Night shift, on-call, ASC vs hospital, Level I trauma
Surgical Tech Shift Differentials and Setting Pay (2026)
Night differentials add $2-5/hr. On-call stipends $3-6/hr plus full rate when called in. Level I trauma retention premiums 5-10%. The difference between a hospital night-call position and an ASC day-shift role can represent $8-18k annually.
Pay by Work Setting (BLS May 2025)
| Setting | Mean Annual | Mean Hourly | Call / Schedule |
|---|---|---|---|
| Colleges / universities (academic med centers) | $77,270 | $37.15 | Varies by teaching hospital |
| Specialty (except psychiatric) hospitals | $75,540 | $36.32 | Night/weekend common |
| Outpatient care centers (incl. ASCs) | $69,250 | $33.29 | Minimal |
| General medical / surgical hospitals | $69,000 | $33.17 | Night/weekend/call standard |
| Offices of physicians | $68,090 | $32.74 | None typically |
Typical Shift Differential Rates
| Differential Type | Typical Range | Notes |
|---|---|---|
| Evening shift (3pm-11pm) | $2-4/hr | Most facilities define evening as starting 3pm-7pm. |
| Night shift (11pm-7am) | $2-5/hr | Higher than evening at most facilities. Some pay 1.1x base. |
| Weekend (Sat/Sun) | $2-4/hr | May apply regardless of shift start time. |
| Holiday | $5-10/hr or 1.5-2x | Varies widely. Union contracts often mandate 2x. |
| On-call stipend | $3-6/hr | Paid for every hour on call, even if not called in. |
| Call-in (when called during call) | Full base rate (or 1.5x if OT) | Minimum call-in pay provisions vary. Some contracts guarantee minimum 2-4 hours. |
| Level I trauma retention | +5-10% of base | Flat premium for accepting ongoing Level I call commitment. |
Worked Example: Night + Weekend + Holiday Differential
Scenario: Christmas night shift (12-hour)
- Base rate$31.08/hr
- Night differential+ $3.00/hr
- Weekend differential+ $3.00/hr
- Holiday differential+ $7.00/hr
- Total effective rate$42.14/hr
- 12-hour shift total$505.68 gross
Annual impact of regular night-call rotation
A CST working two overnight shifts per week with 2 call-ins per month at a Level I trauma center might earn:
- Base (FT 2,080 hrs)$64,650
- Night differentials (2 shifts/wk)+$7,488
- Weekend differentials+$3,744
- On-call stipend (16 hrs/wk)+$3,328
- Call-ins (8 hrs x 2x/mo)+$5,590
- Level I retention premium (7%)+$4,243
- Total compensation$84,993
ASC vs Hospital: The Trade-Off
Hospital (inpatient/trauma)
- +Base on par with outpatient (~$69,000 BLS mean), differentials on top
- +Night/weekend/holiday differentials available
- +On-call stipends add $5-15k annually
- +Broader case mix; Level I trauma premium
- -Required nights, weekends, holidays
- -Unpredictable schedule; emergency call-ins
Ambulatory Surgical Center (ASC)
- +Predictable daytime hours (typically 6am-4pm)
- +No required nights, weekends, or holidays
- +No on-call requirement at most ASCs
- +IC first-assistant arrangements at higher rates
- -No differential or call income (base ~$69,250, outpatient BLS mean)
- -No differential income; fewer overtime opportunities
FAQ
How much do surgical techs make on night shift?
Night shift surgical technologists typically earn a differential of $2-5 per hour above their base rate. For a CST earning $31.08/hr base, a $3/hr night differential adds $108 per 12-hour night shift, or approximately $14,040 per year for someone working exclusively nights (with 10 shifts per month). Many hospital contracts define night shift as shifts starting between 7pm and 11pm, with the highest differentials for shifts starting at or after 11pm.
How does surgical tech on-call pay work?
On-call pay for surgical techs typically has two components: a call stipend paid for every hour on call (typically $3-6/hr), and a call-in rate paid at full hourly rate (or 1.5x for overtime hours) when you are actually called in to work. For example, a 16-hour call shift where you are called in for 4 hours might pay: 12 hours at $4/hr stipend ($48) plus 4 hours at $31.08/hr base ($116.56), totaling $164.56. Level I trauma centers may pay higher stipends to incentivize availability.
Do ambulatory surgical center surgical techs earn less than hospital techs?
BLS does not publish a separate wage for freestanding ambulatory surgical centers; the outpatient care centers category that includes ASCs has a mean of $69,250 (BLS OEWS May 2025), essentially on par with general medical and surgical hospitals at $69,000. So the gap is not really in base pay. It is in differentials: ASC positions typically have no required night, weekend, or holiday shifts, and no on-call requirement, so they lack the differential and call income a hospital tech can earn on top of base. The ASC tech trades that differential income for schedule predictability, which is why many experienced CSTs prefer ASC work even though hospital roles can pay more in total.