Guide to Maximize Your Spine Surgeon Salary

Working as an orthopedic surgeon focusing on the spine puts you into the position to treat people’s back pain and problems. You could help keep people mobile and active after other back solutions have failed them. A good spine surgeon salary compensates for the hard work of performing surgery on the spine, as well as the extensive schooling and training needed to get started in this position.

In this article, we share the average salary of orthopedic surgeons working in the specialty of the spine. We take a look at multiple data sources and break down salary fluctuations by factors that play a role. In this discussion, we will show you how to make the highest salary possible and ways to best manage your income as a spine surgeon.

Average Spine Surgeon Salary

An orthopedic surgeon specializing in the spine makes a nationwide median salary of $844,422, according to the 2022 Medical Group Management Association (MGMA) Compensation & Production Report. This median point reflects the midpoint salary at which 50 percent come in below and 50 percent come in above it. The salary range for this position is $468,787 in the 10th percentile to $1,423,413 in the 90th percentile.

The Medscape Physician Compensation Report 2022 named orthopedics as the second most compensated physician specialty, at $557,000 on average, falling only behind plastic surgery at $576,000. Keep in mind that this refers to orthopedics in general rather than further specialization in spine surgery. This same source found that 97 percent in orthopedics would choose the same specialty again, so that shows a large majority that is happy with this occupation.

Let’s take a look at average spine surgeon salary across numerous sources:

Why is there such a discrepancy between salary averages in the same position? In general, variations in the spine surgeon salary from site to site happen due to differences in the way data is collected. Different sources tend to vary in factors like:

  • Number of years studied
  • The sources of information (some ask for submissions while others look at physician data, for example)
  • The specific job role, as some may include broader roles than others (MGMA specifically looks at orthopedic spine surgeons while some sources look at general orthopedic surgeons, for example)
  • Base salary versus total compensation

It’s helpful to compare a range of sources, as we did here. Also, you’ll gain more information by taking a closer look at what’s included in total compensation for this role as well as various factors that impact salary. We consider these factors in the next section.

Factors That Affect Salary

There are many reasons for salary fluctuations, which include:


There is expected to be good demand for this type of physician. Merritt Hawkins explains that a shortage of about 5,000 orthopedic surgeons is anticipated by the year 2025, as about 60 percent of them are at least 55 years of age and expected to retire in the near future. Demand in this area may help you command a higher salary.


In orthopedics in general, women only make up 11 percent of the physicians in this role, according to Medscape. Among physician specialists overall, women make $307,000 compared to men’s $402,000, according to Medscape. Nonetheless, Medscape notes that the gap has been going down over time. It notes that more are getting into physician specialties, including high-paying ones, and that organizations are aiming to bring more women into these roles and target gender pay gaps that may be present.

Read More: How Female Physicians Can Counteract the Gender Pay Gap

Practice Location

You could expect to make differing amounts of money in this same occupation depending on where in the country you practice. The MGMA report shows that the salary can range from $746,682 to $882,154 depending on the region of the United States.

In addition, the highest salary is found in metro areas with less than 250,000 people, with a median salary of $882,502. Areas with a larger population demographic earn less, between $589,540 and $831,366. This range of salaries across the population demographics is often true regardless of specialty, with higher salaries in the lower populated areas.

One other location-based factor is the type of practice. Spine surgeons earn about 7% more in multispecialty practices, as compared to single specialty practices. In addition, a spine surgeon can earn about 5% more if working in physician-owned facilities as compared to those working in a hospital.

Nonetheless, beyond the region of the country, it’s also worth considering the specific state. ZipRecruiter shows that the orthopedic spine surgeon average with pay above the national average are in Massachusetts, Washington, New York, Maryland and Virginia.

Related: How Moving Can Help Physicians Pay Off Student Loans

Total Compensation

Depending on the source, average salary may only include the base salary offered by an employer or it may include the total compensation. The difference between the two tends to vary broadly, and total compensation is an area that plays a major role in maximizing salary. On top of base salary, you can get bonuses, receive a significant value in benefits and potentially earn through profit sharing.

Medscape shows the average incentive bonus for orthopedics as $126,000. Payscale says that orthopedic surgeons earn bonuses up to $108,000, in addition to up to $90,000 in profit sharing.

Years of Experience

In all occupations, you tend to make more money as you gain experience. Payscale shows that an entry level orthopedic surgeon makes 20 percent less than the average, and one in their early career makes nine percent less. In their late career, they make four percent more than average, and experienced ones make 13 percent more.

Average Loan Debt for Orthopedic Spine Surgeons

For the most part, all physicians incur about the same level of school debt regardless of the physician specialty. This is because specialization happens for the most part after medical school, during paid residencies and fellowships. School debt does vary due to factors like the chosen school, the number of years in school and how much of the cost was initially covered by loans. To give you a general idea, Student Loan Planner says that those who have gone through medical school have an average of about $200,000 in student loan debt.

