salaries have grown 59% since 2019, nearly twice the 29% growth rate for anesthesiologists over the same period. A significant driver is the widespread availability of locum tenens work, where CRNAs can earn $190 to $250 or more per hour on contract, according to Marit Health. As CRNAs become more willing to leave stable W-2 positions for contract work, hospitals and ASCs are faced with the choice to either raise permanent staff salaries or lose anesthesia coverage to the contract market.
5. Independent practice authority has strengthened CRNA negotiating power
More than 25 states have opted out of the CMS physician supervision requirement, allowing CRNAs to bill Medicare and Medicaid without physician oversight, and several states advanced legislation in 2025 to expand that further. CRNAs already make up more than 80% of anesthesia providers in rural counties, often as the sole anesthesia coverage available.