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FirstAssistPA

Orthopaedic PA placement · United States

Pre-vetted first assist PAs for the world's best surgeons.

We place physician assistants who first assist in the OR, take trauma call and run ortho clinic. Permanent hires and 3 to 6 month contract coverage. Now placing in California, Las Vegas, Phoenix, Colorado, New York City and Pennsylvania. Your first placement is free.

Request a PAI'm a PA looking for ortho work

Ortho only. New, small, and adding places as we grow. PAs never pay a fee.

Three numbers every ortho practice should know

1:8

Physician-to-PA supervision ratio in California since January 1, 2026, up from 1:4.

Source: Cal. Bus. & Prof. Code §3516(b), as amended by AB 1501 (2025) · in our guide

85%

Of the physician fee schedule: what Medicare allows for services billed under a PA's NPI.

Source: CMS Medicare Claims Processing Manual, Ch. 12, §110 · in our guide

13.6%

Of the surgeon's fee schedule amount: Medicare's payment for a PA first assist billed with modifier AS.

Source: CMS Medicare Claims Processing Manual, Ch. 12, §110.2 · in our guide

How it works

Three steps on each side

A short process, run by one person who knows ortho, from first call to the 90-day check-in.

For practices

Request a PA

  1. Step 1

    Tell us about the role

    Case mix, clinic and OR days, call, which hospitals, and when you need someone. Takes about ten minutes.

  2. Step 2

    We send a short list

    Ortho PAs only. We check first-assist and call experience with a surgeon they worked with, not only a manager.

  3. Step 3

    You interview and decide

    We handle scheduling and terms. We check in at 30, 60 and 90 days. Not happy? We replace the PA at no cost.

For PAs

Join as a PA

  1. Step 1

    Tell us what you want

    Regions, schedule, call tolerance, permanent or 3 to 6 month contract. A CV helps but isn't required.

  2. Step 2

    We match you to ortho roles

    Only orthopaedic roles, only where you want to work, and only ones that fit what you told us. No spray of irrelevant jobs.

  3. Step 3

    We negotiate for you

    Rate, housing or travel stipend, and schedule. Contract roles are W-2, not 1099. In California, AB 5 requires it.

The guarantee

Your first placement is free. If you are not happy with the PA, we find a replacement at no cost.

For any reason. You don't have to prove the PA did something wrong. We're new, and this is how we'd like to earn your trust: do the work first, and carry the risk ourselves.

  • No fee on your first placement. Permanent or contract.
  • Replacement at no cost. If you aren't happy with the PA we place.
  • Later placements are quoted up front. Fees are agreed in writing before a search starts.
  • PAs never pay us. Matching is free for candidates.

Why ortho-only

A general PA recruiter doesn’t know what to ask

Ortho hiring turns on details a generalist skips. These are the ones we check on every search.

“First assist” means different things

On a résumé it can mean holding retractors or closing on your own. We ask which cases, which implant systems, and what a surgeon would let them do alone.

Call and trauma are their own skill

Reductions and splints without the surgeon present, knowing when to wake the attending, working across hospitals where your surgeons hold privileges.

State rules differ, and they change

Each state sets its own supervision and practice-agreement rules. In California, for example, the ratio went from 1:4 to 1:8 on January 1, 2026, and chart co-signature is optional unless your practice agreement requires it.

Licensing takes months

A PA needs a license in the state where they practice. California, for one, isn't in the PA Licensure Compact and has no general temporary license. We plan start dates around the real timeline instead of promising around it.

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Fig. 326Shoulder
Engraving of the bones of the left hand and wrist, palm side, with the muscle attachments labeled.
Fig. 219Hand and wrist
Engraving of the right hip joint from the front, showing the iliofemoral ligament over the femoral neck.
Fig. 339Hip
Engraving of the bones of the right foot seen from above, from the ankle to the toes.
Fig. 268Foot

Markets

Where we place ortho PAs

Each market page covers local trauma centers, the state's PA rules and, where we have verified data, pay.

All markets

Free guides · CA, NV, AZ, CO, NY, PA

What we know, written down and sourced

A hiring guide for each state we place in, plus a guide to billing and deploying the PAs you already have. Every number and legal statement is footnoted to a primary source. No email required.

