Gynecologic Oncologist Salary Guide 2026: Radical Hysterectomy, Debulking, and HIPEC Income

Gynecologic oncologist salary overview 2026

Gynecologic oncology is a surgical subspecialty combining obstetrics and gynecology with surgical oncology — managing ovarian, uterine, cervical, vulvar, and vaginal cancers through surgery, chemotherapy, and targeted therapy. Physicians complete a 4-year OB/GYN residency followed by a 3-year SGO-accredited gynecologic oncology fellowship. Mean total compensation in 2026 ranges from $350,000–$580,000 in academic settings and $400,000–$650,000 in employed health system, cancer center, and private gynecologic oncology practices. The specialty is predominantly employed at cancer centers and academic medical centers — the multimodal (surgical + chemotherapy) scope requires oncology pharmacy infrastructure, and the surgical complexity (cytoreductive surgery, HIPEC, pelvic exenteration) demands Level I or NCI-accredited cancer center support.

Income by practice setting

• Academic gynecologic oncology (NCI-designated cancer center): $350,000–$580,000; complex surgical oncology (radical hysterectomy, debulking, exenteration); ovarian cancer chemotherapy management (carboplatin/paclitaxel, PARP inhibitor maintenance); research in ovarian cancer biology, uterine cancer prevention, cervical cancer disparities; GOG and NRG Oncology clinical trial participation; NCI R01 and K award supplement income; fellowship training program oversight
• Employed community cancer center: $400,000–$620,000; full surgical scope for GYN malignancies; medical oncology for GYN cancers (chemo, PARP inhibitors, immunotherapy); robotic surgery program; strongest volume growth in this setting as community cancer centers build GYN oncology service lines to compete with academic referral networks
• Regional comprehensive cancer center (ACS Commission on Cancer accredited): $420,000–$650,000; highest-compensation employed setting for GYN oncologists outside major academic centers; volume-driven wRVU production bonus; robotic and complex open GYN oncology scope; chemotherapy administration in-house adds to patient management billing
• Private gynecologic oncology group (rare but exists): $500,000–$800,000; independent practices that contract with multiple hospitals; primarily outpatient surgery and chemotherapy infusion; PARP inhibitor and bevacizumab prescribing generates buy-and-bill income; very few truly independent GYN oncology practices exist outside of Texas, Florida, and a few other markets with physician-owned cancer centers

Procedure-level billing: surgical

• Total laparoscopic hysterectomy (TLH) for endometrial cancer: CPT 58570 (TLH) / 58571 (with bilateral salpingo-oophorectomy + removal of tube/ovary); professional fee $3,000–$5,500; early-stage endometrial cancer; robotic-assisted TLH (CPT 58571 with robotic modifier) growing rapidly for GYN oncology; BSO required for staging; sentinel lymph node mapping (CPT 38900) increasingly standard
• Radical hysterectomy (Type III Wertheim): CPT 58210 (abdominal radical) / 58200 (with bilateral pelvic lymph node dissection); professional fee $4,000–$7,500; cervical cancer (stage IB1–IIA); parametrial, upper vaginal, and paracervical tissue removal with pelvic lymphadenectomy; robotic radical hysterectomy (same codes with robotic modifier) growing but LACC trial controversy regarding open superiority ongoing
• Radical trachelectomy: CPT 57548; professional fee $3,500–$6,500; fertility-sparing radical surgery for early cervical cancer (≤2 cm); robotic-assisted growing; abdominal vs. vaginal approach; specialized procedure concentrated at major GYN oncology programs treating young women with cervical cancer
• Cytoreductive surgery for ovarian cancer (primary debulking): CPT 58943 (bilateral salpingo-oophorectomy + hysterectomy for ovarian cancer); professional fee $4,000–$8,000 for base procedure; add-on codes for omentectomy (CPT 49255), peritoneal stripping (CPT 49203–49205), bowel resection (CPT 44204/44140), diaphragm stripping (CPT 39599/unlisted), splenectomy (CPT 38100-38102); complex maximal debulking surgeries for stage III/IV ovarian cancer can generate total professional fee billing of $8,000–$20,000+ when all add-on procedures are coded
• Interval debulking surgery (IDS): Same CPT codes as primary debulking; performed after 3 cycles of neoadjuvant platinum-based chemotherapy; growing adoption as EORTC 55971 and CHORUS trials supported NACT → IDS as equivalent to primary surgery for most advanced ovarian cancer cases
• HIPEC (Hyperthermic Intraperitoneal Chemotherapy): CPT 96522 (chemotherapy administration, intraperitoneal); combined with cytoreductive surgery (above); professional fee for HIPEC administration $1,000–$2,500 on top of surgical fee; OVHIPEC-1 trial supported HIPEC in interval debulking for ovarian cancer; growing adoption at comprehensive cancer centers; requires specialized perfusion pump team and cisplatin intraperitoneal chemotherapy delivery
• Pelvic exenteration: CPT 45126 (posterior exenteration) / 47710 (total exenteration); professional fee $8,000–$18,000; en bloc resection of pelvic organs for locally recurrent or advanced cervical and vaginal cancer; rare procedure; highest-complexity and highest-RVU single surgery in GYN oncology; concentrated at major pelvic surgery programs with colorectal surgery, urology, and plastic surgery collaboration
• Vulvectomy (radical): CPT 56630 (partial) / 56631 (radical) + CPT 38760-38765 (bilateral inguinal-femoral lymph node dissection); professional fee $3,000–$6,000; vulvar cancer surgery; sentinel lymph node biopsy growing as alternative to full inguinofemoral dissection in early-stage disease (CPT 38900)
• Colposcopy with biopsy: CPT 57452 (colposcopy without biopsy) / 57454 (with biopsy) / 57455 (with LEEP); professional fee $200–$600; high-volume clinic procedure for cervical dysplasia management; LEEP (loop electrosurgical excision procedure, CPT 57522) $400–$800
• Ovarian cystectomy / salpingectomy: CPT 58661 (laparoscopic removal of adnexal structures) / 58770 (salpingostomy); professional fee $1,500–$3,000; ovarian masses requiring surgical management; benign vs. malignant determination drives pathology management decisions

