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)
$368,212
Texas
Take-Home TX
$241,105
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):
$61,351
ACGME stipend $65K-$95K · 60-80 hr/week · pre-attending
New Attending (year 1-3)
$380,000
gross/year
Est. take-home (TX):
$266,532
Hospital W-2 base or guarantee · stub partnership track
Mid-Career Attending (4-10 years)
$525,000
gross/year
Est. take-home (TX):
$358,679
Partnership track · RVU-driven · subspecialty premium
Senior Partner / Department Chair (10-25 years)
$750,000
gross/year
Est. take-home (TX):
$499,779
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 | $368,212 | |
| $535,000 | $365,034 | |
| $525,000 | $358,679 | |
| $525,000 | $358,679 | |
| $510,000 | $349,147 | |
| $510,000 | $349,147 | |
| $510,000 | $336,772 | |
| $490,000 | $336,437 | |
| $515,000 | $330,324 | |
| $480,000 | $330,082 | |
| $500,000 | $327,902 | |
| $475,000 | $326,904 | |
13Ohio | $500,000 | $325,817 |
14Maryland | $510,000 | $325,634 |
| $510,000 | $325,634 | |
16Illinois | $510,000 | $324,644 |
| $510,000 | $324,397 | |
| $510,000 | $324,397 | |
19Indiana | $490,000 | $321,474 |
20Utah | $500,000 | $320,724 |
21Virginia | $510,000 | $320,684 |
22Michigan | $495,000 | $319,214 |
| $480,000 | $318,457 | |
| $510,000 | $317,615 | |
| $500,000 | $317,087 | |
| $490,000 | $316,249 | |
27Georgia | $500,000 | $316,165 |
28New York | $510,000 | $315,239 |
29Oklahoma | $490,000 | $313,874 |
30Missouri | $490,000 | $312,924 |
31Alabama | $480,000 | $311,482 |
| $480,000 | $311,482 | |
| $525,000 | $311,249 | |
34Kansas | $480,000 | $306,832 |
35Kentucky | $475,000 | $306,204 |
| $490,000 | $306,037 | |
37Nebraska | $485,000 | $305,811 |
| $520,000 | $305,759 | |
| $470,000 | $305,527 | |
| $470,000 | $305,072 | |
41Delaware | $480,000 | $304,507 |
42Arkansas | $470,000 | $303,707 |
43Iowa | $480,000 | $303,577 |
| $470,000 | $303,252 | |
45Idaho | $470,000 | $297,337 |
46Montana | $470,000 | $296,882 |
47Oregon | $500,000 | $294,777 |
48Maine | $470,000 | $291,194 |
49Vermont | $470,000 | $289,147 |
50Hawaii | $480,000 | $288,232 |
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
$311,482
net
AlaskaNo state tax
$358,679
net
Arizona
$336,772
net
Arkansas
$303,707
net
California
$311,249
net
Colorado
$330,324
net
Connecticut
$324,397
net
Delaware
$304,507
net
FloridaNo state tax
$365,034
net
Georgia
$316,165
net
Hawaii
$288,232
net
Idaho
$297,337
net
Illinois
$324,644
net
Indiana
$321,474
net
Iowa
$303,577
net
Kansas
$306,832
net
Kentucky
$306,204
net
Louisiana
$316,249
net
Maine
$291,194
net
Maryland
$325,634
net
Massachusetts
$324,397
net
Michigan
$319,214
net
Minnesota
$305,759
net
Mississippi
$305,527
net
Missouri
$312,924
net
Montana
$296,882
net
Nebraska
$305,811
net
NevadaNo state tax
$349,147
net
New HampshireNo state tax
$336,437
net
New Jersey
$317,615
net
New Mexico
$305,072
net
New York
$315,239
net
North Carolina
$325,634
net
North Dakota
$318,457
net
Ohio
$325,817
net
Oklahoma
$313,874
net
Oregon
$294,777
net
Pennsylvania
$327,902
net
Rhode Island
$311,482
net
South Carolina
$306,037
net
South DakotaNo state tax
$326,904
net
TennesseeNo state tax
$349,147
net
TexasNo state tax
$368,212
net
Utah
$320,724
net
Vermont
$289,147
net
Virginia
$320,684
net
WashingtonNo state tax
$358,679
net
West Virginia
$303,252
net
Wisconsin
$317,087
net
WyomingNo state tax
$330,082
net