The average U.S. physician earned about $386,000 in total compensation in 2025, up 3.0% from 2024, according to Medscape's 2026 Physician Compensation Report. Pay ran from $266,000 in pediatrics to $611,000 in orthopedic surgery, so the specialty you hire for sets the cost more than any other factor.
Medscape surveyed 5,916 full-time U.S. physicians in more than 29 specialties between September 5 and December 17, 2025. The figures below come from that survey as reported by The DO, Advisory Board and Medical Economics. Medscape builds its specialty averages from specialty, age, gender, location and self-reported answers, assumes full-time work, and counts incentive bonuses.
What did the average physician earn in 2025?
Medscape put average total compensation at $386,000 for 2025. That is a 3.0% gain over 2024. Core inflation ran at 2.7% in 2025, according to the figure The DO cites alongside the report, so average pay beat inflation by 0.3 points.
The average hides a split. Primary care physicians averaged $298,000 and specialists averaged $417,000, as Advisory Board reported from the Medscape data. Eight specialties paid more than $500,000. Nine specialties reported pay that stayed flat or fell.
Inflation matters here because a 3.0% raise only holds purchasing power when prices rise less than that. At 2.7% core inflation, the real gain was small, and a physician in a specialty with flat pay lost ground.
For a practice that budgets physician pay from one blended number, the blend is the wrong tool. A $386,000 line item overstates a pediatrics hire by $120,000 and understates an orthopedic hire by $225,000.
Which specialties pay the most and the least?
Orthopedics led at $611,000, followed by cardiology at $575,000 and radiology at $571,000. Family medicine, at $288,000, sat 25.4% below the all-physician average. Pediatrics, at $266,000, sat 31.1% below it.
| Specialty | Average 2025 compensation |
|---|---|
| Orthopedics | $611,000 |
| Cardiology | $575,000 |
| Radiology | $571,000 |
| Anesthesiology | $543,000 |
| Urology | $535,000 |
| Gastroenterology | $530,000 |
| Dermatology | $448,000 |
| General surgery | $442,000 |
| OB-GYN | $390,000 |
| Neurology | $341,000 |
| Psychiatry | $331,000 |
| Internal medicine | $307,000 |
| Family medicine | $288,000 |
| Rheumatology | $284,000 |
| Pediatrics | $266,000 |
Source: Medscape 2026 Physician Compensation Report (5,916 full-time physicians, fielded September to December 2025), as published by The DO on July 9, 2026.
The middle of the list is crowded. Oncology and hematology averaged $464,000, ophthalmology $446,000, critical care $427,000 and emergency medicine $421,000. Pulmonary medicine ($395,000), pathology ($394,000) and nephrology ($359,000) fall between that group and neurology.
Six specialties in the full Medscape list averaged under $300,000: family medicine, diabetes and endocrinology, rheumatology, infectious diseases, public health and preventive medicine, and pediatrics.
How big is the gap between primary care and specialists?
Specialists averaged $119,000 more than primary care physicians, which is 39.9% above the primary care average of $298,000. Cardiology out-earned family medicine by $287,000. Orthopedics out-earned pediatrics by $345,000, a ratio of 2.3 to 1.
Inside primary care the spread is narrower. Internal medicine averaged $307,000, $19,000 more than family medicine at $288,000. A practice that hires either one pays within 6.6% of the other, measured against the family medicine figure.
Procedure-heavy fields cluster at the top. Anesthesiology ($543,000), urology ($535,000) and gastroenterology ($530,000) all sit within $13,000 of each other. Dermatology ($448,000) and general surgery ($442,000) sit $6,000 apart.
Do physicians think they are paid fairly?
Medscape found that 53.0% of physicians said they feel fairly paid, up from 48.0% a year earlier. That is a 5.0 point rise and the highest reading in three years. Medical Economics, which reported the same survey on July 14, 2026, gave the same two figures.
The perception of the profession as a whole is different. Advisory Board reported that 61.0% of respondents said most physicians are underpaid, the same share as the prior report. Only 34.0% said physicians are paid about right, and 5.0% said physicians are overpaid.
The split inside the group matters for retention. The DO reported that exactly half of primary care physicians feel fairly paid, against 53.0% of medical specialists. The group with the lowest pay also has the lowest satisfaction with it.
What does this mean for a practice budget?
Take a five-physician family medicine group at the Medscape average. Total compensation comes to $1,440,000 a year. A 3.0% raise on $288,000 adds $8,640 per physician, or $43,200 for the group.
Hiring speed also affects what a vacancy costs. MGMA's November 2025 Stat poll drew 305 responses. It found that 48.0% of practices added advanced practice providers relative to physicians in 2025, 40.0% kept the ratio steady and 11.0% moved toward more physicians. MGMA also cited April 2025 data in which 38.0% of leaders said time to fill physician vacancies increased year over year and 9.0% said it shortened.
Two checks make the Medscape numbers usable. Match your specialty to the table, not to the $386,000 average. Then compare your own pay on a total basis, because Medscape counts incentive bonuses and a base salary alone will look low against it.
The survey closed in December 2025. A 2027 budget needs its own growth assumption, and the 3.0% gain is the only year-over-year figure Medscape reported for all physicians together. The sources used here do not name the nine specialties with flat or falling pay, so check the full Medscape report for your own field before you set an offer.
Sources
- The DO (American Osteopathic Association), What physicians are getting paid in 2026, July 9, 2026
- Advisory Board, The current state of physician compensation, in 6 charts, June 2026
- Medical Economics, 10 highest-paid physician specialties in 2026, July 14, 2026
- MGMA Stat, APP utilization and how care team redesign continues into 2026, November 12, 2025
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