How to Pay a Med Spa Injector: Hourly, Salary, Commission, and Per-Unit Plans

Four ways to pay an injector

The real difference between injector pay plans is who absorbs a slow week. An hourly wage or a salary puts that risk on the practice. A share of revenue or a per-unit rate puts it on the injector. Many plans split it, with a guaranteed floor and a bonus tied to treatments.

• Hourly: a set rate for every scheduled hour, booked or not, with time and a half past 40 hours in a week under federal law.
• Salary: a fixed weekly amount that does not move with patient volume, which is what the professional overtime exemption requires.
• Share of revenue: a percentage of collected treatment revenue, figured on gross revenue or on revenue after product cost.
• Per unit: a set amount for each unit of neurotoxin and each syringe of filler, whatever price the patient paid.
• Floor plus production: an hourly wage or a salary with a bonus figured on treatment revenue or volume.

One sample week under each plan

Take an injector who works four 10-hour days. In a normal week the injector treats 400 units of neurotoxin at $15 a unit and five syringes of filler at $800, so the clinic collects $10,000. Product costs $7 a unit and $340 a syringe, or $4,500. These are round numbers picked so the arithmetic is easy to check, not market prices or a pay recommendation.

Now set each plan to pay $2,200 in that normal week: $55 an hour for 40 hours; a $1,700 weekly salary ($88,400 a year) plus 5% of collected treatment revenue; 22% of collected treatment revenue; or $3 a unit and $200 a syringe. After product and pay, the clinic keeps $3,300 under every plan. The plans only separate when the week changes.

In a slow week, with bookings down 40% ($6,000 collected and $2,700 of product), the hourly plan still pays $2,200, salary plus 5% pays $2,000, and the 22% plan and the per-unit plan each pay $1,320. The clinic keeps $1,100, $1,300, $1,980 and $1,980.

In a promotion week, with neurotoxin at $12 a unit and the same volume ($8,800 collected and $4,500 of product), the hourly and per-unit plans still pay $2,200, salary plus 5% pays $2,140, and the 22% plan pays $1,936. The clinic keeps $2,100 under hourly or per-unit pay, $2,160 under salary plus 5%, and $2,364 under the 22% plan.

Wages and salaries leave a slow week with the clinic, and production plans hand it to the injector. Per-unit pay also leaves the whole cost of a discount with the clinic, while a share of revenue splits it. A percentage of gross revenue pays the injector on product cost as well: in the normal week, $990 of the 22% plan's $2,200 is a share of the $4,500 spent on product. A plan figured on revenue after product cost avoids that. At 40% of the $5,500 left after product, it pays the same $2,200 in a normal week, drops to $1,720 in the promotion week, and gives the injector a direct reason to care about pricing and product waste.

What the license earns elsewhere: May 2025 wages

The Bureau of Labor Statistics does not track med spas or injectors as their own category, so the useful benchmarks are national medians by license from its May 2025 wage estimates. They show what the same license earns across all employers, which is the alternative a candidate weighs against your plan.

Registered nurses had a median of $97,550 a year, or $46.90 an hour; in ambulatory healthcare services, the industry group that includes physicians' offices, the median was $91,230. Nurse practitioners had a median of $132,300 a year. Physician assistants had a median of $135,880 a year, or $65.33 an hour, and $132,000 in physicians' offices.

Divided by 52, the median RN salary is about $1,876 a week. A production plan that pays less than that in an ordinary week asks an experienced RN to accept a pay cut now for the chance of more later. The sample plans above pay $2,200 in a normal week, and the production plans pay as little as $1,320 in a slow one.

Which plans keep an injector exempt from federal overtime

Under the Fair Labor Standards Act, an RN, NP or PA injector is exempt from overtime as a professional only when three tests are met: professional duties, pay on a salary basis, and a salary of at least $684 a week ($35,568 a year). The Labor Department restored the $684 level in a technical amendment published May 15, 2026, after federal courts vacated the 2024 rule that would have raised it to $844 and then $1,128 a week.

Most injectors pass the duties test. Federal regulations say registered nurses generally meet it, and nurse practitioners are registered nurses. Physician assistants with four academic years of pre-professional and professional study, a degree from an accredited program and NCCPA certification generally meet it as well. Licensed practical nurses generally do not, whatever their experience.

The salary basis test is where production plans fail. A salary is a predetermined amount that is not reduced because of the quality or quantity of the work. Commission-only and per-unit pay move with the quantity of work by design, so they cannot meet it. The fee-basis rule does not save per-unit pay either, because it covers unique jobs, not a series of jobs repeated an indefinite number of times. And nurses cannot skip the salary requirement, because the exception for people practicing medicine does not extend to nurses.

What works is a guarantee plus extras. The regulations let an exempt employee who is guaranteed at least $684 a week on a salary basis also earn a commission or a percentage of sales or profits without losing the exemption. That is the federal case for a salary plus production bonus. Hourly pay is the opposite case: the Labor Department's nurse fact sheet says registered nurses paid on an hourly basis should receive overtime pay. Several states, California among them, set salary floors well above $684, so check yours before you rely on the federal number.

Overtime and minimum wage on production pay

A nonexempt injector earns overtime at one and a half times the regular rate for hours over 40 in a workweek. With commission or per-unit pay, the regular rate is the week's total pay divided by the hours actually worked. Because the production pay already covers straight time for every hour, the overtime owed is an extra half of that rate for each hour past 40.

Say a per-unit injector works 45 hours and earns $2,475 in per-unit pay. The regular rate is $2,475 divided by 45, or $55. The overtime premium is 5 hours at $27.50, or $137.50, so the week costs $2,612.50.

