Surgeon Salary 2026 — Take-Home Pay by State
Surgeons (MD/DO with 5-9 year residency + 1-3 year fellowship) and anesthesiologists (MD/DO with 4-year residency) sit at the apex of US clinical compensation. MGMA 2024 medians: orthopedic $625K, cardiothoracic $720K, neurosurgery $785K, vascular $560K, plastic $510K, general $440K, anesthesiology $445K. Compensation structure post-2024 splits across (1) hospital W-2 employed, (2) private group partnership (1099 + S-corp + group equity buy-in $200K-$1.5M), (3) academic faculty. Tax architecture is uniquely complex: Healthcare IS SSTB for QBI purposes (Section 199A phases out at $241K single / $483K MFJ — eliminated above), making S-corp distribution + 401(k)/cash-balance plan stacking + non-conformity QBS planning structurally consequential.
National Median
$339,990
Best State (Net)
$365,537
Texas
Take-Home TX
$240,230
No state tax
Job Growth
BLS projects 3%
Key Facts — Surgeon 2026
MGMA 2024 medians: orthopedic $625K, cardiothoracic $720K, neurosurgery $785K, vascular $560K, plastic $510K, general $440K, anesthesiology $445K
Healthcare IS SSTB for Section 199A QBI — phases out at $241K single / $483K MFJ, eliminated above phase-out (no 20% deduction at typical surgeon income)
ASC (Ambulatory Surgical Center) partnership buy-in $200K-$1.5M = $80K-$400K/yr facility-fee distribution + capital gain on PE consolidator exit
Cash-balance defined-benefit + Solo 401(k) stacking at 1099 / S-corp surgeon = $200K-$300K/yr pre-tax shelter at age 50+
S-corp election at $400K+ net SE income for 1099 surgeon saves $8K-$20K/yr SE tax (vs. Schedule C structure)
457(b) at non-profit hospital + 403(b) dual-shelter for academic faculty = $47K+/yr tax-advantaged shelter
PSLF (Public Service Loan Forgiveness) at academic/non-profit hospital — 10-year qualifying-payment + 501(c)(3) employer = $0 tax-free med school debt forgiveness ($300K-$500K typical attending debt)
Malpractice tail coverage on group / partnership separation costs $50K-$300K — material wealth-build friction at career transitions
Salary by Experience Level
PGY 1-7 Resident / Fellow
$75,000
gross/year
Est. take-home (TX):
$61,593
ACGME stipend $65K-$95K · 60-80 hr/week · pre-attending
New Attending (year 1-3)
$380,000
gross/year
Est. take-home (TX):
$265,297
Hospital W-2 base or guarantee · stub partnership track
Mid-Career Attending (4-10 years)
$525,000
gross/year
Est. take-home (TX):
$356,139
Partnership track · RVU-driven · subspecialty premium
Senior Partner / Department Chair (10-25 years)
$750,000
gross/year
Est. take-home (TX):
$495,236
Group equity buy-in · ASC partnership · academic chair LTI
Specialties & Salary Premiums
| Specialty | Est. Salary | Premium |
|---|---|---|
| Neurosurgery | $526,985 | +55% |
| Cardiothoracic Surgery | $475,986 | +40% |
| Orthopedic Surgery | $407,988 | +20% |
| Vascular Surgery | $373,989 | +10% |
| Plastic Surgery (cosmetic cash-pay) | $526,985 | +55% |
| Anesthesiology + Pain Management | $288,992 | -15% |
| General Surgery | $288,992 | -15% |
Best States for Surgeons — Real Take-Home Pay
Ranked by estimated take-home pay (single filer, no additional deductions). The highest gross salary doesn't always mean the most money in your pocket.
▲Top 5 — Highest Take-Home
Surgeon Salary by State — All 50 States
Take-home estimates for a single filer with no additional deductions. Click any state for the full breakdown.
