What to Pay a Medical-Surgical Registered Nurse in Fresno, CA (2026)
Last updated: May 15, 2026Built for: Total Rewards, Comp, HRSample: BLS OEWS + disclosed-range postings
Market Median
$108,000
base, annual
Competitive Range
$94K–$124K
25th–75th percentile
YoY Movement
+3.7%
trailing 12 months
Days to Fill
~28
Fresno metro average
To hire a Medical-Surgical Registered Nurse in Fresno at market, plan on a base salary range of
$94,000 to $124,000,
with $108,000 as the midpoint.
To attract candidates in a market where average time-to-fill runs 28 days,
expect to lead at $124K–$143K plus a sign-on bonus,
common in skilled nursing settings. California requires a pay range in job postings.
How to set your Med-Surg RN pay range in Fresno
Three pay positions, modeled against current Fresno market data. Pick the one that matches your comp philosophy and the role's strategic value.
Lag Market
Pay Below Median
$82K–$94K
Workable in non-acute settings with strong non-cash differentiation. Expect longer fill times and turnover ~1.4× the Fresno average.
Match Market — recommended
Pay at Median
$102.4K–$114.4K
Default for most Fresno employers. Competitive enough to fill in ~28 days.
A range width of ~30% (min $94,000 to max $124,000) keeps compa-ratio movement smooth across a Med-Surg RN's typical 8–12 year tenure.
Lead Market
Pay Above Median
$117.6K–$143K
Use for hard-to-fill specialties (wound care, IV therapy, bilingual), 24/7 SNF roles, or when speed-to-hire trumps budget. Reduces fill time by 35–45% on average.
Med-Surg RN salary percentile distribution in Fresno, CA
Where the Fresno market actually sits for Med-Surg RN base pay.
10th$82K
25th$94K
Median$108K
75th$124K
90th$143K
Most Fresno employers building a range for this role anchor the midpoint to the market median ($108,000) and set range width at 30–35% — a min of $94,000 and a max of $124,000. This keeps the band wide enough for experience-based progression without concentrating range penetration at the cap.
California pay transparency compliance for Med-Surg RN job postings
What you must post when hiring a Med-Surg RN in California.
Required. Under California law (SB 1162, as amended by SB 642), employers with 15 or more employees, and at least one worker in California, must include a good faith estimate of the salary or hourly wage range they expect to pay in every job posting, including roles posted through third parties. The rule has applied since January 1, 2023, with the good-faith-estimate wording effective January 1, 2026. Penalties run from $100 to $10,000 per violation, enforced by the California Labor Commissioner.
Requirement
Applies When
Penalty for Non-Compliance
Pay range in job postings
Employers with 15 or more employees must follow the law, and the Labor Commissioner applies it when at least one of those employees is in California.
Penalties range from $100 to $10,000 per violation.
For a Med-Surg RN role in Fresno, a compliant good-faith range looks like $94,000 to $124,000.
Job ads must include a good faith estimate of the salary or hourly wage range the employer reasonably expects to pay for the position upon hire.
Top Med-Surg RN employers in Fresno — who you're competing against
Top healthcare employers hiring Med-Surg RNs in the Fresno metro and what they're posting.
Employer
Type
Disclosed Range
Sign-on Bonus
Community Health System
Health system
$102K–$127K
Very common ($10K–$18K)
Kaiser Permanente
Integrated health system
$102K–$127K
Very common ($10K–$18K)
Saint Agnes Medical Center
Health system
$102K–$127K
Very common ($10K–$18K)
Adventist Health
Health system
$102K–$127K
Very common ($10K–$18K)
Valley Children's Healthcare
Pediatric specialty
$102K–$127K
Very common ($10K–$18K)
Med-Surg RN talent supply and hiring difficulty in Fresno
How hard is it to fill a Med-Surg RN role in Fresno.