Production bonuses paid on top of an hourly wage count too. Nondiscretionary bonuses, including production bonuses set by a formula, go into the regular rate. An injector paid $50 an hour who works 45 hours and earns a $450 bonus is owed $2,250 in straight time, the $450 bonus, and a premium of half the $60 regular rate ($2,700 divided by 45) for 5 hours, or $150: $2,850 in all. Figuring overtime on the $50 wage and adding the bonus afterward comes to $2,825, which underpays by $25 that week.

Every week also needs a minimum wage check. A new injector on a 22% plan who works 40 hours and brings in $1,000 of treatments earns $220, below the $290 that the $7.25 federal minimum wage requires for 40 hours, so the clinic owes at least $70 more. Your state's minimum may be higher; in California the floor for the same week is $676.

One narrow federal exception can apply. Section 7(i) of the Fair Labor Standards Act exempts an employee of a retail or service establishment from overtime when the regular rate exceeds one and a half times the minimum wage and more than half of earnings over a representative period are commissions. Whether a med spa qualifies as a retail or service establishment is a fact question, so get an employment lawyer's opinion before a plan depends on it.

Federal overtime is counted by the week. Four 10-hour days come to 40 hours, so federal overtime never starts on that schedule. California counts by the day as well.

California rules that change the math

California's wage orders, following Labor Code section 515(f), say registered nurses employed to practice nursing are not exempt professional employees. An RN who spends the day injecting is owed overtime in California on an hourly wage, a salary or a production plan alike. Certified nurse practitioners who are primarily doing work that requires their certification are carved out of that rule, but they still have to meet the professional duties tests and earn a monthly salary of at least twice the state minimum wage for full-time work. With the 2026 minimum wage at $16.90 an hour, that floor is $70,304 a year, or $1,352 a week, and an exempt PA needs the same salary.

California overtime is daily as well as weekly: time and a half for hours over 8 in a workday, and double time over 12. A four-day, 10-hour schedule puts 8 hours a week into daily overtime. At $55 an hour, that week costs $2,420 (32 hours at $55 plus 8 hours at $82.50) instead of $2,200 under federal rules. A clinic can schedule up to 10 hours a day within a 40-hour week without daily overtime only through an alternative workweek schedule adopted in a secret ballot election, before the work is performed, by at least two-thirds of the affected employees.

Per-unit pay raises a second California issue. The state's Department of Industrial Relations says the nature of the pay, not its label, decides whether it is piece-rate compensation. Piece-rate employees must be paid for rest and recovery periods separately from their piece-rate earnings, at the higher of the week's average hourly rate or the minimum wage, and their pay stubs must show those hours, the rate and the pay. Other nonproductive time, such as waiting on a late patient, must be paid at least the minimum wage, a requirement a clinic meets by paying at least the minimum wage for every hour on top of the piece rate.

Paying an injector as a 1099 contractor

Calling an injector a contractor does not make the injector one. Under federal wage law the question is whether the worker is economically dependent on the clinic for work. The Labor Department's 2024 rule weighs six factors with no set weight, among them control, permanence, investment and whether the work is integral to the business. A proposal published February 27, 2026 would return to the department's 2021 analysis, in which two core factors carry the most weight: the nature and degree of control over the work, and the worker's opportunity for profit or loss. Check the Federal Register for the final version before you sign a contractor agreement.

Per-unit pay does not turn an injector into a business. Under the proposal, the profit or loss factor points toward employee when the worker can raise earnings only by working more hours or faster, and the control factor points toward employee when the clinic sets the schedule or workload or requires the injector to work only for it. An injector who works the hours you schedule, treats patients you booked, injects product you bought and charges your prices fits that description. A contractor sets their own schedule, can work for other practices, including competitors, and invests in their own product, equipment or staff.

California is stricter. Its ABC test treats a worker as an employee unless the work is free of the clinic's control, outside the usual course of the clinic's business, and done by someone customarily engaged in an independently established business of the same kind. Injections at a med spa are the usual course of its business. The state's list of licensed health professionals judged under the older Borello test names physicians, surgeons, dentists, podiatrists, psychologists and veterinarians; nurses and PAs are not on it.

Put the plan in writing before the offer

A production plan that lives in the owner's head turns into a dispute the first time a patient gets a refund. The base matters as much as the rate. Collected revenue is cleaner than booked revenue, because refunds, chargebacks and package discounts never reach the bank. Revenue after product cost ties pay to margin, but only if the injector can see the product costs you use.

Write the plan down and have an employment lawyer in your state review it before the injector's first shift. The written plan should settle each of these terms.

• The guaranteed amount, how often it is paid, and whether it is a salary or an hourly wage.
• The bonus base: collected or booked revenue, gross or after product cost, and which services count.
• The product cost per unit and per syringe used in the calculation, and how a change is announced.
• How refunds, chargebacks, complimentary touch-ups, package and membership discounts, and model patients affect pay.
• When production is earned, such as at treatment rather than at package sale, and when bonuses are paid.
• Who keeps time records, since a nonexempt injector's overtime and minimum wage checks depend on them.
• A healthcare attorney's review of any payment for bringing in patients rather than treating them, under your state's fee-splitting and referral rules.

How the pay plan shapes an injector search

An injector who already has a full schedule at another practice is comparing your offer with a paycheck they know. An offer that states the guaranteed floor, the bonus base and an example week is easier to weigh than a promise of competitive commission.

ScrubOps runs local searches for injectors, NPs and PAs and charges 25% of the hire's first-year base salary, with no placement fee if you do not hire. On the salary plus 5% plan above, first-year base salary is $88,400, so the fee would be $22,100. The published percentages apply to base salary, and any treatment of variable pay such as bonuses or commission is agreed in writing before the search begins, so settle the pay plan first and the fee follows from it.