The need for further improvement of the remuneration system in the public sector is considered, in particular, the features of the new remuneration system for medical workers, which has been tested as part of the pilot project of the Government of the Russian Federation in certain regions. The necessity of extending this practice to all regions is justified, which will allow applying a unified approach and actually ensuring a fair differentiation of incomes of medical workers associated with the need to maintain their income level at the level of average salaries in the economy of the relevant region. The analysis of the salary structure of medical workers, which includes, along with the official salary by qualification groups, compensatory and incentive payments, including at the expense of income-generating activities; the formula for adjusting the level of official salaries by regional coefficients, taking into account the objective economic differentiation of the subjects of the Russian Federation, is considered.