Salario de Cirujano en North Carolina (2026)
El salario promedio de un Cirujano en North Carolina es de $480,000/año. Después de impuestos, tu sueldo neto estimado es de $309,303/año ($25,775/mes).
Desglose del Sueldo Neto
| Categoría | Cantidad |
|---|---|
Sueldo Neto Anual | $309,303 |
Sueldo Neto Mensual | $25,775 |
Sueldo Neto Quincenal | $11,896 |
Sueldo Neto por Hora basado en 2,080 hrs/año | $149/hr |
Impuesto Federal | $131,134 |
Impuesto Estatal | $18,643 |
Impuestos FICA | $20,919 |
Tasa Efectiva de Impuesto impuestos totales ÷ salario bruto | 35.56% |
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Rangos de Salario de Cirujano en North Carolina
No todas las Cirujanos ganan lo mismo — ni de cerca
NC surgeon comp clusters around three regional ecosystems plus the cosmetic plastic + RTP biomedical career arc. Triangle (Raleigh-Durham-Chapel Hill): Duke Health + UNC Health + WakeMed + RTP biomedical companies (GSK / Biogen / Merck / IQVIA). Charlotte: Atrium Health + Novant Health + OrthoCarolina + Tryon Medical Partners. Greensboro / Winston-Salem: Cone Health + Atrium Wake Forest Baptist + Novant. Secondary markets: ECU Health (Greenville) + Mission Health (Asheville) + Novant New Hanover (Wilmington).
Duke Cardiothoracic + Transplant Surgery
$565,000–$835,000 + RVU + call
Duke Heart Center · transplant + complex CT · top-20 US academic · 403(b) + 457(b) + research time
UNC Surgical Oncology (Lineberger Cancer Center)
$485,000–$725,000 + RVU + research
NCI-designated comprehensive cancer center · academic faculty + research time + PSLF-qualifying
Atrium Health Cardiothoracic + Neurosurgery (Charlotte)
$525,000–$795,000 + RVU + call
Atrium Health Sanger Heart & Vascular Institute · ~70K employees · ~40 hospitals
OrthoCarolina (Charlotte large private orthopedic group)
$525,000–$895,000 + ASC distribution
Top US private orthopedic group · partnership + ASC equity · 5-15% buy-in · PE consolidator pressure
Charlotte SouthPark / Triangle Cosmetic Plastic Surgeon
$525,000–$1.3M+ owner draw
Cash-pay aesthetic · S-corp + Solo 401(k) + cash-balance · Charlotte Southeast aesthetic market
WakeMed Cardiothoracic + Trauma Surgery (Raleigh)
$465,000–$715,000 + RVU + call
WakeMed Heart & Vascular + Trauma I · Raleigh community + academic mix
Atrium Wake Forest Baptist Cardiothoracic + Surgical Onc
$465,000–$685,000 + RVU + faculty
Wake Forest School of Medicine + Wake Forest Baptist Comprehensive Cancer Center · academic faculty
Anesthesiology + Pain Management (NC private group)
$385,000–$555,000 + group share
CRNA-supervision · ASC partnership at outpatient surgical centers
New-Attending General Surgery (year 1–3)
$365,000–$465,000 guarantee
Hospital-employed entry · cash-balance plan begins year 2–3 post-attending
Vale la pena saber: NC-specific layers: NC flat 3.99% (2026 endpoint of phase-down from 5.499%) is the lowest non-zero rate in the Southeast — cheaper than GA (5.19%), SC (6.0%), or VA (5.75% top). No local income tax (cleaner than OH RITA / CCA or PA EIT). Bailey pension settlement provides FULL exemption on federal / state / local government retirement vested as of 8/12/1989 — transformative for retiring military surgeons. Property tax 0.84% — among lowest in country. NC $500K cap on non-economic damages held constitutional 2018.
