What Is the Average Physician Salary (and Hourly Rate) Across US States in 2026?
Thinking about doctor earnings down to the hourly dime? Nationally, the 2026 median total comp hits $449,000 yearly (base ~$365K + $75K bonuses for 97% of physicians), translating to about $216/hour at a typical 48-hour week. Hourly rates soar to $120–$130 in high-pay spots like California metros, per ZipRecruiter data, while BLS caps many at $115+/hour (top states like Wyoming at $163). This blend of annual/hourly reveals real workload value—specialists often net more per clocked minute.
Why Do Hourly Rates Vary So Much State by State?
Hourly pay spikes in shortage zones (e.g., $130+/hr in Alaska outposts) due to locums demand, while urban saturation drops it to $100–$120. Analysis: Divide annual by ~2,080 work hours (40/wk x 52) for baselines, but physicians average 48–50 hrs/wk, boosting effective hourly to $200+ in top states. Pro insight—locums gigs hit $242/hr averages, per Barton Associates.
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Which States Pay Physicians the Most (Annual + Hourly) in 2026?
Top states crush it with $400K+ annual and $120–$163 hourly, fueled by rural premiums and bonuses up to $100K. Updated tables now include hourly (annual/2080 hrs estimate + sourced highs):
| Rank | State | Avg. Annual (2026) | Est. Hourly | Hourly Highs |
|---|---|---|---|---|
| 1 | Iowa | $464,000 | $223 | $130+ |
| 2 | Arkansas | $462,000 | $222 | $125 |
| 3 | Minnesota | $444,000 | $213 | $128 |
| 4 | Wisconsin | $419K–$464K | $220 | $140 |
| 5 | Indiana | $372K–$420K | $210 | $155 |
| 6 | Arizona | $433,000 | $208 | $122 |
| 7 | Washington | $414,000 | $199 | $121 |
| 8 | New Jersey | $360K–$414K | $200 | $128 |
| 9 | South Carolina | $360K–$412K | $198 | $157 |
| 10 | California | $358K–$412K | $198 | $130 |
| 11 | North Dakota | $408,000 | $196 | $130+ |
| 12 | Missouri | $357K–$406K | $195 | $121 |
| 13 | Illinois | $405,000 | $195 | $163 |
| 14 | Georgia | $363K–$402K | $193 | $125 |
| 15 | Montana | $399,000 | $192 | $115+ |
Which States Offer the Lowest Physician Salaries (Annual + Hourly) in 2026?
Bottom ranks stick to $300K–$370K annual (~$100–$120/hr), hit by high COL and competition—yet perks like research gigs balance it.
| Rank | State | Avg. Annual (2026) | Est. Hourly | Hourly Highs |
|---|---|---|---|---|
| 1 | Maryland | $306,000 | $147 | $120 |
| 2 | New Hampshire | $357,000 | $172 | $121 |
| 3 | Colorado | $327K–$360K | $165 | $106 |
| 4 | Virginia | $330,000 | $159 | $106 |
| 5 | Massachusetts | $331,000 | $159 | $121 |
| 6 | Delaware | $366,000 | $176 | $120 |
| 7 | Louisiana | $369,000 | $177 | $125 |
| 8 | Texas | $346K–$371K | $168 | $167 |
| 9 | New York | $348K–$372K | $169 | $123 |
| 10 | Michigan | $356K–$374K | $171 | $121 |
| 11 | Alabama | $348K–$374K | $170 | $125 |
| 12 | Alaska | $357,000 | $172 | $130 |
| 13 | Kansas | $379,000 | $182 | $125 |
| 14 | Kentucky | $391,000 | $188 | $125 |
| 15 | Maine | $346,000 | $166 | $121 |
What Do These 2026 Salary + Hourly Stats Reveal?
Hourly lens shows top states net $200+/hr post-hours adjustment, vs. national $104–$140 baselines from ZipRecruiter/BLS. Trends: 5–7% growth in the Midwest amid shortages; locums add $242/hr flexibility. For career moves, hourly math favors volume-heavy roles—pair with your specialty for custom calcs!
What Are Physician Salaries by Industry in the US for 2026?
Ever wondered which work setting pays doctors the most these days? In 2026, private practice leads US physician earnings at a median $440,000 total comp, outpacing academic roles at $407,500 thanks to RVU bonuses and higher volume. Hospital-employed docs average $280K–$400K base, while locums hit $242/hour for flexibility. This breakdown draws from Sermo, SalaryDr, and MaritHealth data across thousands of US physicians.
Which Industry Tops Physician Pay in the US?
