Complete surgeon salary comparison for 2026 across all subspecialties including neurosurgery, orthopedics, cardiothoracic, plastic, and general surgery with RVU data and malpractice costs.
Key Takeaways
- Neurosurgery leads surgical compensation at a median of $800,000+ total comp
- Orthopedic spine surgeons can earn $900,000–$1.2M+ in high-volume private practice
- RVU-based models pay 20-40% more than flat salary for productive surgeons
- Malpractice costs range from $15,000 to $150,000+ per year depending on specialty
Surgical specialties consistently rank among the highest-paid fields in medicine, but the range within surgery is enormous. A pediatric surgeon earning $400,000 and a spine surgeon earning $1.2 million are both "surgeons," but their compensation trajectories are completely different. This guide provides a detailed comparison across all major surgical subspecialties.
Data is sourced from SalaryDr's compensation database, MGMA, and AMGA benchmarks. All figures represent 2026 compensation data.
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Surgical Specialty Compensation Comparison
The following table ranks surgical specialties by median total compensation. Total comp includes base salary, productivity bonuses, call pay, and partnership distributions where applicable.
| Surgical Specialty | Median Total Comp | Training Years* | Call Burden |
|---|---|---|---|
| Neurosurgery | $810,000 | 7 | Heavy |
| Orthopedic Surgery | $700,000 | 5 (+1 fellowship) | Moderate-Heavy |
| Cardiothoracic Surgery | $690,000 | 6-7 | Heavy |
| Plastic Surgery | $575,000 | 6 | Low-Moderate |
| Vascular Surgery | $560,000 | 5-7 | Heavy |
| Urology | $520,000 | 5-6 | Moderate |
| ENT / Otolaryngology | $480,000 | 5 | Low-Moderate |
| Ophthalmology | $470,000 | 4 | Low |
| General Surgery | $435,000 | 5 | Heavy |
| Colorectal Surgery | $430,000 | 6 | Moderate |
| Pediatric Surgery | $410,000 | 7 | Heavy |
* Training years after medical school (residency + typical fellowship)
SalaryDr Data Snapshot
Based on verified physician submissions on SalaryDr. Surgical salary data reflects 500+ verified surgeon submissions across all subspecialties. Add your data to improve accuracy for your specialty.
RVU-Based vs. Salary Compensation Models
The two dominant compensation models for surgeons produce very different earnings profiles, especially for high-volume operators.
Flat salary (guaranteed): Common in academic settings and newer hospital-employed positions. You receive a fixed amount regardless of case volume. This provides income stability but limits upside for productive surgeons. Typical salary ranges are at or near the median for each specialty.
RVU-based (productivity): Your compensation is directly tied to the work RVUs you generate. Most models provide a base salary at the 25th-50th percentile, then pay a per-wRVU rate for production above a threshold. Common wRVU rates by specialty:
| Specialty | Typical wRVU Rate | Median wRVUs | Top-Quartile wRVUs |
|---|---|---|---|
| Neurosurgery | $85–$110 | 8,500 | 11,000+ |
| Orthopedic Surgery | $65–$85 | 9,500 | 12,500+ |
| Cardiothoracic | $75–$100 | 8,000 | 10,500+ |
| General Surgery | $55–$70 | 7,000 | 9,000+ |
| Urology | $55–$75 | 8,500 | 11,000+ |
Partnership vs. Employed Models
Surgical private practice partnership still exists and remains financially advantageous — but it is less accessible than a decade ago. Hospital consolidation has reduced the number of independent surgical groups, particularly in general surgery and cardiothoracic surgery.
Where partnership remains strong:
- Orthopedic surgery: Large orthopedic groups with ASC (ambulatory surgery center) ownership are thriving. Partners benefit from both professional fees and facility revenue.
- Ophthalmology: LASIK and cataract surgery centers generate strong facility revenue for practice owners.
- ENT: Sinus surgery, allergy testing, and hearing aid dispensing create diversified revenue streams.
- Plastic surgery: Cosmetic cash-pay revenue provides income outside of insurance reimbursement.
Malpractice Costs by Surgical Subspecialty
| Specialty | Annual Premium Range | Tail Coverage Cost |
|---|---|---|
| Neurosurgery | $80,000–$150,000+ | $100,000–$200,000 |
| Cardiothoracic | $50,000–$100,000 | $80,000–$150,000 |
| Orthopedic Surgery | $35,000–$65,000 | $50,000–$90,000 |
| General Surgery | $30,000–$55,000 | $40,000–$75,000 |
| Plastic Surgery | $25,000–$50,000 | $35,000–$65,000 |
| Ophthalmology | $15,000–$30,000 | $20,000–$40,000 |
| ENT | $15,000–$30,000 | $20,000–$40,000 |
When comparing surgical offers, always determine whether malpractice is employer-paid (most common) and whether tail coverage is provided upon departure. A contract that does not cover tail coverage could leave you with a $50,000–$200,000 bill when you leave.
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For specialty-specific data, explore individual surgeon salary pages: General Surgery, Orthopedic Surgery, Neurosurgery, and Plastic Surgery. Or request a benchmark report for your negotiation.