The 2026 Physician Salary Guide: Compensation Benchmarks by Specialty and State

The average U.S. physician earned about $386,000 in total compensation in the most recent survey year, up roughly 3% — but physician salary by specialty in 2026 spans more than half a million dollars, from about $230,000 in some pediatric subspecialties to roughly $749,000 in neurosurgery. This guide compiles the verified 2026 benchmarks by specialty and state, explains why the major surveys disagree, and shows you how to compare your own contract against the right number — not the headline average.

Every figure below is either cited to a dated public source or drawn from the Physicians' Copilot live market board with an "as of" date. Nothing is estimated or filled in. This page is refreshed quarterly.

How much do doctors make in 2026? The headline numbers

Medscape's 2026 Physician Compensation Report — a survey of 5,916 full-time U.S. physicians fielded September 5 to December 17, 2025 — puts average total compensation at $386,000, a 3% year-over-year gain. Total compensation in that survey means base salary plus incentive bonus and other income such as profit-sharing, not base alone.

Primary care physicians averaged $298,000; specialists averaged $417,000. Eight specialties now average above $500,000, up from seven the year before, and orthopedics became the first specialty to clear $600,000.

Two sentiment numbers are worth knowing before you benchmark. First, 53% of physicians now say they personally feel fairly paid — up from 48% and the highest reading in three years — even though 61% still believe the profession as a whole is underpaid. Second, the average reported workweek dropped from 50 hours to 49. Pay is up modestly, hours are down slightly, and sentiment has recovered from its decade low. One AMGA consultant summarized the year, in Medscape's own report, as "a return to normalization."

A caution that applies to every number on this page: the $386,000 average is nearly useless in a negotiation. Averages are pulled upward by high earners, blend every region and practice type, and hide more variation within a specialty than exists between many specialties. What matters is the median for your specialty, your market, and your practice setting — which is exactly what the tables below and the live market board are for.

Physician salary by specialty in 2026: the benchmark table

The table below combines the two most-cited public surveys with the live figures on the Physicians' Copilot market board. Medscape reports a self-reported average of total compensation; Doximity reports a statistically adjusted mean that typically runs about 10% higher for the same specialty. Neither is "wrong" — they measure differently (more on that in the methodology section).

Dashes indicate the survey did not publish a verifiable figure for that specialty in its public materials; the full specialty list is on the live market board.

Three specialties posted the biggest verified gains in the Medscape data: cardiology at roughly 10%, ophthalmology at 9%, and radiology at 8.5%, with orthopedics close behind at 8.3%. Radiology's surge is notable enough that hospital-based fields like radiology and anesthesiology — historically self-sustaining — are reportedly requiring institutional financial support for the first time, a marker of how far demand has outrun physician supply.

Seven specialties saw average pay decline: psychiatry and allergy/immunology fell about 3%; pulmonary medicine and oncology/hematology about 2%; and PM&R, nephrology, and dermatology about 1% each. A specialty's payer mix and its exposure to Medicare's shifting fee schedule can matter as much as its procedure list in any given year.

Doctor salary by state: where physicians earn the most

Specialty explains most of the variance in physician pay; geography explains much of the rest — and often in the opposite direction from what physicians expect.

In the Medscape 2026 data, the Midwest was the highest-paid region at $400,000 average total compensation, followed by the West at $390,000 and the South at $381,000. The pattern is consistent across survey years: employers in rural and underserved markets bid pay up to attract physicians, while dense coastal markets with deep physician supply can pay less despite far higher costs of living. AMGA's consulting arm notes the same regional picture, with the added wrinkle that Southern physicians are producing more wRVUs even while their region trails on average pay.

Three structural forces drive the state-level differences:

• Supply and demand. States with fewer physicians per capita pay recruitment premiums — higher bases, larger signing bonuses, and loan repayment.
• Payer mix and reimbursement geography. Medicare adjusts payment by locality through Geographic Practice Cost Indices, and commercial rates vary even more; CMS finalized updated GPCIs for 2026, phasing in over two years.
• Taxes and cost of living. Identical salaries can differ by tens of thousands of dollars in take-home pay across state lines. One 2026 analysis put the after-tax difference between states at $40,000–$80,000 per year for physicians with identical gross salaries, with no-income-tax states dominating the take-home rankings.