Surgical comp levers, RTP biomedical adjacency, and Bailey pension settlement
Top 20
Duke University Hospital + UNC Hospitals — both top-20 US academic medical centers
3.99%
NC flat state rate — lowest non-zero in Southeast (vs GA 5.19%, SC 6.0%, VA 5.75%)
$0
Bailey pension settlement — full NC tax exemption on government retirement income vested 8/12/1989
NC surgeon RVU compensation parallels PA / IL / OH — $55-$75 per work-RVU above threshold. High-volume orthopedic + cardiothoracic surgeons at Duke / UNC / Atrium / OrthoCarolina clear 12,000-15,000 work-RVU/year ($650K-$950K combined comp before ASC). Call coverage at WakeMed Trauma I + Atrium Carolinas Medical Center Trauma I + ECU Trauma I + Duke Level I adds $1,500-$5,000/24-hour shift. Combined federal + NC + Medicare marginal at $700K is ~41-43% — meaningfully lower than CA's 50-54% or NY+NYC's 50-53%. Every $100K of base / RVU / call yields $57K-$59K take-home.
eligibility at Duke Health, UNC Health, WakeMed, Atrium Health, Novant Health, Cone Health, Atrium Wake Forest Baptist, ECU Health, Mission Health (all 501(c)(3) non-profit + government hospital systems) = $0 tax-free $300K-$500K student loan forgiveness over 10 years post-PGY1. Pair with + dual-shelter at Duke / UNC / Atrium Wake Forest faculty appointment + research time, and the academic comp gap closes substantially. RTP biomedical adjacency creates research-physician hybrid roles at GSK, Biogen, Merck, IQVIA — clinical advisor / chief medical officer paths not available in most regional markets.
Bailey pension settlement (Bailey v. State of North Carolina, 1998) provides FULL NC state-tax exemption on federal / state / local government retirement income vested as of 8/12/1989 — transformative for retiring military surgeons (Camp Lejeune Marine Corps, Fort Liberty Army, Cherry Point MCAS, Seymour Johnson AFB) and federal civil-service medical retirees (VA medical, NIH). Pair with home-sale exclusion + cash-balance plan distribution and Bailey-eligible retirees structure NC retirement uniquely favorably vs Southeast peers.
Atrium Health is one of the largest Southeast non-profit health systems (~70K employees, ~40 hospitals, anchored by Carolinas Medical Center Trauma I). The Atrium + Advocate Aurora Health 2022 merger created Advocate Health (~150K employees + 67 hospitals across NC + IL + WI + AL + GA + SC). Charlotte private-practice ecosystem is among the strongest in the Southeast — OrthoCarolina (top US private orthopedic), Tryon Medical Partners (multi-specialty), Carolinas Center for Oral Health, Charlotte ENT all offer partner-track paths. PE consolidator pressure 2022-2026 has reached Charlotte ASC partnership market — equity sales realize $500K-$3M+ partner capital gains.
ASC partnership in NC operates at substantial scale — Charlotte + Triangle metropolitan ASC density. Buy-in $200K-$1.5M generates $80K-$400K/year facility-fee distribution. NC conforms to federal Section 1202 — federal $10M exclusion preserved at NC state level. NC malpractice premium for high-risk surgical specialties (neurosurgery / cardiothoracic / OB-Gyn) runs $35K-$95K/year — mid-low tier US (between TX HB 4 capped $25K-$60K and IL no-cap $80K-$200K). NC $500K cap on non-economic damages (held constitutional 2018) caps premium pressure. Cash-balance + Solo stack at NC 1099 / surgeon: same federal architecture — $270K-$370K/year pre-tax shelter at age 50+. NC PTET election available — saves $4K-$9K/year SALT-cap workaround on $400-800K net SE income.
North Carolina surgeon economics — Triangle + Charlotte + Triad
Triangle surgeon market: Duke Health (Durham — academic, top-20 US, especially strong cardiology / oncology / neurology), UNC Hospitals (Chapel Hill — academic, Lineberger Cancer Center, public health programs), WakeMed (Raleigh — Trauma Level I), Rex Healthcare (UNC affiliate). RTP biomedical adjacency creates research-physician hybrid roles at GSK / Biogen / Merck / IQVIA. Workforce housing in Cary / Apex / Holly Springs / Wake Forest / Chapel Hill / Hillsborough — top-tier suburban schools $500-900K with strong commute access. The Triangle has emerged as a major medical-relocation destination post-2020.
