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

A typical Paramedic in North Dakota earns about $29.96 per hour, or $62,320 per year, according to the latest government wage data (May 2025). Calculated from that annual figure, pay works out to around $5,193 a month and $1,198 a week. Those numbers describe the statewide typical rate, not a starting wage or the highest pay experienced staff can reach.

This pay sits 3% above the national typical pay of $60,600 a year for Paramedics, and it puts North Dakota at 20th out of 51 states. Nationally, about 100,610 Paramedics were counted in the same period, compared with roughly 220 working across North Dakota. The state's small workforce size doesn't change the relative pay standing, which places it solidly in the middle of the national range.

Entry-level positions in North Dakota typically offer around $23.21 an hour, or about $48,270 a year. Pay at this level reflects the first years on the job, before certifications, call volume, and shift experience push earnings higher. Most Paramedics move beyond this starting range within a few years as they gain field experience. By the time someone reaches the state's typical pay of $29.96 an hour, they've usually logged several years on an ambulance crew.

Experienced Paramedics in North Dakota often earn upwards of $31.41 to $36.27 an hour, with the top 10% of earners making over $75,440 a year. That puts the gap between entry-level and top-tier pay at $27,170 a year. The difference usually comes down to years on the job, the setting (rural ambulance service versus a hospital-based or fire department program), and which city or region someone works in.

North Dakota's typical Paramedic pay has climbed from $46,950 in 2021 to $62,320 in 2025, according to the same wage data series. That's a gain of $15,370 over five years, with the steepest jump between 2022 ($47,700) and 2023 ($55,990). Pay has risen every year since 2021, without a single downturn in the data.

Nationally, typical Paramedic pay rose 30% over the past decade, a longer stretch than North Dakota's five-year climb but a useful point of comparison. Pay for Paramedics starting out today in North Dakota is higher than it was for anyone starting in 2021. That trend doesn't guarantee future increases, but it shows a consistent multi-year climb rather than a one-time jump.

North Dakota's wage data reports one metro area for Paramedics: Fargo, where typical pay runs $62,320 a year ($29.96 an hour), matching the statewide figure exactly. Fargo also carries the largest reported Paramedic workforce in the state, with about 100 workers counted in the metro area. Because Fargo's figure matches the statewide number, pay for Paramedics looks fairly uniform across North Dakota rather than concentrated in one high-paying pocket.

With only one city reported, there's no separate low-paying metro to compare against, and no measurable city-to-city spread to point to. Figures for Fargo cover its full metro area, not just the city center. Cost of living in North Dakota runs lower than in larger coastal metro areas, which typically tracks with pay levels that sit closer to the national typical rate than to the country's highest-paying markets.

Minnesota pays the most among North Dakota's neighbors, at $76,300 a year, about 22% higher than North Dakota's figure. South Dakota pays the least, at $48,830 a year, about 22% lower, with Montana landing in between at $50,890 a year, 18% below North Dakota. For Paramedics considering a move, licensure earned in one state can often be transferred or endorsed into a neighboring state, though requirements vary by state EMS office.

Paramedics in North Dakota typically earn $62,320 a year ($29.96 an hour), a figure that has climbed $15,370 since 2021. Pay sits close to the national typical rate and ranks 20th among the 51 states. Anyone weighing a move or a new certification should check North Dakota's EMS licensing and registry requirements directly, and look at city-level figures for a clearer picture of local pay before relocating.