Healthcare Recruiting
Emergency Medicine Physician Salary by State 2026
Emergency medicine physicians are among the most mobile doctors in the country — working shift-based schedules that allow them to move markets, work locums, and compare compensation across systems easily. The national median salary for an employed EM physician in 2026 is approximately $375,000, but total compensation varies substantially by ownership model, location, and clinical model.
National EM Physician Salary Benchmarks (2026)
| Model | Median Annual Comp | Top 25% |
|---|---|---|
| Democratic / physician-owned group | $420,000 | $500,000+ |
| Hospital-employed | $385,000 | $445,000 |
| Corporate staffing group (TeamHealth, Envision) | $345,000 | $395,000 |
| Academic / residency-affiliated | $310,000 | $370,000 |
| Locum tenens (1099) | N/A | $280–$380/hr |
| Freestanding ER (24-hr) | $400,000 | $470,000 |
Sources: ACEP Emergency Physician Compensation Report 2024, Medscape 2025 Physician Compensation Report, MGMA 2024 Physician Compensation Survey.
Top 15 Highest-Paying States for EM Physicians (2026)
| Rank | State | Median EM Salary | Notes |
|---|---|---|---|
| 1 | Wyoming | $460,000+ | Rural premium, limited EM supply |
| 2 | Montana | $450,000+ | Critical access hospital premiums |
| 3 | Alaska | $445,000+ | Island/rural isolation premium |
| 4 | North Dakota | $440,000+ | Oil country hospital demand |
| 5 | Nevada | $435,000+ | Las Vegas trauma centers, freestanding ERs |
| 6 | Idaho | $428,000+ | Rural demand, growing population |
| 7 | Texas | $420,000+ | Freestanding ER market, high volume |
| 8 | Florida | $415,000+ | Tourist trauma centers, large EM market |
| 9 | Colorado | $412,000+ | Outdoor recreation injuries, mountain ERs |
| 10 | Arizona | $408,000+ | Phoenix metro growth, freestanding ERs |
| 11 | South Dakota | $405,000+ | Rural premium, compact state |
| 12 | Virginia | $400,000+ | Northern VA/DC metro, trauma volume |
| 13 | Washington | $395,000+ | Pacific NW trauma, Level I centers |
| 14 | Georgia | $392,000+ | Atlanta metro, Grady trauma system |
| 15 | Tennessee | $390,000+ | Nashville growth market |
Ownership Model: The Most Important Variable
More than geography, the group ownership model determines EM physician compensation ceiling:
- Democratic groups: Physician-owners share profits directly. After covering group overhead (billing, malpractice, admin), earnings typically run $50,000–$100,000 higher than corporate employment. The tradeoff: democratic groups require buy-in periods (1–3 years), partnerships are illiquid, and governance can be contentious.
- Corporate staffing firms: TeamHealth, Envision (now restructured post-bankruptcy), US Acute Care Solutions, and regional competitors offer predictable but compressed compensation. Following Envision's 2023 bankruptcy and TeamHealth's restructuring, many physicians moved back toward independent groups.
- Hospital employment: Offers benefit stability (malpractice tail coverage, retirement matching) but compensation is typically intermediate — above corporate groups, below strong democratic partnerships.
Shift Economics: What Hourly Rates Look Like
EM compensation is often discussed in hourly terms because shift work makes the conversion meaningful:
| Setting / Model | Effective Hourly (based on 12-hr shift) |
|---|---|
| Urban Level I trauma, democratic group | $200–$260/hr |
| Community ER, hospital-employed | $185–$230/hr |
| Rural critical access ER | $220–$300/hr (lower volume, higher rate) |
| Locum tenens (contract) | $280–$380/hr + housing |
| Freestanding ER, Texas/Florida | $240–$320/hr |
The Texas Freestanding ER Market
Texas has the largest freestanding emergency room market in the country — over 700 licensed FSERs as of 2026. These facilities pay premiums ($380,000–$500,000) for EM physicians willing to staff lower-volume, higher-acuity call environments. Florida has a growing freestanding ER market. However, balance billing regulation risk and changes to PPACA market rules have increased revenue uncertainty for some FSER operators.
Browse EM physician positions or source candidates at app.avahealth.co.
Related: EM Physician Salary Guide, Physician Interview Questions, How to Recruit Physicians in 2026, Hospitalist Salary Guide.
Hiring in this space?
Browse 1.4M+ verified providers across all 50 states
NPI-sourced, free, no account required. Filter by specialty + state in seconds.
Search the directory →Free tool
2026 Healthcare Salary Calculator
Estimate comp by specialty, state, experience, and practice setting. Based on MGMA, AMGA, and BLS benchmarks.
Try the salary calculator →Be on the launch list
Salary data, hiring plays, and market trends. We'll email you when issue 1 ships. Free, unsubscribe anytime.
No spam. Unsubscribe anytime. We never share your email.