Charlotte surgeon market: Atrium Health (~70K employees, ~40 hospitals, anchored by Carolinas Medical Center Trauma I), Novant Health Charlotte, OrthoCarolina (large private orthopedic group), Tryon Medical Partners (large multi-specialty private practice). Charlotte is consistently among fastest-growing US metros. Workforce housing in Ballantyne / SouthPark / Myers Park / Lake Norman / Cornelius / Davidson / Matthews ($550K-$1.2M). Charlotte private-practice ecosystem is among the strongest in the Southeast — OrthoCarolina + Tryon Medical Partners + Carolinas Center for Oral Health + Charlotte Eye Ear Nose & Throat all offer partner-track paths. SouthPark cosmetic plastic surgery cluster operates the regional Southeast aesthetic market.
Triad surgeon market (Greensboro / Winston-Salem): Cone Health (Greensboro regional system, ~12K employees), Atrium Wake Forest Baptist (Winston-Salem academic — Wake Forest School of Medicine + Wake Forest Baptist Comprehensive Cancer Center), Novant Health Greensboro. Smaller market than Triangle or Charlotte but offers complete academic-medicine ecosystem at meaningfully cheaper housing. Workforce housing in Summerfield / Oak Ridge / Lewisville / Clemmons ($400-700K). Wake Forest Baptist has strong cancer center and cardiothoracic surgery reputation.
NC late-career retirement: NC flat 3.99% + 0% local + 0.84% property tax + Bailey pension settlement (for qualifying retirees) make NC retirement structurally attractive. For senior NC surgeons retiring with $300K-$500K of cash-balance + + Social Security: NC tax burden $10K-$18K/year (or $0 if Bailey-eligible). Combined with paid-off Outer Banks coastal property or Asheville-area retirement, NC in-state retirement is genuinely competitive with FL or TN. Many NC career surgeons stay through retirement specifically because of this combination. Some still relocate to FL (Naples / Sarasota) for partner-tier comp + winter lifestyle.
How NC flat 3.99% + Bailey pension + 0.84% property tax reshape surgeon comp
NC flat 3.99% (2026 endpoint of 2013-2026 phase-down from 5.499%) is the lowest non-zero rate in Southeast. For a $700K-TC surgeon, NC state tax ~$28K/year vs GA ~$38K, VA ~$40K, NJ ~$72K, NYC ~$103K. NC has no local income tax overlay — cleaner than OH (RITA / CCA) or PA (EIT). Combined federal + NC + Medicare marginal at $700K ~41-43% — 7-12 points lower than CA / NY+NYC.
Bailey pension settlement (Bailey v. State of North Carolina, 1998) provides FULL NC state-tax exemption on federal / state / local government retirement income vested as of 8/12/1989 — transformative for retiring military surgeons. For non-Bailey retirees, NC taxes pension and at flat 3.99% (no exemption like PA's $0 or IL's full). Social Security is fully NC-exempt regardless. A senior NC surgeon retiring with $300K of 401(k) + SS pays ~$12K/year state tax (or $0 if Bailey-eligible).
eligibility broad: Duke / UNC / WakeMed / Atrium / Novant / Cone / Atrium Wake Forest / ECU / Mission all qualify = $0 tax-free $300K-$500K student loan forgiveness. RTP biomedical adjacency creates research-physician hybrid roles at GSK / Biogen / Merck / IQVIA — clinical advisor / CMO paths not available in most regional markets.
NC conforms to federal Section 1202 — federal $10M exclusion preserved (no addback). Property tax averages 0.84% — among the lowest in country, dramatically below TX 1.6-2.5%. On a $1M Charlotte SouthPark or Triangle Cary home, NC property tax ~$8.4K/year vs $16K-$25K on equivalent TX homes. NC homestead exclusion (50% reduction for elderly / disabled under income thresholds) provides late-career relief.
NC $500K cap on non-economic damages (held constitutional 2018) caps malpractice premium pressure. High-risk subspecialty premium $35K-$95K/year — mid-low tier US (between TX HB 4 capped $25K-$60K and IL no-cap $80K-$200K). Cash-balance + Solo stack: $270K-$370K/year pre-tax shelter at age 50+. NC PTET election = federal -cap workaround saves $4K-$9K/year on $400-800K net SE income.
