The neurosurgeon average salary has long been one of the highest in medicine. The specialty’s rigorous training, relatively few practitioners, and intensive operations on the brain and spine command premium compensation. Comparing the neurosurgeon salary with similar high-earning surgical fields like orthopedic, cardiac, and plastic surgery can provide context on practice location, case volume, and subspecialization effects.
Key Takeaways
- The 2024 Physicians Thrive Physician Compensation Report shows a nationwide neurosurgeon average salary of $788,000
- Orthopedic surgeons average $839,000 median compensation, but practice and spine surgeons often top $900,000
- Cardiac surgeons have a median salary of about $648,000, and plastic surgeons report about $619,000
- Long-term earnings will vary as much by region, practice ownership, and contract structure as by specialty choice
Table of Contents
Neurosurgeon Average Salary by Region
The 2024 Physicians Thrive Compensation Report found a nationwide neurosurgeon average salary of $788,000.Some of the highest pay occurs in the West, where neurosurgeons have a median compensation of $959,000. Physicians in the South have a lower median of about $812,000, but both are among the top of any surgical specialty.
Regional variation in the neurosurgeon average salary closely follows the supply of local providers. The long residency and fellowship training period, combined with the intense nature of the work, result in smaller numbers of neurosurgeons relative to other fields.
Average salaries mirror the residency requirements, with neurosurgeons in private practice putting in several high-risk procedures like aneurysm repairs or brain tumor removals each day. The RVUs for these complex cases with hospital and anesthesia fees are correspondingly high.
Orthopedic vs. Neurosurgeon Average Salary
Orthopedic surgery is the other specialty with the highest earning potential for surgeons. The 2024 Physician Compensation Report shows a median orthopedic surgeon salary of $839,000. Spine surgeons in particular frequently report incomes above $900,000 when in private practice.
Orthopedic surgeons and neurosurgeons are often both involved in spine operations. In general, the most highly compensated orthopedic surgeons perform advanced spine or joint replacement procedures that have correspondingly high RVUs and reimbursement potential.
In many cases, these high-end salaries in orthopedics and neurosurgery are similar, though orthopedic surgery sometimes has the edge. However, NERVES reports the neurosurgeon average salary has maintained an advantage in every region of the country.
The top salaries of orthopedic and neurosurgeons suggest that when deciding which surgical field to pursue, physicians should give as much weight to call schedules, procedure preferences, and lifestyle as to expected income. Both fields are lucrative, but also demand more time and have a higher bar to entry than most other medical specialties.
Cardiac Surgery vs. Neurosurgeon Average Salary
Cardiac surgeons provide a valuable service in medicine but generally do not have the same earning potential as neurosurgeons. In the 2024 Physicians Thrive report, the median cardiac surgeon salary was $648,000. As with most surgical fields, hospital system work is more common, with salaried pay, extensive benefits, and team models.
Cardiac surgeon income is substantial, but patient and procedural factors in recent years have inhibited growth in open-heart surgery. Patient age and alternative developments in minimally invasive cardiology procedures have limited cardiac surgeon volume growth, and so overall compensation will not rise to the neurosurgeon average salary.
Still, cardiac surgery is one of the highest-paying and most respected fields. For those interested in high-acuity operating room cases with salaried hospital support, it can be a great choice, even with a lower median income than neurosurgery.
Plastic Surgery and Salary Range
Plastic surgery is one of the specialties with the widest income range. While the 2024 report cites a median income of $619,000, this can vary widely based on practice type. Hospital-employed or academic plastic surgeons typically earn $400,000 to $500,000.
In contrast, private practices that emphasize elective cosmetic surgery can cross the $700,000 threshold. This is because plastic surgeons rely more than other specialties on the patient self-pay market.
To succeed, these surgeons must build a practice that can generate enough revenue to cover overhead and payroll. This requires both business savvy and the ability to adjust to economic cycles. Neurosurgeons, by contrast, largely treat non-elective conditions that are regularly covered by insurance.
Practice Type and Ownership
Practice setting is another major factor influening the neurosurgeon average salary. NERVES shows neurosurgeons who own their practice make a median of $862,938, while those working in a hospital-owned practice make $766,648. Physician ownership allows professionals to share in practice profits and build equity.
In contrast, an employee model provides stability and benefits but a capped income. Similar dynamics exist in all surgical subspecialties. Orthopedic, cardiac, and plastic surgeons in private practice tend to have higher income potential and associated risk.
Contract terms are also critical to long-term earnings. Productivity incentives, practice revenue sharing, and partnership tracks can have a large impact on total income over a career. Understanding these concepts is the first step to negotiating a better contract and boosting income.
Build Lifetime Value
Physicians Thrive compares specialties so you can see the neurosurgeon average salary in context. While neurosurgery, orthopedics, cardiac, and plastic surgery all offer the potential for high incomes, practice patterns, regional demographics, and contract details will matter just as much.
In addition to initial salary, you should consider where you want to work, what kinds of procedures you want to do, and what business model will give you the most control over your income. Some surgeons and residents will have compelling reasons to pick another field, but those who stay in one of the highest-paying areas of medicine can set themselves up for a lifetime of wealth.
At Physicians Thrive, we do more than provide data. We assist in the contract review process, help develop negotiation strategies, and offer guidance on maximizing income and wealth. Whether you are starting out in neurosurgery or thinking about other surgical fields, we will help you take the next steps in your career.
