Neurosurgery is the highest-earning medical specialty in terms of median pay, but the salary of a neurosurgeon can vary based on where they practice medicine. This leads many to ask, “where do neurosurgeons make the most money?”.
Our 2024 Physician Compensation Report found the national median salary for neurosurgeons was $788,000 in 2023, above the median salaries of thoracic surgery ($750,000) and orthopedic surgery ($749,000), two of the other highest-paying surgical subspecialties.
Key Takeaways
- The median neurosurgeon salary was approximately $788,000, the highest of any physician specialty.
- The Midwest reported a median neurosurgeon salary of $959,000 compared to $812,000 in the East,showing clear regional trends in where do neurosurgeons make the most money.
- The highest-paying metro areas for physicians across all specialties were Charlotte, St. Louis, and Oklahoma City, with median pay above $425,000. At the other end of the scale, most Eastern seaboard cities ranked in the lowest 10% of the market.
- Rural areas and those with physician shortages also have higher compensation and larger bonuses for neurosurgeons, further influencing where do neurosurgeons make the most money.
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Regional Insights: Where Do Neurosurgeons Make the Most Money
Understanding where do neurosurgeons make the most money depends largely on factors like cost of living, demand for specialized care, and supply of trained neurosurgeons in each region.
We can see from our analysis of regional neurosurgeon salary data that those in the West have the highest reported median pay at $959,000. Close behind is the Midwest ($900,000), followed by the South ($866,000) and the East ($812,000). There are many factors that can affect the neurosurgeon salary in a given state and region, such as the cost of living, demand for specialized surgical care, and the supply of trained neurosurgeons in the market.
Specialties may have to offer higher salaries and signing bonuses to recruit and retain neurosurgeons in markets with greater physician shortages, such as Midwestern and Southern states, per the report. By contrast, the East has a more concentrated presence of academic medical centers, large hospitals, and a denser healthcare market but lower median pay for neurosurgeons due to higher competition among physicians.
Based on these regional trends, the West and Midwest are currently where do neurosurgeons make the most money in the United States.
Metro Area Trends: Where do Neurosurgeon Make the Money Money
When examining where do neurosurgeons make the most money, metro areas such as Charlotte, St. Louis, and Oklahoma City provide insight into the markets offering the highest physician compensation. Specifically, we found that metro areas with the highest median salaries for physicians across all specialties were Charlotte ($430,890), St. Louis ($426,370), and Oklahoma City ($425,096).
We do not publish the neurosurgeon salary in these metro areas, but given the geographic pattern seen across all specialties, it is highly likely that neurosurgeon salary in these markets is significantly above the all-specialty average. Physicians considering moving to these metro areas for their new position should keep in mind that they may be able to command salaries at the higher end of the market.
Neurosurgeon Salary: Rural Versus Urban Considerations
For physicians researching where do neurosurgeons make the most money, rural regions often stand out due to strong demand and generous recruitment incentives. Our report showed that such areas, especially in the Midwest and South with significant physician shortages, can offer more competitive salaries and signing bonuses for neurosurgeons. We do not publish neurosurgeon salary in rural areas but do show which parts of the country have the highest demand for physicians and pay the highest salaries. This holds true for bonus compensation as well as salary, for example, in Tallahassee, FL and Springfield, IL, two of the three metro areas with the highest demand for physicians.
Bonuses and Incentives: A Piece of the Geographic Puzzle
Bonuses and incentive pay are another important component of total neurosurgeon compensation, and geography can also be an important piece of this puzzle. As a general rule of thumb, our data shows that in-demand specialties such as orthopedic surgeons and neurosurgeons earn six-figure incentive bonuses. For instance, orthopedic surgeons have an average bonus of $134,000.
Neurosurgery is a similar demand category for most healthcare markets and is also a high-revenue-generating surgical subspecialty. As a result, neurosurgeons can also reasonably expect to earn a similar or even larger total incentive payment in a competitive market.
Bonus pay can be structured around different metrics, including relative value units (RVUs), net collections, and quality performance, but RVU-based bonuses are the most common. Regions with more severe physician shortages are likely to have more aggressive bonus structures to ensure physician recruitment.
These data points also play a role in determining where do neurosurgeons make the most money, since markets with physician shortages tend to offer higher incentive bonuses.
Negotiating Career Moves with Geographic Salary Insights
Knowing where do neurosurgeons make the most money can help physicians negotiate stronger compensation packages and make strategic career moves. The geographic location of a physician job opportunity is one of the most important factors to know when it comes to neurosurgeon salary. The Physician Compensation Report we publish can help physicians compare average neurosurgeon salaries in the city of their choice with the national market or others, but a move from one end of the country to another can represent a difference of more than $100,000 in annual salary before bonuses and benefits are taken into account. For this reason, physicians should account for the local demand for neurosurgeons, as well as their own geographic and career preferences when negotiating a new contract or job opportunity.
Contracts should be evaluated holistically, with an eye toward total cash compensation (salary plus bonus), benefits, non-cash incentives, and non-financial considerations such as flexibility and long-term career trajectory. For more personalized assistance with contract negotiations, physicians can turn to a service like Physicians Thrive.
Whether you’re comparing opportunities or exploring where do neurosurgeons make the most money, understanding salary trends by region can help you maximize your earning potential.
At Physicians Thrive, we ensure that our members receive competitive salaries that match their experience and professional value. We also have decades of experience in helping members contract for new positions and protecting them against malpractice and E/M shortfalls. Schedule a call with one of our team members today to learn more about the services we can offer you and your family.