| State | Gross Salary | Est. Take-Home |
|---|---|---|
| $540,000 | $365,537 | |
| $535,000 | $362,404 | |
| $525,000 | $356,139 | |
| $525,000 | $356,139 | |
| $510,000 | $346,742 | |
| $510,000 | $346,742 | |
| $510,000 | $334,394 | |
| $490,000 | $334,212 | |
| $480,000 | $327,947 | |
10Colorado | $515,000 | $327,923 |
11Ohio | $500,000 | $327,162 |
| $510,000 | $326,901 | |
| $500,000 | $325,127 | |
| $475,000 | $324,814 | |
15Illinois | $510,000 | $321,497 |
| $510,000 | $321,462 | |
| $490,000 | $319,887 | |
18Indiana | $490,000 | $319,786 |
| $480,000 | $318,693 | |
20Utah | $500,000 | $318,227 |
21Virginia | $510,000 | $318,177 |
22Michigan | $495,000 | $316,558 |
23Georgia | $500,000 | $316,275 |
| $510,000 | $315,492 | |
25New York | $510,000 | $314,526 |
26Oklahoma | $490,000 | $312,707 |
27Missouri | $490,000 | $312,119 |
| $510,000 | $311,493 | |
29Alabama | $480,000 | $310,743 |
| $500,000 | $310,649 | |
31Iowa | $480,000 | $310,319 |
32Nebraska | $485,000 | $309,715 |
| $490,000 | $309,649 | |
| $520,000 | $308,989 | |
35Kentucky | $475,000 | $308,307 |
36Maryland | $510,000 | $307,792 |
37Arkansas | $470,000 | $304,463 |
| $470,000 | $302,974 | |
| $525,000 | $302,368 | |
40Kansas | $480,000 | $301,962 |
| $480,000 | $301,227 | |
| $470,000 | $301,045 | |
43Idaho | $470,000 | $297,880 |
44Delaware | $480,000 | $297,608 |
| $470,000 | $297,544 | |
46Montana | $470,000 | $296,488 |
47Oregon | $500,000 | $293,020 |
48Maine | $470,000 | $288,596 |
49Vermont | $470,000 | $286,900 |
50Hawaii | $480,000 | $285,025 |
Job Market Outlook
BLS projects 3% growth 2022-2032 — slower than average overall. Subspecialty shortage (cardiothoracic / neurosurgery / pediatric subspecialty / transplant) is severe with 8-15 year training pipeline lag. Aging Boomer demographic (post-2025 wave 78M+ at 65+) drives sustained surgical volume through 2035+. ASC (Ambulatory Surgical Center) partnership equity is increasingly the structural wealth-build layer for orthopedic / GI / pain / ophthalmologic / urologic / plastic — partnership buy-in $200K-$1.5M generates $80K-$400K/year facility-fee distribution + capital-gain on eventual ASC sale to PE consolidator (KKR / Blackstone / Welsh Carson). MedTech AI augments imaging + robotics but does not replace operative judgment in 10-year window.
Maximize Your Take-Home
401(k) — $24,500 max
Reduces taxable income dollar-for-dollar
HSA — $4,400 single
Triple tax advantage — deductible, grows tax-free, tax-free withdrawals
FSA — $3,300 max
Medical expenses with pre-tax dollars
State consideration
Moving to TX, FL, WA can save $5,000–$15,000/year in taxes
Calculate Your Exact Take-Home as a Surgeon
Add 401(k), HSA, dependents, and more to see your personalized take-home in your state.
Open Calculator →Frequently Asked Questions
Find answers to common questions about your taxes and our calculator.
Surgeon Salary by State — Detailed Pages
Alabama
$310,743
net
AlaskaNo state tax
$356,139
net
Arizona
$334,394
net
Arkansas
$304,463
net
California
$302,368
net
Colorado
$327,923
net
Connecticut
$311,493
net
Delaware
$297,608
net
FloridaNo state tax
$362,404
net
Georgia
$316,275
net
Hawaii
$285,025
net
Idaho
$297,880
net
Illinois
$321,497
net
Indiana
$319,786
net
Iowa
$310,319
net
Kansas
$301,962
net
Kentucky
$308,307
net
Louisiana
$319,887
net
Maine
$288,596
net
Maryland
$307,792
net
Massachusetts
$321,462
net
Michigan
$316,558
net
Minnesota
$308,989
net
Mississippi
$302,974
net
Missouri
$312,119
net
Montana
$296,488
net
Nebraska
$309,715
net
NevadaNo state tax
$346,742
net
New HampshireNo state tax
$334,212
net
New Jersey
$315,492
net
New Mexico
$297,544
net
New York
$314,526
net
North Carolina
$326,901
net
North Dakota
$318,693
net
Ohio
$327,162
net
Oklahoma
$312,707
net
Oregon
$293,020
net
Pennsylvania
$325,127
net
Rhode Island
$301,227
net
South Carolina
$309,649
net
South DakotaNo state tax
$324,814
net
TennesseeNo state tax
$346,742
net
TexasNo state tax
$365,537
net
Utah
$318,227
net
Vermont
$286,900
net
Virginia
$318,177
net
WashingtonNo state tax
$356,139
net
West Virginia
$301,045
net
Wisconsin
$310,649
net
WyomingNo state tax
$327,947
net