How Much Does a Paramedic Make in North Carolina in 2026?

A typical Paramedic in North Carolina earns about $27.56 per hour ($57,320 per year), according to the latest government wage data (May 2025). Broken down further, that comes to roughly $4,777 a month, calculated from the annual figure. On a weekly basis, pay works out to about $1,102. These figures represent the typical pay level for Paramedics working across the state.

North Carolina pay runs 5% below the national figure of $60,600 a year for Paramedics, according to the same May 2025 data. That gap puts the state at 36th among the 51 states and territories ranked. Around 5,660 Paramedics work in North Carolina, compared with 100,610 nationwide. Lower pay in North Carolina often tracks lower living costs relative to higher-cost states.

Entry-level positions in North Carolina typically offer around $21.51 an hour ($44,730 a year). Pay at this level covers those just starting out in the field. Positions with slightly more experience move up to about $23.38 an hour ($48,630 a year). From there, pay typically climbs toward the state figure of $27.56 an hour within a few years.

Experienced Paramedics in North Carolina often earn upwards of $30.69 an hour ($63,820 a year). The top 10% of earners make over $36.14 an hour (about $75,170 a year). That leaves a spread of $30,440 between entry-level and top pay in the state. Setting, years of experience, and city all factor into where an individual Paramedic falls within that range.

North Carolina Paramedic pay has climbed steadily in recent years, rising from $38,830 in 2021 to $57,320 in 2025. That is a gain of $18,490, or a 48% rise, over that stretch, according to the same wage data. Pay moved higher each year across that period, without a single downturn. The increase reflects broader wage trends across emergency medical services in the state.

Nationally, Paramedic pay rose about 30% over a comparable decade-long stretch, according to government wage data. North Carolina's rise outpaced that national trend by a wide margin. For someone starting a Paramedic career in North Carolina now, pay has moved up substantially in recent years. That said, past increases are not a guarantee of future gains.

Pay runs highest in Fayetteville, where Paramedics earn $68,220 a year ($32.80 an hour), about 19% above the state figure. Raleigh and Cary follow, both at $65,220 a year ($31.36 an hour). Chapel Hill and Durham come in close behind, at $64,310 a year. These figures reflect pay across each city's full metro area, not just the city itself.

Pay runs lowest in Lenoir, where Paramedics earn $49,460 a year ($23.78 an hour), creating a spread of $18,760 between the highest- and lowest-paying cities in the state. Charlotte holds the largest Paramedic workforce in North Carolina, with 1,180 employed at $61,660 a year ($29.64 an hour). Cities with lower pay typically also carry a lower cost of living. That trade-off is worth weighing alongside the raw pay figures.

North Carolina's pay sits close to some neighbors and further from others. Virginia pays Paramedics $60,480 a year, about 6% more than North Carolina. Tennessee and Georgia both pay close to the state figure, at $57,690 and $57,660 respectively. South Carolina pays less, at $53,550 a year, about 7% below North Carolina. Paramedic licensure earned in one state can often be transferred or endorsed into a neighboring state, though requirements vary.

Paramedics in North Carolina typically earn $57,320 a year, a figure that has risen 48% since 2021. Pay varies by city and experience level, with Fayetteville leading the state and entry-level positions starting lower. Readers weighing a move into or within the field should check North Carolina's licensing and registry requirements for specifics, and review city-level pages for local pay figures before making a decision.