Private practice reigns supreme, especially for procedural specialists, where patient throughput drives 20–30% bonus uplifts over base pay.
| Industry/Setting | Median Total Comp (2026 US) | Hourly Est. (48-hr wk) |
|---|---|---|
| Private Practice | $440,000–$450,000 | $211 |
| Self-Employed/Group | $320K–$450K | $200+ |
| Locums/Temporary | $387K–$500K equiv. | $242 |
How Do Other US Sectors Stack Up for Doctors?
Academics and hospitals offer stability but lag in raw dollars—government roles emphasize benefits over cash.
| Sector | Median Annual (2026 US) | Hourly Est. | Bonus Rate |
|---|---|---|---|
| Academic Centers | $407,500 | $196 | 85% |
| Hospital/Clinic | $365,000 base | $175 | 97% ($75K) |
| Government/Military | $260K–$350K | $125–$168 | Benefits-heavy |
| Non-Clinical (Pharma) | $352,000 avg | $169 | Variable |
What Trends Shape 2026 US Physician Industry Pay?
Private edges academics by ~8% nationwide, with experienced self-employed docs (45+) hitting $450K peaks versus $250K for early-career. Locums shine for work-life balance at premium hourly rates, while non-clinical gigs attract those eyeing pharma consulting. Data analysis shows: match your specialty and lifestyle—surgeons thrive in private practice, primaries value hospital perks.
How Do Physician Salaries by Experience Compare Across Specialties in the US for 2026?
Salary growth accelerates with experience, but procedural specialties like orthopedics pull ahead fastest—entry-level primaries earn $230K while ortho starts at $350K–$450K, exploding to $800K+ senior vs. $350K–$500K for family medicine. US national median remains $427K–$449K, yet gaps widen: seniors (10+ years) average $450K–$600K overall, with top fields doubling juniors. Data from Doximity, Medscape, and SalaryDr highlights this trajectory.
How Much Do Entry-Level Physicians (0–5 Years) Earn by Specialty?
New grads post-residency start lower in cognitive fields, higher in surgery—averages blend base + early bonuses.
| Specialty Group | Entry (0–5 Yrs, 2026 US) | Notes/Source |
|---|---|---|
| Primary Care (Family/Internal/Peds) | $230K–$300K | Steady ramp, loan burdens |
| Emergency Medicine | $350K–$411K | Shift premiums boost early |
| Orthopedics/Surgery | $350K–$450K | Procedural volume pays quick |
| Cardiology | $400K–$450K | Fellowships delay but elevate start |
What Do Mid-Career Physicians (6–10 Years) Make Across Specialties?
Bonuses (97% receive ~$75K) and RVUs propel mid-levels; gaps emerge here.
| Specialty Group | Mid (6–10 Yrs, 2026 US) | Notes/Source |
|---|---|---|
| Primary Care | $300K–$400K | Volume-driven stability |
| Dermatology/Oncology | $450K–$500K | High demand, procedures |
| Orthopedics | $550K–$700K | Partnership tracks accelerate |
| Anesthesiology | $450K–$550K | OR efficiency premiums |
Senior Physician Salaries (11+ Years): Top Performers by Specialty
Veterans (45+) hit peaks—self-employed proceduralists soar past $600K.
| Specialty Group | Senior (11+ Yrs, 2026 US) | Notes/Source |
|---|---|---|
| Family Medicine | $350K–$500K | Partnership caps growth |
| Neurology/Psych | $350K–$450K | Cognitive fields plateau |
| Plastic Surgery | $600K–$800K | Elective cash-pay |
| Orthopedics (Top) | $795K–$1.1M | Elite: $800K+ common |
What Insights Emerge from 2026 Specialty + Experience Data?
Procedurals like ortho gain ~100% more senior-to-entry vs. primaries’ ~80%—ortho: $400K entry to $800K+ vs. family: $250K to $450K. Overall progression: doubles every ~10 years, fastest in private practice (2.9% YoY growth). Choose wisely—surgeons’ max earnings are quickest, but primaries offer balance sooner.
How Have Physician Salaries Trended by US State from 2023 to 2026?
US physician salaries grew steadily from 2023–2026, with national averages rising ~10–15% cumulatively (e.g., $363K in 2023 to $427K–$449K median in 2026), though growth slowed to 2.9–3.7% annually amid Medicare cuts. States like Wisconsin and Indiana saw stronger gains (4–8%) due to shortages, while coastal areas lagged at 2–4% after COL adjustments. Doximity/Medscape data tracks this, with CMS projecting 3.26% Medicare bump for 2026.