State-by-specialty medians move too quickly for a static table to stay honest — a published figure can be a full hiring cycle out of date. The live figures below come from the Physicians' Copilot market board:

See live salary by specialty and state on the Physicians' Copilot market board. For a worked example of how state-level pay diverges within a single specialty, see our breakdown of hospitalist salary by state in 2026.

Primary care vs. specialists: a gap that is enormous — but finally stable

The primary care picture in 2026 is genuinely mixed, and unusually, some of the news is good.

The averages still sit near the bottom of the table: family medicine at $288,000, internal medicine at $307,000, pediatrics at $266,000. In Doximity's most recent data the average neurosurgeon out-earned the average pediatric endocrinologist by roughly $519,000.

But the trend has turned. Doximity found surgical specialists earned 87% more than primary care physicians in 2024 — a huge premium, but down from 100% two years earlier. MGMA's group-reported data shows primary care compensation rising for four consecutive years. And demand is doing the pushing: family medicine was the single most-requested physician search in AMN Healthcare's latest recruiting review, and consultants consistently name family medicine, internal medicine, and obstetrics as the specialties where shortage pressure on pay is sharpest.

Pediatrics is the exception that deserves its own flag. Doximity's report highlighted pediatricians and pediatric subspecialists as facing acute strain from persistently lower pay and reimbursement — a workforce-stability and patient-access problem, not just a compensation statistic.

What's actually driving physician pay in 2026

Five forces explain most of what you see in the tables above.

• The 2026 Medicare fee schedule gave with one hand and took with the other. For the first time, CMS finalized two conversion factors: $33.5675 for qualifying participants in advanced alternative payment models (+3.77%) and $33.4009 for everyone else (+3.26%), both up from $32.35 in 2025. Most of that increase is a temporary 2.5% bump Congress passed in 2025 — and it expires at the end of 2026, meaning 2027 opens with a cut unless Congress acts again.
• An "efficiency adjustment" quietly cut procedural work RVUs. CMS applied a −2.5% adjustment to the work RVUs and intraservice time of most non-time-based codes, sparing time-based E/M services, telehealth-list services, and maternity global codes. Separately, CMS halved the indirect practice-expense allocation for facility-based services, producing total RVU reductions around 10% for some hospital-based procedures. Net effect: primary care came out largely unscathed and proceduralists absorbed the hit — one reason the 2.5% increase was described by valuation consultants as a rare win for primary care.
• Pay and productivity are moving in opposite directions. The most striking finding of the year comes from MGMA: in its 2026 data, median total compensation rose about 1.5%–3% (depending on specialty) even as work RVUs fell in 16 of 23 common specialties and patient encounters fell in all 23. MGMA's own leadership attributes part of this to lower-acuity visits shifting to APPs while physicians see sicker, more complex patients — and openly questions whether pay can keep rising while measured production falls. If your compensation plan is productivity-based, this divergence is the single most important trend to understand before your next contract cycle. Our guide to physician compensation models — salary vs. RVU vs. collections breaks down how each structure behaves in a year like this.
• The long-run reimbursement squeeze hasn't gone anywhere. Adjusted for practice-cost inflation, Medicare physician payment declined 33% from 2001 to 2025, per the AMA. The behavioral consequences are measurable: Doximity found 17% of physicians had already reduced the number of Medicare or Medicaid patients they see because of reimbursement, with another 13% likely to follow.
• The shortage is structural. The AAMC projects a shortfall of up to 86,000 physicians by 2036. Whatever the precise number, the recruiting-market evidence — sign-on premiums, rural pay leadership, hospital subsidies for previously self-funding specialties — all points the same direction: physician scarcity is putting a floor under compensation even in a tight-reimbursement environment.

Starting salaries: what new physicians are being offered in 2026

If you're a resident or fellow, the number that matters is the starting offer, not the all-career average — and it comes from a different dataset entirely.

AMN Healthcare's most recent review of its own search engagements put the average physician starting salary at $403,000, down slightly from $406,000 the year before. Orthopedic surgery led starting offers at $576,000, with gastroenterology at $552,000; on the primary care side, internal medicine averaged $290,000, family medicine $275,000, and pediatrics $258,000. MGMA's read on the dip: the sharp post-COVID run-up in starting salaries has plateaued rather than reversed, and significant decreases aren't expected.

