Neurosurgeon Salary: What Should You Earn?

Neurosurgeons are much more than elite brain surgeons. They treat the brain and every part of the nervous system, as well.

They also endure more years of study than most other physicians.

Shouldn’t their annual salary reflect their intense training and delicate work?

For the most part, neurosurgery is one of the highest-paid medical specialties. However, even within this group of physicians, there can be a wide salary range.

Neurosurgeons can position themselves as some of the top-earning physicians.

This article will reveal how to do that and what steps to take to protect that wealth after achieving such a high income.


Average Neurosurgeon Salary

There are many sources that show their own version of the average salary for a neurosurgeon. All of them are high. However, some sources claim that neurosurgeons make much more than others.

According to Salary.com, neurosurgeons can make between $473,301 at the 25th percentile to $795,501 at the 75th percentile, with the median salary being $628,701

MGMA reports that their salary survey revealed neurosurgeons as the highest-paid position in the medical industry. They earn $875,626 per year. Not even orthopedic surgeons earn a higher salary than neurosurgeons.

Payscale has a much lower number for neurosurgeon salary in their compensation data. According to their website, the average neurosurgeon base salary is only $413,292.

The Economic Research Institute has a slightly higher reported total compensation for neurosurgeons at $511,689 per year.

Comparably lists the average salary for a neurosurgeon at $771,498, which is much higher and more along the same lines as MGMA.

The compensation data on the Doximity report also backs the higher reported salary for neurosurgeons, listing $746,544 as the average annual compensation.

Related Reading: Guide to Maximize Your Spine Surgeon Salary 


Factors That Affect a Brain Surgeon’s Salary

Two surgeons performing a surgery

Even with such a high expected income, neurosurgeons can still position themselves to earn more than the national average for their job description.

You can do this by leveraging the factors that affect your salary. Below are the three main factors that affect a brain surgeon’s potential salary.

Years of Experience

According to Medscape, residents studying to become neurosurgeons earn $64,000 base salary per year on average. This income is reported to increase during each year of residency.

Once finished with the residency program and entering into the world of practicing medicine, neurosurgeons see a great jump in salary. This even takes place in the entry-level years.

As with most jobs, the expected pay will increase as you gain experience, but this is also greatly dependent on the location and type of practice.

Location

When considering the location in which to pursue your career path, you should always consider the cost of living and the amount of demand there is for your skillset.

This will affect how much any health system is willing to pay for a full-time neurosurgeon.

Highest Paying States

According to ZipRecruiter, the states with the highest paying salaries for neurosurgeons are Hawaii, Massachusetts, and Rhode Island.

Lowest Paying States

This same website lists the lowest-paying states for neurosurgeons as Mississippi, Florida, and New Mexico.

Type of Practice

Another factor that can affect how much a neurologist makes is which type of practice they work with.

Much of the data below comes from the Fall 2019 issue of the Neurosurgery Market Watch, a newsletter distributed by the Harlequin Recruiting company.

The neurosurgeon salary information in this newsletter comes from NERVES (Neurosurgery Executives’ Resource Value and Education Society), AMGA, and MGMA.

Private Practice

The NERVES survey showed that compensation for private practice neurosurgeons averaged about $889,000 in 2019.

Of course, physicians in private practice have a little more freedom as to how and when they work, as well as how much they charge.

Some physicians are great businessmen and can see exponentially higher returns from their practice.

Hospital

In the hospital setting, those with the job title of neurosurgeon make a lower salary, but they usually have many benefits that come with their employment contracts.

Neurosurgeons working at a hospital earn an average of $786,000 per year.

Academic

The lowest-salary practice setting for neurosurgeons is the same as most other physicians: academia.

Compensation for academic neurosurgeons is around $647,000 per year.

Neurosurgery Subspecialties

Within brain surgery, there are several subspecialties that a physician can choose to pursue.

Here are two of the best-paying subspecialties along with salary data:

Pediatric Neurosurgeon

While many pediatric subspecialties of the medical field cause physicians to take a significant cut in pay, this is not so in neurosurgery.

According to Payscale, pediatric neurosurgery compensation averages at $900,000 per year.

MGMA listed pediatric neurologists as the third highest-earning physicians, with an average annual income of $818,325.

Neurocritical Care

Brain surgeons sub-specializing in neurocritical care take a significant cut in salary.

According to Comparably, neurocritical care physicians earn an average annual salary of $282,500.

The Neurocritical Care Society published the findings of a salary survey for physicians of this subspecialty. The data from this survey correlates with that of Comparably, listing the annual brain surgeon salary between $250,000 to $300,000.


Brain Surgeons and Their Student Loan Debt

Physician wearing scrubs and stethoscope holding a laptop

One of the reasons why neurosurgeons earn some of the highest salaries in the medical field is because they’re required to spend much of their younger years in medical school.

Needless to say, these extra years of study at a medical college come with a price tag.

