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 2024)
| Setting | Mean Annual | Mean Hourly | Call / Schedule |
|---|---|---|---|
| Federal government (VA, military) | $71,820 | $34.53 | Varies; GS pay schedule |
| General medical / surgical hospitals | $62,140 | $29.88 | Night/weekend/call standard |
| Ambulatory surgical centers | $60,280 | $28.98 | Typically none |
| Outpatient care centers | $58,570 | $28.16 | Minimal |
| Offices of physicians | $55,340 | $26.61 | 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$29.14/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)$60,610
- 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)
- +Higher base pay ($62,140 vs $60,280)
- +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
- -Lower base ($60,280 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 $29.14/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 $29.14/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?
Base pay at ASCs is typically $1,500-$3,000 less per year than hospital employment. BLS data shows ASC mean of $60,280 vs hospital mean of $62,140. However, total compensation comparison shifts when you factor in that ASC positions typically have no required night, weekend, or holiday shifts, and no on-call requirement. The ASC tech trades shift differential income for schedule predictability. For lifestyle reasons, many experienced CSTs prefer ASC employment even at a slightly lower base.