National Growth Snapshot (2023–2026)
Overall comp climbed despite reimbursement pressures—private practice outpaced hospitals.
| Year | National Median Comp | YoY Growth | Key Driver |
|---|---|---|---|
| 2023 | $363K–$376K | – | Post-COVID demand surge |
| 2024 | $376K–$390K | 3.7% | Modest amid cuts |
| 2025 | $400K–$420K | 2.9–3% | Inflation lag |
| 2026 | $427K–$449K | 3.26% | CMS update + shortages |
Top State Growth Leaders (2023–2026)
Midwest/South shone with 6–9% cumulative gains; e.g., Oklahoma City metro +6.3% in one year.
| State/Key Metro | 2023 Est. | 2026 Est. | Cumulative Growth | Notes/Source |
|---|---|---|---|---|
| Wisconsin | $370K | $397K–$464K | ~8% | #1 median, rural demand |
| Indiana | $345K | $372K | ~8% | Shortages + low COL |
| Rochester, MN | ~$450K | +8.7% YoY to ~$520K | 15%+ | Mayo anchor |
| Oklahoma City | – | +6.3% (2024) | 6–9% | Metro surge |
| Missouri | $340K | $361K | ~6% | Steady Midwest rise |
Lagging States (Slower Growth 2023–2026)
High-COL coasts grew 2–5%, offset by inflation/living costs; e.g., Baltimore +4.6%.
| State/Key Metro | 2023 Est. | 2026 Est. | Cumulative Growth | Notes/Source |
|---|---|---|---|---|
| Maryland/Baltimore | $332K | $306K | ~2–4.6% | Saturation |
| Colorado | $315K | $327K | ~4% | Lifestyle premium eats gains |
| New York | $335K | $348K | ~4% | High COL (132%) |
| Massachusetts | $320K | $331K | ~3.5% | Academic focus |
| California | $340K | $358K–$412K | 5–6% | Volume vs. 138% COL |
Key Takeaways from 2023–2026 Trends
Growth tapered from 5.9% (2023) to 2.9% (2025) due to Medicare cuts (e.g., 2% in 2022, proposed ongoing), but 2026’s 3.26% CMS hike revives momentum. Midwest states like WI/IN outpace coasts by 2x in real terms post-COL; primaries saw 1.3–3% vs. specialists’ 5–18% (e.g., cardiology +18.7%). Future: Shortages favor rural/high-demand areas.
Why Did Physician Salary Increases Slow After 2023 in the US?
Post-2023, US physician pay growth dipped to 2.4–3.7% annually (e.g., $363K median in 2023 to $427K–$449K by 2026), trailing 4–7% inflation and non-healthcare wage hikes. Medicare cuts eroded reimbursements (29% real decline since 2001), squeezing practices amid rising costs. Medscape/Doximity reports confirm: specialists saw just 2.4% in some years, primaries 3.9%, as systems prioritized flexibility over cash.
Main Culprits Behind the Slowdown
High inflation outpaced modest gains, compounded by policy and market shifts.
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Medicare Reimbursement Cuts: 2–2.83% annual drops (e.g., 2022–2025), totaling 29% inflation-adjusted loss since 2001; 2026’s 3.26% bump is a partial rebound but lags MEI costs (up 56% since 2000).
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Rampant Inflation: 6.5–7% in 2022–2023 ate gains (e.g., 3% pay rise vs. 7% CPI); costs like insurance tripled over a decade.
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Operational Pressures: Staffing shortages, burnout, prior auth burdens reduced productivity; hospitals passed less to docs amid flat/declining specialist pay in plastics/ortho.
How This Played Out Year-over-Year
Growth peaked post-COVID, then tapered—physicians traded raises for schedules.
| Year | Avg. Growth | Vs. Inflation | Impact Notes |
|---|---|---|---|
| 2023 | 3–4% | Trails 4–7% | Medicare 2% cut; 61% feel underpaid |
| 2024 | 2.4–3.7% | Trails ~3–4% | Specialists flat; primaries +3.9% |
| 2025 | 2.9% | Trails 3% | Inflation lag, 70% saw ≤ single digits |
| 2026 | 3.26% est. | ~2–3% | CMS hike, but shortages persist |
Broader Effects and Outlook
61% of physicians felt underpaid by 2023 (up from prior years), driving locums ($242/hr) and flexibility over salary. Practices faced no-shows, APP shifts, and burnout exits, capping raises. Looking ahead: Shortages may spur 5–7% in high-demand states, but Medicare gaps threaten access unless reformed.