You must consider that when you factor in the interest to repay the loan, you end up paying far more than the initial amount of the debt. This introduces one way to save on expenses and thereby maximize your physician salary once you become an orthopedic surgeon. You can pay less over the course of repaying your loan by lowering your interest rate, which cuts down your loan payments and the cost of your repayment overall. Take a look at the discount rates we offer to help physicians refinance student loan debt and save.

You may also want to consider loan forgiveness or other strategies to repay your medical school loans.

Ways to Increase Salary

As a spine surgeon, you have many opportunities to increase your salary from the lower ranges. An important option is to relocate. Moving to one of the states with the highest incomes, such as Massachusetts, or the top regions, such as the eastern or midwestern U.S., could significantly improve your income prospects. You could also earn more by switching to a single-specialty or hospital-owned facility if you’re not already working in one.

In addition, you could consider hiring a PA or other type of assistant to help with some of the less advanced tasks, freeing up your time for direct patient hours that are more financially rewarding. Orthopedic physicians spend 14 hours on paperwork and administrative tasks each week, according to Medscape, so this is time you could potentially free up. For example, you could potentially work locum tenens by filling in for other physicians or take on extra hours at a hospital.

Another major way to increase your spine surgeon salary is by negotiating your contract. For instance, you have the potential to negotiate a large signing or production bonus that could greatly add to your overall income.

Read More: The Definitive Guide to Physician Compensation Review

Spine Surgeon Salary Negotiations

As we previously mentioned, negotiating your salary provides an opportunity to significantly increase your annual salary and thus your lifetime financial picture. Don’t believe the myth that contracts cannot be negotiated. Negotiating a signing bonus gives you an instant boost that can help with those student loans or otherwise improve your finances. You can also negotiate for an incentive package or other type of bonus structure. The sources we looked at showed that bonuses could increase a spine surgeon salary by over $100,000, which is why it’s such an important factor.

Negotiations should help set the right starting salary by considering the demand for your role and what you have to offer, such as top schooling and certain skills, credentials and experience. In addition to bonuses, negotiations should include a good benefit package, including paid time off. You may even be able to add other features like profit sharing or more patient-focused time rather than administrative work.

Salary negotiations are not a one-time event. Ideally, they should happen at the start of your career and also any time you switch positions or employers, and as you gain experience, skills or credentials.

Since your specialty is medicine rather than salary negotiations, it may be wise to hire a professional in contract review and negotiation to help in this area. We use our expertise in physician salary expectations and contract negotiations to ensure you get what you’re worth each time a contract review is relevant.

Protect Your Profession

Once you are making a large salary as an spine surgeon, think about ways to protect and maximize your finances. Your state and employer will likely ensure you obtain malpractice insurance, but just in case, we want to point out the importance of having this.

Being sued for malpractice takes the majority of physicians by surprise; it’s best to be prepared in the case of a lawsuit. There are many aspects to take into account when considering malpractice insurance. You should ensure you have sufficient coverage in case anything should go wrong with a patient. You will want to consider if your coverage is occurrence or claims-based and what, if any, tail insurance you may  need.

As your work is with the spine, it’s essential to have the right coverage as a problem during surgery could have major consequences. This important insurance will protect you and your ability to practice if a situation like this arises at some point.

Protect Your Spine Surgeon Salary

While you want malpractice insurance in case something happens to a patient, disability insurance is there if something happens to you. While one can hope that you will never need to use disability insurance, one in four of today’s 20-year-olds are likely to be disabled and out of work for at least a year before retiring.

When it comes to disability insurance, physicians have a few options for managing their income protection. They can use a 1) group plan through their employer, 2) an individual own occupation plan or 3) both.

You shouldn’t solely rely on an employer’s group plan. While a group plan can provide some protection, the scope of the plan is very limited. There are four major problems we share with physicians about group plans, we have summed them up in the chart below.


In case an event occurs that interferes with your ability to work, an individual own occupation disability policy is a backup plan to protect your spine surgeon salary and full financial picture for the future.

Contact Physicians Thrive today for a free disability quote. We’ll do the legwork to find you the best policy for your unique needs.


Spine surgeons will continue to be in high demand, there’s no doubt about that.

By the year 2040, approximately one in five Americans will be age 65 or older. An aging population comes with increased need for healthcare and spine surgeons should also expect the demand for their expertise to only increase over time.

Spine surgeons can use the information above to position themselves in the right location and in the right practice setting to not only increase their salary, but also to ensure they will be protected in the event they are not able to work.

Contact Physicians Thrive to learn more about how you can make the highest salary and strategies to maximize your earnings over the course of your career.

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