Chief executive pay has roared back after two years of stagnation and decline. America's top bosses enjoyed pay hikes of between 27 and 40% last year, according to the largest survey of US CEO pay. The dramatic bounceback comes as the latest government figures show wages for the majority of Americans are failing to keep up with inflation.

America's highest paid executive took home more than $145.2m, and as stock prices recovered across the board, the median value of bosses' profits on stock options rose 70% in 2010, from $950,400 to $1.3m. The news comes against the backdrop of an Occupy Wall Street movement that has focused Washington's attention on the pay packages of America's highest paid.

The Guardian's exclusive first look at the CEO pay survey from corporate governance group GMI Ratings will further fuel debate about America's widening income gap. The survey, the most extensive in the US, covered 2,647 companies, and offers a comprehensive assessment of all the data now available relating to 2010 pay.

Last year's survey, covering 2009, found pay rates were broadly flat following a decline in wages the year before. Base salaries in 2009 showed a median increase of around 2%, and annual cash compensation increased just over 1.5%. The troubled stock markets took their toll, and added together CEO pay declined for the third year, though the decrease was marginal, less than three-tenths of a percent. The decline in the wider economy in 2007, 2008 and 2009 far outstripped the decline in CEO pay.

This year's survey shows CEO pay packages have boomed: the top 10 earners took home more than $770m between them in 2010. As stock prices began to recover last year, the increase in CEO pay outstripped the rise in share value. The Russell 3000 measure of US stock prices was up by 16.93% in 2010, but CEO pay went up by 27.19% overall. For S&P 500 CEOs, the largest companies in the sample, total realised compensation – including perks and pensions and stock awards – increased by a median of 36.47%. Total pay at midcap companies, which are slightly smaller than the top firms, rose 40.2%.

GMI released a preliminary report on 2010 CEO pay earlier this year, before all the data was available. Paul Hodgson, a senior research associate at GMI, said that report had shown a significant bounce but he had expected a wider sample to dampen the effect.

"Wages for everybody else have either been in decline or stagnated in this period, and that's for those who are in work," said Hodgson. "I had a feeling that we would see some significant increases this year. But 30-40% was something of a surprise." Bosses won in every area, with dramatic increases in pensions, payoffs and perks – as well as salary.

Still, there are no bankers among this year's big winners. Three of this year's top 10 earners come from the healthcare industry. Top earner John Hammergren at McKesson, the world's largest healthcare firm, made $145,266,91 last year – most of it from stock options.

The rising stock markets were especially good to CEOs, said Hodgson. Stock options were the main area that drove these outsized awards. "They got the options, the market collapsed, then it came back – and all of a sudden they were in the money again," he said.

And there will be more to come. GMI, formerly known as the Corporate Library, is expecting a rash of massive stock option bonuses as many firms awarded their top executives big option deals when the stock markets hit their lows in 2007-2008.

"There's still a lot of money just waiting in the market," said Hodgson. He described the upcoming awards as a "bombshell" likely to dwarf this year's figures.

2010 was a great year to lose your job as a CEO. Four of the 10 highest paid CEOs were retired or departing executives. Ronald Williams, former head of Aetna, a health insurer, exercised 2.4m options for a profit of $50.4m. Aetna's stock price declined by 70% from when Williams assumed the role of CEO in February 2006 until his retirement. At pharmacy chain CVS, Thomas Ryan made a $28m profit on his options. During Ryan's 13-year tenure as CEO, CVS Caremark's stock price decreased almost 54%.

Omnicare's Joel Gemunder retired last August and received cash severance of $16m, part of a final-year pay package worth $98.28m. Adam Metz, the former boss of General Growth Properties, a real estate company that specialises in shopping malls, walked away with a $46m cash bonus in 2010. GGP executives received nearly $115m in bonuses from the firm as it emerged from bankruptcy.

But this year's top earner may have his biggest payday still to come. Hammergren is due a $469m payoff if McKesson changes ownership. "Boards make these decisions, but they don't work out what happens if they stay in the job," said Hodgson.

"If they had have done, one hopes, they would have looked at each other and said: 'This is ridiculous.'"