Dermatologist Salary 2026: Cash-Pay, Mohs, and Partnership Economics
Ava Health Team||8 min read
Dermatology has been structurally transformed by private equity consolidation and the rise of cash-pay aesthetic practices. Median dermatologist base salary reached $475,000 in 2026, but the real wealth creation is in partnership tracks, cosmetic practice ownership, and Mohs surgery volume.
Subspecialty Benchmarks (2026)
| Subspecialty / Model | Median Base | Top Quartile |
|---|---|---|
| General Dermatology (hospital-employed) | $430,000 | $525,000 |
| General Derm (PE-backed private) | $455,000 | $575,000 |
| Mohs Surgeon (fellowship-trained) | $585,000 | $750,000 |
| Pediatric Dermatology | $385,000 | $485,000 |
| Dermatopathology | $465,000 | $575,000 |
| Cosmetic / Aesthetic-heavy Derm | $625,000 | $950,000+ |
| Academic Dermatology | $325,000 | $415,000 |
Private Equity in Dermatology
By 2026, roughly 25-30% of US dermatology practices are PE-backed (up from 5% in 2015). Implications for recruiters and candidates:
- Signing bonuses are aggressive — $100K-$200K common at PE-owned mega-groups
- Base salaries competitive but partnership equity is typically unavailable
- "Partner" titles at PE practices usually don't include real ownership
- Productivity expectations are higher (45-55 patients per day typical)
- Some dermatologists prefer independent/physician-owned practices for autonomy and true partnership
Cosmetic / Aesthetic Practice Economics
Dermatologists with meaningful cosmetic volume can out-earn most specialties:
- Injectables (Botox, filler): Margin 65-80% of gross. High-volume injectors generate $500K-$1M+ from injectables alone.
- Laser + RF: Equipment capex $50K-$250K; 3-year payback typical at volume
- Body contouring (CoolSculpting, EmSculpt): Premium cash-pay, 55-70% margin
- Cosmetic practice owner: $800K-$1.6M+ after 5-7 years
Mohs Surgery Economics
Mohs-trained dermatologists command a significant premium:
- Fellowship in ACMS-accredited program required for top pay
- Standard day: 6-10 Mohs cases, revenue $4K-$10K/case
- Mohs surgeons in private practice average $585K-$750K+
- Dedicated Mohs lab (in-office) adds 10-15% to effective revenue through CPT 88305 pathology
Top 10 Highest-Paying States for Dermatology
| Rank | State | Median Base |
|---|---|---|
| 1 | Wisconsin | $525,000+ |
| 2 | Indiana | $510,000+ |
| 3 | Oklahoma | $505,000+ |
| 4 | Nebraska | $500,000+ |
| 5 | Missouri | $495,000+ |
| 6 | Iowa | $490,000+ |
| 7 | Kentucky | $485,000+ |
| 8 | Florida | $480,000+ |
| 9 | Ohio | $478,000+ |
| 10 | Texas | $475,000+ |
What Dermatologists Negotiate in 2026
- Daily patient load (40-50 is sustainable, 60+ leads to burnout)
- Cosmetic product/laser capex ownership and revenue share
- Mohs case volume allocation (if fellowship-trained)
- Partnership terms (true ownership vs PE "partner")
- Non-compete geographic/time limits
- Malpractice tail coverage
- CME + dermatology board recertification
- Teaching/residency involvement
Ava Health places dermatologists across employment models nationwide. Contact us for current openings.