All guides
Free California guide · For practice administrators and surgeons hiring

The Ortho PA Hiring Guide (California, 2026)

What California law allows since the 1:8 ratio took effect, W-2 vs 1099 under AB 5, realistic licensing timelines, what CA PAs are paid, interview questions for first assist and trauma call, and a 90-day onboarding checklist.

Read the guide
Free California guide · For practices that already employ PAs

Getting the Most From Your Ortho PAs

Medicare billing for PA services, first-assist economics by CPT code, what the studies say about deploying PAs in clinic and the OR, retention, and a one-page utilization self-audit.

Read the guide
Free Nevada guide · For Las Vegas and Nevada practices hiring

The Ortho PA Hiring Guide (Nevada, 2026)

Nevada's two licensing boards (MD vs DO), the three-PA-and-APRN supervision limit, W-2 vs 1099 under Nevada's tests, license by endorsement and Pharmacy Board registration timelines, Las Vegas pay data, interview questions and a 90-day onboarding checklist.

Read the guide
Free Arizona guide · For Phoenix and Arizona practices hiring

The Ortho PA Hiring Guide (Arizona, 2026)

Arizona's 8,000-hour split between supervision agreements and collaborative practice, the six-PA limit, controlled-substance and 2026 CSPMP rules, W-2 vs 1099 under Arizona's tests, licensing timelines, Phoenix pay data, interview questions and a 90-day onboarding checklist.

Read the guide
Free Colorado guide · For Denver and mountain-town practices hiring

The Ortho PA Hiring Guide (Colorado, 2026)

Colorado's collaborative agreements and when they stay supervisory, the 1:8 limit on supervisory agreements, the presumption of employment, the PA Compact timeline, Denver and mountain-town pay data, interview questions, onboarding and seasonal ski-trauma coverage.

Read the guide
Free New York guide · For New York City practices hiring

The Ortho PA Hiring Guide (New York, 2026)

New York's supervision rules and the 2025 ratio change, W-2 vs 1099 under the control test, licensing without the PA Compact, e-prescribing and workers' comp rules, NYC pay data, interview questions and a 90-day onboarding checklist.

Read the guide
Free Pennsylvania guide · For Philadelphia and Pittsburgh practices hiring

The Ortho PA Hiring Guide (Pennsylvania, 2026)

Pennsylvania's 2021 PA reforms, MD vs DO boards, the six-PA limit, the mandatory 12-month countersignature windows, W-2 vs 1099, licensing timelines, Philadelphia and Pittsburgh pay data, interview questions and a 90-day onboarding checklist.

Read the guide

Hiring

Need an ortho PA?

Permanent, 3 to 6 month contract or per diem. Tell us about the role and you'll hear back from a person, not an autoresponder.

Request a PA

Looking

Ortho PA looking for work?

Free, ortho-only matching in California, Las Vegas, Phoenix, Colorado, New York City and Pennsylvania. We negotiate rate, stipend and schedule for you.

Join as a PAEvery PA gets a free profile page

FAQ

Questions we get

What does “first placement free” mean?

We charge no fee for the first PA we place with your practice, permanent or contract. If you aren't happy with that PA for any reason, we find a replacement at no cost. Fees for later placements are agreed in writing before we start a search, so there are no surprises.

Are contract PAs W-2 or 1099?

W-2. Contract PAs we place are W-2 employees, either of the practice or of a staffing entity that bills the practice, in every state we work in. In California it isn't optional: AB 5's ABC test applies to PAs, and Labor Code 2783(b) exempts physicians, dentists and several other professions, but not physician assistants. Our California hiring guide covers the details. Have your employment counsel review any structure.

How fast can a PA start?

It depends mostly on licensing. A PA with an active license in your state can start as soon as privileges and your onboarding allow. A PA licensed elsewhere needs your state's license first, and hospital credentialing adds more. In California, for example, the PA Board targets 30 days for initial review. We tell you the realistic date up front rather than an optimistic one.

Where do you place PAs? Do you work outside orthopaedics?

We place orthopaedic PAs across the US. Right now we're placing in California, Las Vegas, Phoenix, Colorado, New York City and Pennsylvania, and we'll add places as we grow. If you're somewhere else, ask anyway. We don't work outside orthopaedics. That focus is the point.

Do PAs pay anything?

No. Matching is free for PAs. Practices pay us; we never take a cut of your rate.

Who is behind FirstAssistPA?

FirstAssistPA is a new, small placement service founded by Anthony David Adams. You'll deal with a person, not a call center. More about us.