Urologists in the United States earn an average of $505,000 per year, according to the 2025 Medscape Compensation Report. That figure includes base salary, bonuses, and profit-sharing, making urology one of the higher-paying surgical specialties in medicine. But the actual number on a urologist’s paycheck varies widely depending on experience, practice setting, and gender.
Average Urologist Salary in 2025
The $505,000 average represents a slight dip of about 2% from the prior year, one of the few setbacks in urologist pay over the past decade. Despite that small decline, urology has seen remarkable compensation growth overall. In 2018, the average urologist earned $373,000. By 2023, that figure had climbed to $506,000, a $133,000 increase that represented a 36% jump in just five years. That was the largest five-year pay increase among 29 medical specialties tracked by Medscape.
Starting salaries tell a different story. Recruiting data from 2025 puts the typical starting salary for a new urologist at around $330,000. That’s the number you’d see on a first contract offer out of residency or fellowship, before productivity bonuses and partnership tracks push compensation higher.
How Experience Affects Pay
Urology compensation climbs steadily with years in practice, though the trajectory isn’t perfectly linear. Self-reported salary data breaks down roughly like this:
- 0 to 2 years: ~$553,000
- 3 to 5 years: ~$605,000
- 6 to 10 years: ~$584,000
- 11 to 15 years: ~$610,000
- 16+ years: ~$690,000
The dip in the 6-to-10-year range may reflect career transitions, such as moving between practice settings or taking on more administrative roles that temporarily reduce clinical volume. Urologists who stay in practice long term and build established referral networks can expect to earn well above the national average, with late-career physicians approaching $700,000.
The gap between entry-level and senior urologists works out to roughly a 10% increase over the first decade alone, with the biggest jumps coming after 15 years when seniority, reputation, and negotiating leverage all peak.
Hospital Employment vs. Private Practice
Where you practice matters as much as how long you’ve been practicing. Hospital-employed urologists generally earn more than those in private practice, a pattern that surprises many people who assume independent physicians keep more of what they bill.
The reason is structural. Health systems receive higher reimbursement rates from insurers for the same procedures a private practice would perform. That extra revenue allows hospitals to guarantee larger salaries to their employed urologists. As one hospital-employed urologist noted in Urology Times, “we could not be making this kind of money in private practice because the hospital gets more money for what we do.”
The trade-off is control. Hospital-employed urologists typically have less say over scheduling, staffing, and clinical decision-making. Their salaries also depend on contract renewals, and those contracts can end. Private practice urologists earn less on average but build equity in their practice and have more autonomy over how they work. Some private practice urologists who transitioned to hospital employment reported earning 20% to 30% more, even while seeing fewer patients per day.
The Gender Pay Gap in Urology
Urology has one of the largest gender pay gaps in medicine. Female urologists earn roughly 80% of what their male colleagues make. Research published in the Journal of Urology found a median salary gap of about $81,500 per year, with women reporting median annual income of $318,422 compared to $400,000 for men. Broken down hourly, that’s $106.30 for women versus $131.12 for men.
What makes this gap particularly notable is that it persists even after adjusting for differences in training, subspecialty, hours worked, and clinical volume. After controlling for all those factors, women still earned only 81% of male compensation. Earlier research had found an even wider gap of 33%, suggesting some narrowing over time, but the disparity remains significant. Urology is also one of the least gender-diverse surgical specialties, with women making up a small fraction of practicing urologists, which limits the pressure for pay equity that larger workforce representation can create.
How Urology Compares to Other Specialties
At $505,000, urology sits comfortably in the upper tier of physician compensation. It typically ranks among the top 10 highest-paid specialties, alongside orthopedic surgery, cardiology, and gastroenterology. It consistently outearns primary care fields by a factor of two or more, and it edges out several other surgical specialties as well.
The five-year growth rate in urology is especially striking. The $133,000 increase between 2018 and 2023 was the highest of any specialty surveyed. For comparison, emergency medicine, the specialty with the smallest growth, saw only a $2,000 increase over the same period. That growth reflects rising demand for urologic services driven by an aging population, increasing rates of kidney stones and prostate conditions, and a limited pipeline of new urologists entering the field each year.
What Drives the Variation
Geography plays a meaningful role in urologist pay, though specific regional data varies year to year. Rural and underserved areas often offer higher base salaries to attract specialists, while urban academic medical centers may pay less in salary but offer research time, teaching opportunities, and prestige. Urologists in the Midwest and South tend to earn more than those on the coasts, where the supply of specialists is greater.
Procedure volume is another key driver. Urology is a procedure-heavy specialty, and compensation models in most settings tie a portion of pay to the number and complexity of surgeries performed. Urologists who focus on high-volume procedures like kidney stone removal, prostate surgery, or robotic-assisted operations typically out-earn those with more office-based practices. Subspecialization in areas like urologic oncology can also push compensation higher, though pediatric urology, which involves fewer high-reimbursement procedures, tends to pay less than general urology.
The path to becoming a urologist requires four years of medical school followed by a five- or six-year urology residency, with an optional one- to two-year fellowship for subspecialization. That’s 13 or more years of training after college, which partly explains why compensation is high relative to other medical fields. Most urologists don’t start earning a full salary until their early to mid-30s, and many carry significant student debt at that point.