Healthcare Recruiting
Dermatologist Compensation 2026: Medical vs Cosmetic vs Mohs — Comp Tables, Practice Setting, Cash-Pay Math
Dermatology in 2026 is one of the most stratified specialties in medicine. A medical dermatologist at a hospital-employed clinic earns $445K. A Mohs surgeon at a high-volume practice earns $585K. A cosmetic dermatologist running a cash-pay practice in a metro market clears $1M+ in net income. All three carry the same board certification.
This guide covers what dermatologists are actually earning across all major practice paths in 2026, including the impact of private equity (PE) consolidation that has reshaped the comp landscape over the last 5 years.
National compensation by setting — 2026
| Setting | Median (W-2) | 25th | 75th |
|---|---|---|---|
| Medical derm (employed) | $445,000 | $385,000 | $525,000 |
| Medical derm (private group) | $525,000 | $445,000 | $625,000 |
| Mohs surgery | $585,000 | $505,000 | $695,000 |
| Cosmetic / aesthetic dermatology | $675,000 | $525,000 | $1,150,000+ |
| Pediatric dermatology | $365,000 | $315,000 | $435,000 |
| Dermatopathology | $485,000 | $415,000 | $575,000 |
| Academic dermatology | $315,000 | $275,000 | $385,000 |
RVU targets and productivity math
- Medical derm employed: 7,500–9,500 wRVU target, $58–$72/wRVU
- Mohs: 8,000–10,000 wRVU, $72–$92/wRVU (procedure-heavy)
- Pediatric derm: 6,500–8,000 wRVU, $52–$65/wRVU
Dermatology productivity is unique — a single biopsy generates 1.5 RVU and takes 3–5 minutes. A high-volume medical derm sees 35–45 patients/day and generates 12,000+ wRVU/year. A Mohs surgeon doing 4–6 stages per case at $85/RVU generates outsized productivity bonuses.
Cash-pay cosmetic practice math
The highest-earning derm practice structure: cash-pay cosmetic practice in a metro market. Standard fee structure (2026):
| Service | Typical fee | Time |
|---|---|---|
| Botox (1 area) | $425–$650 | 15 min |
| Filler (1 syringe) | $725–$1,050 | 20 min |
| Laser (face) | $650–$1,200 | 30 min |
| Microneedling (face) | $525–$850 | 45 min |
| Mohs surgery (commercial cash-pay) | $3,500–$6,500 | 3 hours |
| Skin cancer screening (cash) | $350–$525 | 20 min |
A solo cosmetic dermatologist seeing 25 patients/day cash, 4 days/week, 46 weeks/year:
- 4,600 visits × $475 average = $2.18M gross
- Overhead (rent, staff, supplies, marketing): 35–45% = $850K
- Net 1099: ~$1.33M
This is the high end. Realistic year-1 cash-pay practice ramps to 50–65% capacity ($550K–$725K net) and stabilizes year 3.
Private equity consolidation impact
Dermatology has been heavily consolidated by PE since 2018. Major PE-backed groups include:
- Forefront Dermatology (700+ providers, OMERS-backed)
- U.S. Dermatology Partners (300+ providers, ABRY-backed)
- QualDerm Partners (200+ providers, Sentinel-backed)
- Schweiger Dermatology (200+ providers, NYC focus)
- Anne Arundel Dermatology (100+ providers)
PE-backed groups typically pay W-2 base $400K–$500K with productivity bonus. They are less generous than independent private groups on partnership equity (often capped or non-existent), but offer faster start, better infrastructure, and more predictable comp.
For mid-career dermatologists choosing between PE and independent private groups: PE groups pay better in years 1–2; independent partnerships pay better in years 4+ once equity vests. The crossover is around year 3.
Top-paying states — 2026
- South Dakota: Medical derm $545K — extreme rural shortage
- Mississippi: $525K medical, $695K Mohs
- Iowa / Nebraska: $515K medical
- Oklahoma: $505K medical
- West Virginia: $495K medical
For cosmetic dermatology, the pattern flips — coastal metros (Beverly Hills, Manhattan, Miami, Aspen) are the highest-earning markets despite below-median medical derm comp. A successful Beverly Hills cosmetic derm practice can clear $2M+ in net.
Locum tenens rates
- Medical derm: $1,800–$2,400/day, $225–$300/hour
- Mohs: $2,500–$3,400/day
- Pediatric derm: $2,200–$2,900/day
Dermatology locum is one of the best-paying locum specialties relative to call burden — most assignments have no overnight call and predictable 4–5 day weeks.
What we see at Ava Health
Demand for medical dermatology is highest in rural and small-metro markets where wait times for new patient consults are 4+ months. The hardest-to-fill positions: rural community private practice with no Mohs surgeon (forces general derm to manage all skin cancer cases) and pediatric derm at children's hospitals.
For dermatologists considering cash-pay cosmetic: the location dependency is sharp. We've placed cosmetic dermatologists in growing metros (Charlotte, Nashville, Austin, Tampa) where the cash-pay market is less saturated than Beverly Hills/Manhattan but still strong. Year-1 ramp is faster in these markets than in oversaturated coastal cities.
Related: Dermatologist Salary by State 2026, Physician Side Hustles That Actually Pay, Physician Contract Negotiation Levers.
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