~28
Avg Days to Fill
~3,240
Active Postings
~32,400
Fresno Med-Surg RN Workforce
Tight
Supply : Demand
Fresno med-surg RN market is the largest RN specialty by headcount. High turnover ratio drives constant recruitment cycles.
Skill premiums Med-Surg RN candidates command in Fresno, CA
Skill / Credential
Pay Premium
Demand Signal
CMSRN (Med-Surg certified)
+5–8%
Standard progression
Telemetry / step-down experience
+4–7%
High
Charge nurse experience
+5–8%
High
BSN (vs ADN)
+5–8%
Standard at Magnet hospitals
Med-Surg RN total compensation in Fresno — what candidates expect beyond base
Total rewards mix for Med-Surg RNs in Fresno. "Prevalence" reflects share of Fresno disclosed-range postings including each element.
Component
Typical Value
Prevalence in Fresno Postings
Base salary
$108,000 (median)
100%
Shift differential
+12–20% premium
~90%
Sign-on bonus
$9K–$19K
~76%
CMSRN certification pay
+5–8% on base
~48%
Overtime opportunity
$12K–$24K annualized
~94%
Estimated total comp benchmark
~$130K–$151K
—
Shift differentials and sign-on bonuses are typically table stakes rather than differentiators. Tuition reimbursement for LPN-to-RN bridge programs is increasingly the lever that wins competitive offers, particularly for early-career candidates.
Med-Surg RN pay by setting in Fresno — SNF, hospital, clinic, home health
Where the Med-Surg RN range splits by employer type in the Fresno metro.
Setting
Median
Competitive Range
Hiring Difficulty
Adult med-surg (community)
$102,000
$91K–$117K
Very high
Adult med-surg (academic)
$110,000
$97K–$125K
Very high
Telemetry / step-down
$114,000
$102K–$130K
Very high
Progressive care unit (PCU)
$117,000
$104K–$132K
Very high
Ortho / surgical unit
$108,000
$97K–$123K
High
FAQ: hiring a Medical-Surgical Registered Nurse in Fresno, CA
Market median is $108,000 for base pay. To match market, set a range with the midpoint at $108,000 — typically $94,000 to $124,000. To lead the market, plan on $124K–$143K base plus a sign-on bonus.
Under California law (SB 1162, as amended by SB 642), employers with 15 or more employees, and at least one worker in California, must include a good faith estimate of the salary or hourly wage range they expect to pay in every job posting, including roles posted through third parties. The rule has applied since January 1, 2023, with the good-faith-estimate wording effective January 1, 2026. Penalties run from $100 to $10,000 per violation, enforced by the California Labor Commissioner. For this role in Fresno, a good-faith range is $94,000–$124,000.
$97,000 falls below the Fresno market median of $108,000 — roughly at the 25th–50th percentile locally. Acceptable in SNF or physician office settings where the candidate pool is deeper; below-market for hospital or specialty roles.
Roughly 76% of Fresno med-surg RN postings include a sign-on bonus ($9K–$19K). Highest values at large hospital systems for tele/step-down roles.
Average fill time is approximately 28 days in the Fresno metro. Roles paid above the 75th percentile ($124K+) fill in roughly 18–22 days. Roles below the 25th percentile ($94K) commonly take 45+ days and have elevated turnover within the first 90 days.
By Fresno-metro posting volume: Community Health System, Kaiser Permanente, Saint Agnes Medical Center, Adventist Health, Valley Children's Healthcare lead the pack.
A 30–35% range width (min to max) is standard for Med-Surg RN in Fresno — for example, $94,000 to $124,000. Narrower than 25% compresses progression and creates compa-ratio pressure within 18 months.
External job ads are covered, including ads posted through third parties and remote roles that could be filled in California. Whether internal postings are covered is unsettled.
Related Med-Surg RN pay benchmarks — California metros and nearby nursing roles
If you're modeling pay ranges across hundreds of roles and dozens of locations, doing this manually is the merit-cycle scramble that ate your last quarter. BetterComp keeps your full range structure current against live market data — without the survey lag.