Medical oncology billing: chemotherapy and PARP inhibitors

• Chemotherapy administration (IV infusion): CPT 96413 (1 hour) + 96415 (additional hour); $150–$350 professional fee per session; carboplatin/paclitaxel q3 week for ovarian cancer; physician oversight billing; chemotherapy drug cost billed separately (J-codes for carboplatin, paclitaxel, bevacizumab, gemcitabine)
• Bevacizumab (Avastin) administration: CPT 96413; J-code J9035; $400–$600 professional/administration fee per cycle; first-line combination (carboplatin/paclitaxel/bevacizumab → bevacizumab maintenance) and recurrent ovarian cancer; buy-and-bill bevacizumab drug cost $2,500–$5,000/cycle with ASP-based margin in physician-owned infusion centers
• PARP inhibitor prescribing (olaparib, niraparib, rucaparib, veliparib): Oral prescriptions dispensed through specialty pharmacy — no buy-and-bill; physician prescribing generates E&M billing for ongoing toxicity management, CBC monitoring, and dose adjustment; growing volume as PARP inhibitors become standard maintenance therapy for all stages of ovarian cancer following PRIMA, SOLO-1, and PAOLA-1 trials
• Pembrolizumab (Keytruda) for MMR-deficient endometrial cancer: CPT 96413; J-code J9271; IV infusion every 3 or 6 weeks; FDA approved for first-line MMR-deficient/MSI-H advanced endometrial cancer (RUBY trial); drug cost $10,000–$15,000/cycle; physician administration and monitoring billing

Geographic variation in gynecologic oncologist compensation

• NCI-designated cancer centers (MD Anderson, Memorial Sloan Kettering, Mayo, Cleveland Clinic, MSKCC): $370,000–$600,000; highest complex GYN oncology case concentration; GOG/NRG clinical trial site activity; academic prestige; NCI R01 supplement income significant for investigator-clinicians; largest ovarian cancer cytoreductive surgery volume nationally
• Major regional cancer programs and community cancer centers: $420,000–$650,000; employed at Commission on Cancer accredited programs; growing robotic GYN oncology; PARP inhibitor prescribing volume; strong endometrial cancer (endoscopic/robotic hysterectomy) and ovarian cancer volume; NACT + IDS growing at community programs
• Sun Belt markets (FL, TX, AZ, GA): $430,000–$660,000; aging population with high GYN malignancy burden; Moffitt Cancer Center (FL), MD Anderson (TX), and Huntsman (UT) program influence; strong private cancer center market in FL and TX; high employed income environment
• Rural and critical access markets: $380,000–$580,000; significant access gap for GYN oncology specialty care; rural patients with GYN cancers travel to urban centers for surgery; teleoncology and collaborative care models growing; NHSC and rural health center programs available for shortage-area commitments

What we see at Ava Health

Gynecologic oncology is in the midst of a treatment paradigm shift driven by PARP inhibitors, immunotherapy, and antibody-drug conjugates (mirvetuximab soravtansine/ELAHERE for FRα-positive ovarian cancer) that is changing the medical oncology practice of GYN oncologists as rapidly as robotic surgery changed their operative practice. Candidates in our network who are pursuing GYN oncology positions consistently prioritize cancer center volume and complexity — particularly ovarian cancer cytoreductive surgery volume — over compensation when evaluating their first attending position. For cancer centers recruiting GYN oncologists, the robotic surgery infrastructure and the ovarian cancer surgical program (whether they offer primary debulking, NACT + IDS, HIPEC, and recurrence management) is the most important differentiator in candidate attraction. The GYN oncologists who are happiest in their positions are those who feel they can do the full scope of their training at their institution — and those who feel constrained by program volume or infrastructure are the most likely to seek other opportunities.

Related: OB/GYN Salary Guide, Hematologist-Oncologist Salary Guide, Colorectal Surgeon Salary Guide, Radiation Oncologist Salary Guide.