Two practical implications. First, a starting offer near the specialty average is not automatically a good offer — signing bonus, relocation, loan repayment, call pay, and the wRVU conversion rate determine what you actually take home. Second, offers with identical salary lines can be worlds apart once call obligations and productivity thresholds are compared. Before you sign anything, run the numbers on what a fair $/wRVU rate looks like for your specialty.

The pay gaps inside the averages

Every average on this page conceals systematic gaps that are worth naming precisely.

• Gender. Medscape's 2026 data puts the gap at roughly $102,000 — a 31% male advantage, wider than the ~$91,000 and 29% measured two years earlier. Doximity, whose method adjusts for specialty, geography, and hours worked, measured a $120,917 gap in 2024, widening to 26% from 23% as men's pay rose 5.7% against women's 1.7%. Both surveys found the gap in every specialty they measured.
• Race and ethnicity. Over a two-year window, White physicians in the Medscape survey reported 6.1% total-compensation growth versus 6.0% for Asian American, 3.5% for Hispanic/Latinx, and 2.9% for Black physicians; average incentive bonuses ranged from roughly $51,000 for White physicians down to $32,000 for Black physicians.
• Practice setting. Private-practice and single-specialty-group physicians generally out-earn hospital-employed peers, particularly after partnership — a premium that must be weighed against ownership's administrative load and financial risk. The backdrop: the AMA reports the share of physicians in private practice fell from 60.1% to 42.2% between 2012 and 2024.

If your own number sits below the benchmarks in this guide, that's a data point — not a verdict. Our companion piece, Am I Being Underpaid? How to Benchmark Your Physician Salary, walks through how to tell a real gap from a survey artifact.

How to benchmark your own compensation: a 5-step method

Roughly half of physicians — 49% in Panacea Financial's 2026 survey — name "is my pay competitive?" as a top career challenge, and contract-review attorneys suspect even that understates it. Here is the method that avoids the most common mistakes.

• Pick the right yardstick for your question. Medscape reports self-reported total-compensation averages; Doximity reports an adjusted mean that runs higher; MGMA reports group-submitted medians that employers treat as fair-market value; AMN reports starting offers only. Citing the wrong survey in a negotiation is an easy way to argue against yourself.
• Benchmark your specialty + region + setting, never the national average. Pay varies more within a specialty than the headline gap between specialties suggests.
• Think in percentiles, not points. A single median tells you the middle; the 25th–75th percentile band tells you whether your offer is low, fair, or aggressive for the market. (Example: Internal Medicine in Texas — 25th percentile $285,000 | 50th percentile $325,000 | 75th percentile $370,000 as of July 2026.)
• Decompose total compensation. Base, wRVU conversion rate, productivity thresholds, quality bonus, call pay, signing bonus, loan repayment — two contracts with identical headline numbers can diverge by six figures in realized income, especially in a year when pay and productivity are decoupling.
• Re-check at every contract cycle. Benchmarks move annually; the 2026 fee-schedule changes alone will shift wRVU economics for proceduralists in ways that flow into 2027 offers.

Where these numbers come from (and why they disagree)

This guide draws only on dated, verifiable sources: Medscape's 2026 Physician Compensation Report (5,916 physicians, surveyed September–December 2025, published April 2026); Doximity's 2025 Physician Compensation Report (approximately 230,000 responses over six years, including 37,000+ in 2024); MGMA's 2026 provider compensation dataset, reported by medical groups rather than individual physicians; AMN Healthcare's annual review of its physician search engagements; and CMS's final CY2026 Physician Fee Schedule rule, published October 31, 2025.

They disagree because they measure different things: self-reported averages (Medscape) run below adjusted means (Doximity), which sit above employer-reported medians (MGMA), while recruiting-firm data (AMN) captures starting offers only. Differences of 10–15% for the same specialty across surveys are normal, not errors. Where this page cites the Physicians' Copilot market board, the figure comes from live posted-position and verified-compensation data with an explicit "as of" date, and is refreshed quarterly along with this article.

Key takeaways