According to the AMA, neurosurgeons are among the top five most indebted physicians as a group, with over 65% of graduates having over $187,500 in debt.

The Student Loan Planner has a great article on the best repayment strategies for neurosurgeons.

As a quick summary, SLP recommends choosing an income-driven repayment plan while in residency, then changing it up when you start practicing.

The best repayment plan for you depends on the type of practice you choose.

At Physician’s Thrive, we believe that the best debt repayment strategy starts with the right loans before you even start medical school.

Get in touch with our team of student loan advisors to learn more about this tactic so you don’t spend the rest of your professional days paying off a massive debt.


How to Increase Your Salary as a Neurosurgeon

As you saw under the heading of factors that affect a brain surgeon’s salary, your best course of action is to go into private practice.

This can be a difficult and intimidating career move. However, you don’t have to go at it alone. Our private practice advisors are available to help you maneuver this brave and lucrative endeavor.

When you do open your own practice, there are some things you can do to increase your income:

Buy a Medical Building

Instead of renting office space and putting money into someone else’s pocket, consider buying a building that has enough room for yourself and other physicians.

This way, you will not only have a place to practice, but you will also create a separate stream of passive income.

Hire Physician Assistants

Many neurosurgeons with their own practices hire PAs and NPs to provide team-based care. This can help to improve the efficiency of your practice and increase your profits.

Practice a Subspecialty

You can also try to develop your own niche or subspecialize to hone your skills and market them to a specific demographic.

Subspecialties in neurosurgery generally concentrate on specific areas of the nervous system. For example, you can specialize in brain tumors, conditions involving the spinal cord, and peripheral nerves.

Keeping up with new and groundbreaking procedures is a must.

Work at a Hospital on the Side

Another great way to boost your income is to work as many on-call hours as you can for a level-1 trauma hospital.

The Neurosurgery Market Watch that we mentioned above reports that this is one of the most effective and popular ways for brain surgeons to increase their salary.

If you work in a hospital or academic setting, it is important that you take advantage of bonuses in order to earn the highest possible income.

According to Today’s Hospitalist, the average bonuses and incentives earned by physicians are $45,000.

Surgeons who are in the midst of signing a new employment contract shouldn’t forgo asking for a signing bonus. Read more about negotiating a signing bonus.


How to Negotiate Your Neurosurgery Employment Contract

Although contract negotiations can be a nerve-wracking experience, the brains surgeons that take initiative will do much better.

Being tied to an employment contract that is not in your financial favor can be challenging. That’s why it’s best to have a team of financial and legal advisors who will ensure your employment contract is best for you.

A list of items for discussion should be settled and clearly laid out in your employment contract. A professional contract review can check off all the items on the list.

Many physicians make the mistake of thinking that a contract review is only necessary when signing an employment contract for the first time.

However, any time that your employment contract is adjusted in any way, it would be in your best interest to have a professional contract review.


Disability Insurance to Protect Your Brain Surgeon Salary

After doing all you can to ensure your salary reflects your fair market value or more, you should protect what you worked so hard to earn.

One of the fundamental ways to do this is through a comprehensive disability insurance policy.

Although unpleasant to consider, to protect yourself from financial ruin, a physician is wise to purchase disability insurance to cover their living expenses in case of a tragedy that leaves them unable to work.

Shopping for disability insurance isn’t fun, but we know where to shop for the best. So let us find the perfect policy for you.

Building a Retirement From Your Annual Neurosurgeon Salary

When considering your plan of action to set yourself up for retirement, many physicians consider grand investments and risky ventures.

However, the surest way to make retirement a reality is by maxing out your contributions.

The tax-advantaged retirement savings accounts available to you will depend on your type of employment.

For those employed by a for-profit company such as a medical center or healthcare provider or are self-employed, you can take advantage of your traditional 401k plans.

Those who work for a non-profit company must open a 403b, which is very similar to a 401k.

After that is maxed out, you can put some more savings towards retirement through a traditional IRA, although a Roth IRA is more popular for several reasons.

There are more ways to make retirement as comfortable as possible, such as profit-sharing and special savings accounts. Our retirement planning team will ensure you make the best investments with your money.


Effective Tax Planning

With such a large annual salary , neurosurgeons also incur a large tax obligation. Earners of this tax bracket have over a third of their entire paycheck taken out for tax purposes.

But, there are a lot of ways to lower your tax burden. You may be missing out on some tax deductions or credits that you are eligible to claim.

Just one deduction can save you thousands of dollars. That’s why it’s worth enlisting the help of a tax professional today.


With such delicate and high-stress responsibilities, neurosurgeons deserve to be paid well.

The data shown above only reinforces that no matter which type of career changes a brain surgeon decides to make, the job outlook for these physicians is very promising.

However, even the highest-paid physicians in the medical field can feel like they deserve more money.

If this is you, we can help you to increase your income and work towards financial independence through our suite of services. Contact Physicians Thrive today to discuss our financial and legal services.

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