Almost eight out of 10 of the most senior NHS managers earn over £100,000, with almost a quarter on more than £142,500, figures show.
Overall, 23.6% of hospital trust non-medical executive directors in the UK earned more than £142,500 in 2015, compared to 21.8% in the previous year.
There were some top earners - with 3.5% earning more than £200,000 a year.
Some 5.6% also earned between £175,000 and £200,000, while 14.5% earned between £142,600 and £175,000.
The pay study found that, overall, there has been a slight rise in the number of non-medical directors at NHS trusts earning over £100,000.
Some 77.4% of non-medical directors were paid more than £100,000 in 2015, up on 75.5% the previous year.
Meanwhile, 53.8% earned between £100,000 and £142,500 and 22.6% earned less than £100,000.
In the largest NHS trusts (income over £425 million), chief executives typically earned £202,500 in 2015.
Most of the top-paid chief executives are employed by the largest trusts in terms of income, including University College London Hospital, Guy's and St Thomas' and Cambridge University - who all received salaries in excess of £250,000.
The survey was carried out by pay analysts E-reward.co.uk and is based on around 1,400 NHS hospital trust directors.
While just 8% of full-time, full-year directors in UK trusts registered bonuses in the last 12 months, some bonuses were substantial.
The chief executive of Oxford University Hospitals received the highest amount at between £30,000 and £35,000 in recognition of performance, the survey found.
Some medical directors also earned up to £60,000 in bonuses for clinical excellence.
The survey also reported record levels of board-level turnover in the year running at over 30% and overall redundancy costs of more than £116 million in 229 trusts.
Experts at E-reward said most directors did not enjoy a salary increase, with there being typically no yearly increase for chief executives, finance directors, human resources directors, nursing and operations directors.
Around 60% of board members were subject to pay freezes, the study found.
The investigation revealed that the chief executive of an acute NHS trust typically earns £182,500 while those who head up ambulance trusts - which continually fail to hit performance targets across England - are on £157,500.
Deputy chief executives at acute trusts are on £137,500 while deputies at ambulance trusts are on £117,500.
HR directors at trusts earn £112,500 while nursing directors earn £112,500 and operations directors are on £117,500.
Rehana Azam, the GMB union's acting national secretary for public services, said the figures were " demoralising for rank-and-file NHS staff".
He added: "This is on top of pay-offs and pay incentives for executives to manage the NHS.
"By contrast, staff who deliver the service have now endured nearly a decade of pay restraints with real-terms pay cuts of around 10%.
"Adding to the injury, the Secretary of State for Health continues to want more staff to work weekends while cutting pay of staff to pay for it. It simply doesn't add up.
"The Government needs to set up independent review of the remuneration of NHS senior managers. There also has to be an end to the two-tier approach to fixing pay for managers and staff."
Unite union national officer for health Barrie Brown said: "What we have here is the Alice in Wonderland world of NHS pay when many NHS top bosses - who do not treat patients - are taking home much more than the Prime Minister's salary of £142,500, while nurses and other health professionals on £22,000 a year have seen their real incomes eroded by 15% since 2010.
"Health Secretary Jeremy Hunt is keen to impose contract changes on the junior doctors, but seems strangely averse to tackling the mega pay packets of NHS chief executives.
"Yet despite these handsome salaries, there still seems to be vacancies for the top jobs and chief executives don't stay very long at trusts. This jobs merry-go-around also needs to be investigated by Hunt."