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 from $201,750 single / $403,500 MFJ and is gone above $276,750 / $553,500 in 2026), making S-corp distribution + 401(k)/cash-balance plan stacking + non-conformity QBS planning structurally consequential.
US Average
$373,930
BLS, May 2025
Best State (Net)
$346,753
North Dakota
Take-Home TX
$223,515
on $313,310 · No state tax
Job Growth
BLS projects 3%
Source: BLS, May 2025 · Surgeons, All Other (SOC 29-1249)
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 = $49K+/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
US Pay Range
Pay percentiles for Surgeons across the US (BLS, May 2025), with the estimated take-home in Texas.
Bottom 10%
$80,320
gross/year
Est. take-home (TX):
$65,335
25th percentile
$134,850
gross/year
Est. take-home (TX):
$103,436
Median
$414,010
gross/year
Est. take-home (TX):
$286,604
75th percentile
$511,420
gross/year
Est. take-home (TX):
$347,631
Top 10%
$655,320
gross/year
Est. take-home (TX):
$437,785
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
BLS average pay in each state (BLS, May 2025) and the estimated take-home for a single filer with no additional deductions. BLS publishes no figure for 14 states: they show the US average, marked "US figure", at the end of the table. Click any state for the full breakdown.
| State | Average Pay (BLS) | Est. Take-Home |
|---|---|---|
| $526,650 | $346,753 | |
2Ohio | $482,910 | $316,925 |
3Iowa | $488,900 | $315,596 |
| $503,070 | $311,772 | |
| $428,950 | $295,964 | |
| $459,440 | $292,888 | |
| $487,710 | $291,940 | |
| $447,720 | $288,121 | |
| $450,490 | $283,472 | |
| $408,230 | $282,983 | |
| $395,300 | $274,882 | |
12Indiana | $413,140 | $273,901 |
| $391,060 | $272,226 | |
14Arizona | $403,010 | $270,040 |
| $382,200 | $266,675 | |
16Michigan | $380,190 | $249,508 |
| $377,270 | $249,042 | |
18Nebraska | $372,610 | $244,593 |
19Illinois | $372,060 | $241,905 |
| $349,520 | $236,090 | |
| $353,810 | $233,573 | |
| $349,910 | $233,181 | |
23Vermont | $367,210 | $232,138 |
24Idaho | $347,980 | $227,902 |
| $346,190 | $227,025 | |
| $313,310 | $223,515 | |
| $335,940 | $221,465 | |
28New York | $345,710 | $220,238 |
| $290,780 | $209,400 | |
30Virginia | $313,960 | $206,684 |
31Maryland | $317,130 | $202,421 |
| $298,710 | $198,508 | |
33Kentucky | $271,370 | $187,831 |
| $250,120 | $167,763 | |
35Arkansas | $234,560 | $164,567 |
| $255,620 | $164,009 | |
| $373,930US figure | $261,494 | |
| $373,930US figure | $261,494 | |
| $373,930US figure | $250,014 | |
40Alabama | $373,930US figure | $247,738 |
41Colorado | $373,930US figure | $245,749 |
42Missouri | $373,930US figure | $244,857 |
43Utah | $373,930US figure | $244,854 |
| $373,930US figure | $242,978 | |
45Montana | $373,930US figure | $241,728 |
46Kansas | $373,930US figure | $241,428 |
47Delaware | $373,930US figure | $238,156 |
48Maine | $373,930US figure | $235,557 |
49Hawaii | $373,930US figure | $230,761 |
50Oregon | $373,930US figure | $226,518 |
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
$247,738
net
AlaskaNo state tax
$261,494
net
Arizona
$270,040
net
Arkansas
$164,567
net
California
$164,009
net
Colorado
$245,749
net
Connecticut
$167,763
net
Delaware
$238,156
net
FloridaNo state tax
$272,226
net
Georgia
$292,888
net
Hawaii
$230,761
net
Idaho
$227,902
net
Illinois
$241,905
net
Indiana
$273,901
net
Iowa
$315,596
net
Kansas
$241,428
net
Kentucky
$187,831
net
Louisiana
$236,090
net
Maine
$235,557
net
Maryland
$202,421
net
Massachusetts
$227,025
net
Michigan
$249,508
net
Minnesota
$291,940
net
Mississippi
$233,181
net
Missouri
$244,857
net
Montana
$241,728
net
Nebraska
$244,593
net
NevadaNo state tax
$209,400
net
New HampshireNo state tax
$295,964
net
New Jersey
$311,772
net
New Mexico
$221,465
net
New York
$220,238
net
North Carolina
$249,042
net
North Dakota
$346,753
net
Ohio
$316,925
net
Oklahoma
$288,121
net
Oregon
$226,518
net
Pennsylvania
$250,014
net
Rhode Island
$198,508
net
South Carolina
$242,978
net
South DakotaNo state tax
$261,494
net
TennesseeNo state tax
$282,983
net
TexasNo state tax
$223,515
net
Utah
$244,854
net
Vermont
$232,138
net
Virginia
$206,684
net
WashingtonNo state tax
$266,675
net
West Virginia
$233,573
net
Wisconsin
$283,472
net
WyomingNo state tax
$274,882
net