- →Bailey pension settlement check: federal / state / local government retirement income vested as of 8/12/1989 is FULLY exempt — transformative for retiring military surgeons; confirm eligibility with a CPA
- →Cash-balance + Solo stack at 1099 / = $270K-$370K/year pre-tax shelter at age 50+
- → at Duke / UNC / WakeMed / Atrium / Novant / Cone / Atrium Wake Forest / ECU / Mission = $0 tax-free $300K-$500K student loan forgiveness
- →Atrium / OrthoCarolina / Tryon Medical Partners ASC partnership equity — facility-fee distribution flows non-, may preserve partial Section 199A
- →NC PTET election for / partnership = federal -cap workaround saving $4K-$9K/year on $400-800K net SE income
- →RTP biomedical adjacency clinical advisor / CMO roles at GSK / Biogen / Merck / IQVIA — research-physician hybrid path at NC flat 3.99%
- →Property tax homestead exclusion (65+ income-eligible) — 50% reduction; meaningful late-career relief at $1M+ home tier
Three North Carolina surgeon markets — what each one looks like
NC surgeon comp varies by employer cluster + Triangle academic vs Charlotte private practice + Triad academic-affiliated. Three regional markets with distinctive employment models.
Triangle (Duke / UNC / WakeMed / RTP biomedical adjacency)
Academic faculty $485K-$835K · cardiothoracic / neurosurgery $565K-$865K · cosmetic owner $525K-$1.1M+Duke Health + UNC Hospitals (top-20 US academic medical centers) + WakeMed Trauma I + Rex Healthcare. RTP biomedical adjacency creates research-physician hybrid roles at GSK / Biogen / Merck / IQVIA. Workforce housing Cary / Apex / Holly Springs / Wake Forest / Chapel Hill / Hillsborough at $500-900K — top-tier suburban schools at price points dramatically below SF / Boston equivalents.
The Triangle has emerged as major medical-relocation destination post-2020 — physicians from NY / NJ / IL / MA settling for academic depth + RTP research adjacency + Sun Belt cost-of-living. Cary and Apex are particularly physician-dense.
Charlotte (Atrium / Novant / OrthoCarolina / Tryon Medical Partners)
Atrium academic $485K-$795K · OrthoCarolina partner $525K-$895K + ASC · cosmetic owner $525K-$1.3M+Atrium Health (~70K employees, ~40 hospitals — anchored by Carolinas Medical Center Trauma I), Novant Health Charlotte, OrthoCarolina (top US private orthopedic group), Tryon Medical Partners (large multi-specialty). Charlotte consistently among fastest-growing US metros. Workforce housing Ballantyne / SouthPark / Myers Park / Lake Norman / Davidson / Matthews ($550K-$1.2M).
Charlotte private-practice ecosystem is among the strongest in the Southeast — OrthoCarolina + Tryon Medical Partners offer partner-track paths. SouthPark cosmetic plastic surgery cluster operates regional Southeast aesthetic market. Lake Norman emerged as destination physician suburb.
Triad (Cone Health Greensboro / Atrium Wake Forest Baptist Winston-Salem)
$465K-$685K + faculty research time + 403(b) + 457(b)Cone Health (Greensboro regional system, ~12K employees), Atrium Wake Forest Baptist (Winston-Salem academic — Wake Forest School of Medicine + Wake Forest Baptist Comprehensive Cancer Center), Novant Health Greensboro. Smaller market than Triangle or Charlotte but offers complete academic-medicine ecosystem at meaningfully cheaper housing. Workforce housing Summerfield / Oak Ridge / Lewisville / Clemmons ($400-700K).
The Triad is the cost-of-living arbitrage NC surgeon market. Wake Forest School of Medicine + Wake Forest Baptist Medical Center provide academic anchor. Many surgeons choose the Triad specifically for cost-of-living math + still-meaningful academic affiliation.
The North Carolina surgeon career arc — residency to retirement
Years 1-9 (med school + residency + fellowship). 4 years med school + 5-9 years residency + 1-3 years fellowship. PGY1 ACGME stipend at NC programs $65K-$85K. Duke / UNC / WakeMed / Atrium / Wake Forest / ECU / Mission residencies all -qualifying. Most NC surgical residents finish with $300K-$500K federal student loan debt; PSLF at non-profit academic hospital = $0 tax-free forgiveness over 10 years post-PGY1.
