Surgeons in the United States earn an average of roughly $344,000 to $434,000 per year, depending on specialty and how compensation is measured. The Bureau of Labor Statistics reports a mean annual wage of $343,990 for the general “surgeons, all other” category, while Medscape’s 2025 compensation report puts general surgeons specifically at $434,000 in average total compensation for 2024. Both figures place surgeons among the highest-paid professionals in the country, but the range across specialties, settings, and experience levels is enormous.
Pay by Surgical Specialty
Specialty is the single biggest factor in how much a surgeon earns. General surgeons sit in the middle of the pack, but subspecialties that involve the heart, brain, or spine command significantly more. Cardiothoracic surgeons, for example, report median salaries between $650,000 and $800,000 depending on whether they focus on cardiovascular or thoracic cases. Data from the American Medical Group Association puts the mean salary for cardiac and thoracic surgeons at roughly $811,000. Among adult cardiac surgeons specifically, about a third report incomes of $800,000 or above, and nearly 40% of congenital heart surgeons reach that level.
Orthopedic surgeons in academic settings earn between roughly $475,000 and $745,000 depending on rank and gender, with department chiefs earning well over $1 million in some cases. Neurosurgeons tend to land in a similar upper range. At the other end, surgeons in less procedure-heavy specialties typically earn closer to the $300,000 to $400,000 range.
The BLS groups all physicians and surgeons together for its median figure, reporting that the median wage is “equal to or greater than $239,200 per year.” That floor reflects the entire physician workforce, including lower-paid primary care doctors, and doesn’t capture how much higher surgical pay typically goes.
How Practice Setting Affects Earnings
Where you work matters almost as much as what kind of surgery you perform. Surgeons in private practice earn about 11% more than those employed by hospitals, averaging $354,000 compared to roughly $319,000 for hospital-employed surgeons. The highest-paying setting is outpatient surgical centers, where the mean annual salary reaches $385,000. These centers tend to handle elective, high-volume procedures that generate strong revenue per case.
Academic surgeons, those working at university-affiliated medical centers, generally earn less in base salary than their private-sector counterparts. Only about 3% of physicians work in academic settings, and those positions trade some income for research time, teaching responsibilities, and institutional prestige. The tradeoff is real: a professor of orthopedic surgery at an academic center might earn $740,000, while a peer in private practice could exceed that by a wide margin.
How Surgeon Pay Is Structured
Most surgeon compensation isn’t a simple salary. Pay plans typically fall along a spectrum from a fixed base salary to models that tie compensation heavily to productivity. The standard productivity metric is the Relative Value Unit, or RVU, which measures how much work each procedure represents. More complex surgeries generate more RVUs, and surgeons who perform a higher volume of procedures earn more.
Many compensation models combine a base salary with bonuses tied to RVUs, patient outcomes, and quality metrics. Bonuses are sometimes discretionary, awarded by department chairs for hitting specific targets. This structure means two surgeons in the same specialty at the same hospital can earn noticeably different amounts depending on how many cases they take and how their contract is designed. The emphasis on volume-based pay has drawn criticism for incentivizing quantity over other contributions like mentoring, research, or quality improvement.
What Surgical Residents Earn
Before reaching attending-level salaries, surgeons spend five to eight years in residency and fellowship training earning a fraction of what they’ll eventually make. At Yale, a representative example of a major academic program, a first-year surgical resident (PGY-1) earns about $86,000 in total compensation for 2025-2026. Pay increases incrementally each year: $89,000 in year two, $93,000 in year three, climbing to roughly $112,000 by year seven and $118,000 by year eight.
These figures are notable because residents routinely work 60 to 80 hours per week, which brings their effective hourly rate well below what the annual number suggests. A PGY-1 working 70 hours a week earns roughly $24 per hour. Residents also carry substantial student debt from medical school, which averages over $200,000. The financial payoff of a surgical career is real, but it arrives after more than a decade of training at modest pay.
Gender Pay Disparities
A persistent gap exists between what male and female surgeons earn. A 2023 analysis of faculty salaries from the Association of American Medical Colleges found that women in orthopedic surgery earned significantly less than men at every academic rank except department chair. At the assistant professor level, men averaged $628,000 while women averaged $476,000. At the full professor level, the gap widened further: $744,000 for men versus $472,000 for women. Among division chiefs, the disparity was stark, with men earning an average of $1,186,000 compared to $596,000 for women.
These gaps held across other surgical specialties as well, not just orthopedics. The differences persist even after accounting for academic rank, suggesting that factors like negotiation dynamics, case volume distribution, and institutional biases play a role beyond simple differences in seniority or hours worked.
Salary Trends and Growth
Surgeon pay has been climbing steadily. General surgeons saw about a 3% increase in total compensation in 2024, slightly below their average annual growth rate of 3.7% since 2014. That decade-long trend has pushed general surgeon compensation from roughly $300,000 to $434,000.
Cardiothoracic surgery has seen even sharper growth at the top end. The share of cardiothoracic surgeons earning $800,000 or more doubled between 2014 and 2019, rising from 13.4% to 27%. Demand for surgical specialists, an aging population needing more procedures, and consolidation among health systems have all contributed to upward pressure on compensation. The shift toward hospital employment, while sometimes reducing individual earnings, has come with more predictable schedules and benefits packages that aren’t captured in raw salary numbers.