Healthcare Recruiting
Anesthesiologist Compensation 2026: National Tables, RVU Targets, Bonus Structures, State-by-State Pay
Anesthesiologist compensation in 2026 has split into two market structures: hospital-employed positions (W-2, productivity + base) and partnership-track private groups (W-2 to start, equity buy-in 2–5 years). Both are pulling base compensation higher than 2024 levels driven by ongoing supply shortages — particularly in rural states and the Southeast.
This guide covers what anesthesiologists are actually earning in 2026 across W-2, 1099 locum, and partnership structures, plus the state-by-state variations that often surprise recruiters.
National compensation snapshot — 2026
| Metric | Value (2026) |
|---|---|
| Median base salary (W-2 employed, no partnership) | $498,000 |
| 25th percentile | $432,000 |
| 75th percentile | $575,000 |
| 90th percentile (productivity-heavy + call-heavy) | $680,000+ |
| Median total compensation (incl. bonuses, RVU, sign-on) | $555,000 |
| Locum tenens rate, daytime | $200–$285/hr |
| Locum tenens rate, nights/weekends | $285–$350/hr |
| Median sign-on bonus (employed) | $45,000–$80,000 |
| Median student loan repayment | $50,000 over 3 years (rural/critical access) |
Top-paying states (W-2 employed, total comp)
| Rank | State | Median total comp | Driver |
|---|---|---|---|
| 1 | Mississippi | $655,000 | Severe supply shortage, rural premiums, loan repayment |
| 2 | Alabama | $642,000 | Same — supply shortage in non-Birmingham markets |
| 3 | Oklahoma | $625,000 | OK-1 (Tulsa) and OK-2 (OKC) competition; CRNA-led practices need MD oversight |
| 4 | Arkansas | $605,000 | Same drivers |
| 5 | South Dakota | $595,000 | Sanford and Avera competition, rural premiums |
| 6 | Indiana | $585,000 | IU Health expansion + outpatient surgery growth |
| 7 | Nebraska | $575,000 | Methodist + CHI Health competition for rural coverage |
| 8 | Iowa | $565,000 | UnityPoint + Mercy + UIHC |
| 9 | Wisconsin | $555,000 | Aurora + Froedtert + UW Health |
| 10 | North Carolina | $545,000 | Atrium + Duke + UNC; outpatient surgery boom |
Lowest-paying states (median total comp under $440K): California, Massachusetts, Hawaii, New York, Maryland. The pattern holds across most physician specialties — high cost-of-living markets pay less in absolute dollars because supply meets demand more easily.
RVU targets and structures
Most W-2 hospital-employed anesthesiologists work on a hybrid model: a base salary tied to a wRVU target, with a per-wRVU bonus above that target. 2026 typical structure:
| Component | Typical 2026 value |
|---|---|
| Base salary | $420,000–$480,000 (varies by state) |
| wRVU target | 10,000–11,500 wRVUs/year |
| Conversion factor (over target) | $50–$75/wRVU |
| Median actual production | 11,800 wRVUs/year |
| Typical productivity bonus earned | $15K–$60K/year |
| Quality bonus | $10K–$25K (PSI, OR utilization, patient experience) |
| Call stipend (per night) | $1,200–$2,000 in-house, $400–$800 home |
Important: the wRVU target structure varies significantly between hospital-employed groups, AMC (Academic Medical Center) groups, and physician-owned private practice. AMC structures often have lower wRVU targets but include teaching/research time; private practice has the highest cash comp but often longer hours.
Partnership-track economics
Roughly 30% of US anesthesia jobs are at physician-owned private groups offering a partnership track. The structure is consistent:
- Years 1–2 (associate/employed track): $380K–$450K base salary + benefits. Lower than hospital-employed because the upside is partnership.
- Year 2 evaluation: Vote on partnership offer. ~85% of associates who reach this point are offered partnership.
- Buy-in: Cash buy-in OR earn-in (reduced compensation for 1–2 more years to "buy" the share). Cash buy-in is typically $150K–$400K depending on group size and revenue.
- Partner compensation: Pre-tax distributions of $625K–$900K+ for full partner status, depending on the practice's case volume and contract terms with hospitals.
The 5-year cumulative income for a partnership-track anesthesiologist often exceeds the 5-year cumulative income from a hospital-employed position by 25–40%, but the buy-in is real cash (or real foregone income) and the upside is contingent on the group keeping its hospital contract.
1099 locum tenens economics
Locum anesthesiology has become one of the highest-paying physician categories in 2026 because supply shortages mean facilities will pay premium rates for short-term coverage. Typical structure:
| Coverage type | 2026 rate range |
|---|---|
| Daytime weekday (M–F, 7a–5p) | $200–$285/hr |
| Weeknight call (5p–7a) | $285–$350/hr |
| Weekend coverage (Sat–Sun, 24hr) | $2,800–$4,200/day |
| Holiday rate | 1.5×–2× standard |
| OB-only coverage | $150–$200/hr (lower acuity, predictable) |
| Cardiac/CT anesthesia | $285–$400/hr (supply premium) |
Net 1099 earnings for a full-time locum anesthesiologist typically run $850K–$1.1M gross before expenses. Self-employment tax (15.3%), malpractice ($8K–$25K depending on coverage), and travel costs are real overhead — most locum docs net 65–75% of gross.
CRNA pay (for context — anesthesiologists supervise CRNAs in most states)
CRNA compensation 2026 nationals: median total comp $245K, top quartile $295K+. Top-paying states for CRNAs mirror anesthesiologist top states (MS, AL, OK, AR, IN). In states with full CRNA practice authority (CA, OR, AK, ME, MT, NH, NM, KS), CRNAs can run independent practices and pay structures differ from supervised models.
Specialty subspecialty premiums
| Subspecialty | Premium over general anesthesia base |
|---|---|
| Cardiac / Cardiothoracic anesthesia | +10–18% |
| Pediatric anesthesia (PEDS-trained) | +8–14% |
| Pain management (board-certified) | +25–40% (high-margin practice) |
| OB anesthesia / regional only | 0 to -5% |
| Critical care anesthesia (intensivist) | +12–20% |
What we see at Ava Health
For anesthesiologists we placed in 2025, the most common move was hospital-employed → private group partnership track, citing the long-term equity upside. The second most common was W-2 → 1099 locum after kids were grown, citing schedule flexibility and the ability to take 8–12 weeks off per year. Both moves typically increased net comp by 15–30%.
The mistake we see most frequently: physicians evaluating only base salary across job offers without modeling out the productivity bonus, call stipend, and partnership economics. A $480K base with realistic productivity bonus and partnership track typically out-earns a $550K straight-salary offer over a 5-year horizon.
Related: Physician Contract Negotiation: 10 Hidden Levers, 1099 vs W-2 Comparison.
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