Median pay for medical secretarys runs from $23,220 in Ponce to $69,350 in San Jose-Sunnyvale-Santa Clara — a 2.99× range across 521 metropolitan areas. The national median of $45,930 sits inside that range but describes no particular market.
From $35,930 at the 10th percentile to $60,530 at the 90th is only 1.68×, which is narrow. Pay for medical secretarys is set more by structure than by individual outcome — scales, steps, licensure. That makes income predictable and makes the ceiling real: the way to earn materially more is usually to change role or location, not to out-perform within this one.
7 of the ten best-paying metros for medical secretarys are in CA. When one state dominates the top of the table like this, cost of living is doing part of the work but rarely all of it — state licensing rules, public-sector pay scales and the presence of a few large employers usually explain the rest. If you are comparing an offer in CA against one elsewhere, adjust for housing before concluding anything.
| Metropolitan area | Median | Hourly | LQ | Employed |
|---|---|---|---|---|
| San Jose-Sunnyvale-Santa Clara CA | $69,350 | $33.34 | 0.9 | 6,340 |
| Napa CA | $61,830 | $29.73 | 1.07 | 510 |
| San Francisco-Oakland-Fremont CA | $61,330 | $29.49 | 0.93 | 13,660 |
| Vallejo CA | $61,220 | $29.43 | 1.11 | 990 |
| Seattle-Tacoma-Bellevue WA | $60,350 | $29.01 | 0.5 | 6,420 |
| Santa Rosa-Petaluma CA | $60,240 | $28.96 | 0.94 | 1,190 |
| Longview-Kelso WA | $58,830 | $28.29 | 0.19 | 50 |
| Sacramento-Roseville-Folsom CA | $57,730 | $27.75 | 1.15 | 7,710 |
| Bellingham WA | $55,670 | $26.77 | 0.41 | 230 |
| San Luis Obispo-Paso Robles CA | $54,740 | $26.32 | 1.11 | 840 |
| Portland-Vancouver-Hillsboro OR-WA | $54,560 | $26.23 | 1.11 | 8,290 |
| Olympia-Lacey-Tumwater WA | $52,900 | $25.44 | 0.4 | 320 |
| Kahului-Wailuku HI | $52,570 | $25.27 | 0.64 | 290 |
| Barnstable Town MA | $51,940 | $24.97 | 0.96 | 560 |
| Minneapolis-St. Paul-Bloomington MN-WI | $51,870 | $24.94 | 0.74 | 8,920 |
| San Diego-Chula Vista-Carlsbad CA | $51,650 | $24.83 | 1.18 | 11,260 |
| Albany OR | $51,650 | $24.83 | 1.05 | 310 |
| Norwich-New London-Willimantic CT | $51,610 | $24.81 | 0.63 | 490 |
| Boston-Cambridge-Newton MA-NH | $51,600 | $24.81 | 0.98 | 16,330 |
| Massachusetts nonmetropolitan area | $51,470 | $24.75 | 0.69 | 180 |
| Los Angeles-Long Beach-Anaheim CA | $51,410 | $24.72 | 1.04 | 40,380 |
| Carson City NV | $50,860 | $24.45 | 0.71 | 140 |
| Kennewick-Richland WA | $50,780 | $24.42 | 0.43 | 350 |
| Mount Vernon-Anacortes WA | $50,740 | $24.40 | 0.57 | 180 |
| Bend OR | $50,640 | $24.35 | 1.92 | 1,290 |
| Metropolitan area | Median | Hourly | LQ | Employed |
|---|---|---|---|---|
| Ponce PR | $23,220 | $11.17 | 1.66 | 650 |
| Mayaguez PR | $28,010 | $13.47 | 2.82 | 910 |
| Puerto Rico nonmetropolitan area | $28,720 | $13.81 | 1.68 | 310 |
| San Juan-Bayamon-Caguas PR | $29,670 | $14.26 | 1.25 | 5,330 |
| Guayama PR | $30,940 | $14.88 | 1.85 | 140 |
| Aguadilla PR | $33,280 | $16.00 | 2.07 | 620 |
| Alexandria LA | $34,460 | $16.57 | 0.4 | 150 |
| Gadsden AL | $34,670 | $16.67 | 2.08 | 430 |
| Southwest Oklahoma nonmetropolitan area | $34,690 | $16.68 | 0.67 | 260 |
| Northeast Alabama nonmetropolitan area | $34,690 | $16.68 | 1.25 | 1,180 |
| Metropolitan area | Median | Hourly | LQ | Employed |
|---|---|---|---|---|
| Pinehurst-Southern Pines NC | $37,920 | $18.23 | 3.64 | 970 |
| East Kentucky nonmetropolitan area | $35,300 | $16.97 | 3.55 | 2,020 |
| Greenville NC | $39,980 | $19.22 | 3.29 | 1,640 |
| Johnson City TN | $36,570 | $17.58 | 3.12 | 1,580 |
| Mayaguez PR | $28,010 | $13.47 | 2.82 | 910 |
| Durham-Chapel Hill NC | $46,860 | $22.53 | 2.74 | 5,820 |
| Asheville NC | $41,520 | $19.96 | 2.69 | 3,000 |
| Paducah KY-IL | $38,340 | $18.43 | 2.6 | 810 |
| Lexington-Fayette KY | $44,450 | $21.37 | 2.59 | 4,600 |
| Sebring FL | $37,500 | $18.03 | 2.45 | 430 |
| North Central Tennessee nonmetropolitan area | $37,230 | $17.90 | 2.42 | 1,720 |
| Knoxville TN | $38,420 | $18.47 | 2.39 | 6,280 |
| Metropolitan area | Median | Hourly | LQ | Employed |
|---|---|---|---|---|
| New York-Newark-Jersey City NY-NJ | $49,230 | $23.67 | 0.9 | 52,640 |
| Los Angeles-Long Beach-Anaheim CA | $51,410 | $24.72 | 1.04 | 40,380 |
| Miami-Fort Lauderdale-West Palm Beach FL | $45,060 | $21.66 | 1.55 | 27,020 |
| Atlanta-Sandy Springs-Roswell GA | $46,370 | $22.29 | 1.26 | 22,590 |
| Dallas-Fort Worth-Arlington TX | $45,630 | $21.94 | 0.87 | 21,700 |
| Houston-Pasadena-The Woodlands TX | $44,210 | $21.25 | 0.99 | 20,220 |
| Chicago-Naperville-Elgin IL-IN | $47,680 | $22.92 | 0.72 | 20,020 |
| Washington-Arlington-Alexandria DC-VA-MD-WV | $48,280 | $23.21 | 0.98 | 18,960 |
| Tampa-St. Petersburg-Clearwater FL | $43,770 | $21.04 | 1.83 | 16,350 |
| Boston-Cambridge-Newton MA-NH | $51,600 | $24.81 | 0.98 | 16,330 |
| Philadelphia-Camden-Wilmington PA-NJ-DE-MD | $47,120 | $22.66 | 0.87 | 15,550 |
| San Francisco-Oakland-Fremont CA | $61,330 | $29.49 | 0.93 | 13,660 |
Figures come from the BLS Occupational Employment and Wage Statistics programme, May 2025 release, SOC code 43-6013. OEWS surveys employers, so it reports what is actually paid rather than what job advertisements claim, and it excludes the self-employed. Estimates cover 521 of 528 metropolitan areas — near-complete coverage, which means the ranges above are reliable rather than drawn from a handful of markets. Read the methodology.