Years 1-3 attending ($365K-$465K). Hospital-employed at Duke / UNC / WakeMed / Atrium / Novant / Cone / Atrium Wake Forest / ECU / Mission, or $345K-$425K + revenue-sharing at private group. Most new attendings buy $500-900K starter home in Triangle exurbs / Charlotte / Triad within year 1-2 — much earlier than CA / NY equivalent.
Years 4-10 attending ($485K-$725K TC). Subspecialty premium: ortho $585K, cardiothoracic $695K, neurosurgery $755K. Duke / UNC / Atrium / OrthoCarolina / Tryon Medical / private-group partnership buy-in ($200K-$1.5M) year 3-5; ASC equity ($150K-$500K) year 5-7. Cash-balance + Solo max age 45-55 = $270K-$370K/year shelter. By year 10 mid-career, NC surgeon net worth typically $2.5M-$8M.
Years 10+ (senior partner / department chair / late career). $665K-$1.2M+ TC. Duke / UNC Department Chair $750K-$1.2M; Charlotte SouthPark cosmetic plastic owner clears $1M-$1.3M draw. PE consolidator exits realize $500K-$3M+ capital gain. NC flat 3.99% + Bailey settlement (qualifying retirees) + 0.84% property tax + 0% local make in-state retirement structurally attractive. Most late-career NC surgeons stay; relocators with $500K+ portfolios still see FL / TN compounding but gap is smaller than higher-tax states.
Where North Carolina surgeons actually live
NC surgeon housing weights schools + commute + practice location. Most under-45 surgeons buy single-family in suburban metro near practice; senior partners + Department Chair tier upgrade to premium primary residence near hospital or top private school. Atlanta intown / Triangle urban for younger attendings, but family-stage migration to suburbs is the dominant pattern.
Cary / Apex (Triangle)
Wake County top schools · Duke / UNC / WakeMed access · $550-900K · physician dense
Chapel Hill / Hillsborough
UNC walkable / short commute · top schools · $600K-$1.1M
Ballantyne / SouthPark (Charlotte)
Atrium uptown 25 min · top schools · cosmetic plastic cluster · $650K-$1.4M
Lake Norman / Davidson (Charlotte)
Lake access · Atrium 30-40 min · top schools · $550K-$1.5M · destination suburb
Summerfield / Oak Ridge (Greensboro)
Cone Health 20-25 min · top schools · $400-700K · Triad arbitrage
Wilmington / Wrightsville (coastal)
Novant New Hanover access · coastal lifestyle · $500K-$1.0M · hurricane risk
NC cost-of-living arbitrage + flat 3.99% + 0% local + 0.84% property tax + Bailey settlement make in-state retirement structurally attractive. Most senior NC surgeons stay through retirement. Lake Norman has emerged as destination physician suburb for Charlotte attendings — lake homes, top schools, 30-40 min Atrium commute.
¿Es la decisión correcta?
North Carolina for surgeons — Sun Belt growth + retirement-friendly
A tu favor
- +Duke + UNC = top-20 US academic medical centers with deep specialty research programs
- +RTP biomedical adjacency creates research-physician hybrid opportunities at GSK / Biogen / Merck / IQVIA
- +Flat 3.99% state tax — lowest non-zero rate in the Southeast (lower than GA, SC, VA)
- +Zero local income tax — structurally cleaner than OH (RITA / CCA) or PA (EIT)
- +Bailey pension settlement fully exempts federal/state/local government retirement vested 8/12/1989 — transformative for retiring military
- +Charlotte private-practice ecosystem (OrthoCarolina + Tryon Medical Partners) is among the strongest in the Southeast
Vale la pena saber antes de firmar
- −Sun Belt summer heat + humidity is real; hurricane risk meaningful along NC coast
- −Healthcare IS SSTB — Section 199A QBI eliminated above $553K MFJ
- −ECU Greenville, Mission Asheville, Wilmington markets are materially smaller than Triangle / Charlotte / Triad
- −Charlotte traffic is growing as the metro continues to expand
- −Triangle housing has caught up significantly — Cary / Apex / Chapel Hill not as cheap as 5-10 years ago
- −NC academic ceiling slightly below UCSF / Stanford / NYP in NIH research-funding rankings
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