← 2026 Salary Report / Orthopedic Surgery
Second-highest compensated surgical specialty. Sports medicine and spine fellowships drive the biggest premiums.
Training: 5 years post-medical school + 1 year fellowship | 5-Year Change: +15% | Range (25th-75th): $480,000-$780,000
New orthopedic surgeons start at $450,000-$550,000 and reach peak earnings by year 8-12 as case volumes mature. Subspecialty matters enormously: sports medicine and spine surgeons earn 20-30% above general orthopedics, while hand and foot/ankle fellowships command more modest premiums of 5-10%.
Texas, Indiana, and Tennessee lead COL-adjusted compensation for orthopedic surgeons. High-volume trauma centers in the Southeast and Midwest often pay above national medians. Rural markets offer $100,000+ premiums over urban academic centers, where salaries typically lag 25-35% behind private practice.
Employed orthopedic surgeons earn $500,000-$650,000 with predictable schedules. Private practice orthopedists with ASC ownership routinely earn $800,000-$1.2M, with some joint replacement-focused practices exceeding $1.5M. Implant-related considerations and payor mix significantly affect private practice margins.
Three highest-leverage actions: (1) Pursue an ASC partnership - joint replacement and sports medicine procedures generate substantial facility fees. (2) Build a subspecialty niche with strong referral relationships. (3) Negotiate wRVU thresholds and productivity bonuses carefully - the difference between 50th and 75th percentile benchmarks is often $100,000+. Use the PhysicianWealth Salary Benchmark for a personalized comparison.
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