Neurologist Salary Guide 2026: Pay by Subspecialty, EMG Revenue & Neurointerventional

Neurology spans one of the widest compensation ranges of any physician specialty — from the $240,000s for pediatric neurologists at academic children's hospitals to over $700,000 for neurointerventional specialists performing mechanical thrombectomy for acute stroke. The primary income variable across neurology subspecialties is the degree of procedural work: purely cognitive subspecialties (headache, MS, behavioral neurology) cluster in the $270,000–$400,000 range, while procedurally active subspecialties (neurointerventional surgery, EMG-integrated neuromuscular) can reach $450,000–$700,000+. This guide covers salary benchmarks by subspecialty and employment model, with detail on EMG revenue, botulinum toxin income, MS biologic prescribing economics, and the neurointerventional compensation tier.

Neurologist salary by subspecialty

• Neurointerventional surgery / interventional neurology: $450,000–$700,000+; the highest-paid neurology subspecialty; image-guided catheter-based procedures — mechanical thrombectomy for acute ischemic stroke, intracranial aneurysm coiling, carotid stenting, AVM embolization; requires neurointerventional fellowship (or neurosurgery or neuroradiology training pathway); high call burden; stroke center 24/7 coverage drives premium
• Vascular neurology / stroke neurology: $300,000–$450,000; acute stroke management, TIA workup, stroke prevention clinic; most vascular neurologists in hospital-employed models covering stroke programs; tPA/thrombectomy decision-making; call premium adds to base
• Epilepsy / epileptologist: $300,000–$430,000; inpatient epilepsy monitoring unit (EMU) management, EEG interpretation, seizure surgery evaluation, vagal nerve stimulator and responsive neurostimulation (RNS) programming; EEG reading adds procedure-adjacent income
• Movement disorders (Parkinson's, DBS): $295,000–$440,000; Parkinson's disease, essential tremor, dystonia, Huntington's disease; deep brain stimulation (DBS) programming adds significant clinical complexity and time; DBS-experienced movement disorder neurologists are highly recruited by academic and private neurology programs
• Multiple sclerosis specialist: $280,000–$400,000; disease-modifying therapy management (natalizumab, ocrelizumab, ofatumumab, alemtuzumab, siponimod); biologic infusion programs for MS patients (ocrelizumab is IV, generating buy-and-bill margin for practices managing the infusion); comprehensive MS centers at academic medical centers
• Neuromuscular / EMG specialist: $285,000–$410,000; ALS, myasthenia gravis, CIDP, Guillain-Barré, muscular dystrophy, polyneuropathy; EMG/NCS generates significant wRVU and procedural income (same EMG economics as in PM&R — $100,000–$175,000 additional income for active EMG practitioners)
• Headache / migraine specialist: $270,000–$380,000; chronic migraine management, cluster headache, NDPH; botulinum toxin (Botox) for chronic migraine is a significant revenue stream for headache neurologists managing high-volume migraine populations; monoclonal antibody CGRP antagonists (erenumab, fremanezumab, galcanezumab) are self-injectable and do not generate in-office buy-and-bill
• Sleep medicine neurologist (fellowship-trained): $270,000–$380,000; polysomnography interpretation, CPAP management, narcolepsy and RBD management; some sleep neurologists operate sleep lab programs with technical component revenue
• General neurology (employed): $280,000–$400,000; broad clinical neurology; the primary recruitment demand segment; cognitive clinic, gait disorders, peripheral neuropathy, general neurological consultation; EMG adds income if practiced
• Academic neurology: $250,000–$380,000; medical school faculty across subspecialties; NIH-funded translational neuroscience, clinical trials in ALS, MS, Alzheimer's disease; lower nominal pay but grant supplementation for active investigators
• Neuro-oncology: $320,000–$480,000; primary brain tumor management (glioblastoma, lower-grade glioma, CNS lymphoma), leptomeningeal disease, brain metastases; tumor board participation; collaboration with neurosurgery and radiation oncology; academic medical center and comprehensive cancer center concentration
• Behavioral neurology / neuropsychiatry: $260,000–$370,000; dementia evaluation, TBI cognitive rehabilitation, frontotemporal dementia, Lewy body disease; often overlaps with geriatric neurology; memory center program participation
• Pediatric neurology: $240,000–$360,000; lowest-paying neurology subspecialty; pediatric epilepsy, cerebral palsy, neurodevelopmental disorders, pediatric headache; children's hospital and academic center concentration; significant shortage nationally

EMG and nerve conduction study income in neurology

EMG/NCS is the most accessible procedural income addition for clinical neurologists:

• wRVU contribution: A complete EMG/NCS study (CPT 95860–95937 series) generates 3–6 wRVUs per patient depending on muscles and nerves studied; a neurologist performing 10–15 EMG studies/week adds 2,500–4,000 wRVUs/year above the E&M baseline
• Income at $48/wRVU: 3,000 additional wRVUs × $48 = $144,000 in additional productivity pay; the combination of general neurology E&M volume and active EMG practice can push total productivity compensation well above the median for the specialty
• Neuromuscular fellowship integration: Neuromuscular fellowship training includes the most intensive EMG exposure; neuromuscular neurologists are the most productive EMG practitioners but general neurologists who add EMG competency during residency or post-training can access the same billing structure

Botulinum toxin revenue in neurology

Botulinum toxin (onabotulinumtoxinA / Botox) is FDA-approved for chronic migraine, cervical dystonia, limb spasticity, blepharospasm, and hyperhidrosis — each creating buy-and-bill revenue opportunities for neurologists who administer it in-office:

• Chronic migraine (Botox for CM): 155 units every 12 weeks per patient; J0585 J-code billing; at ASP pricing, the margin per migraine patient per treatment cycle is $200–$600 depending on payer; a headache neurology practice managing 50 chronic migraine patients on Botox generates $50,000–$150,000/year in drug margin
• Cervical dystonia / spasticity: Higher unit doses (300–400 units) per session; larger margin per patient; spasticity management practices (MS, stroke, TBI populations) can generate significant Botox buy-and-bill revenue with appropriate patient volume
• Practical infrastructure: Botulinum toxin storage (refrigeration protocol), J-code billing, and payer prior authorization workflows are manageable for most neurology practices; buy-and-bill for Botox has a lower operational barrier than chemotherapy or biologic infusion programs

MS biologic infusion (ocrelizumab)

Ocrelizumab (Ocrevus), the anti-CD20 monoclonal antibody for relapsing and primary progressive MS, is administered IV every 6 months in an infusion setting. MS specialists managing patients on ocrelizumab have the option of in-office infusion with buy-and-bill margin:

• Per-infusion drug cost and margin: Ocrelizumab at full dose (600 mg) has an ASP above $30,000/infusion; ASP + 6% commercial margin or variable commercial markup creates meaningful per-patient drug revenue for infusion-equipped MS practices
• Logistical requirements: IV infusion nursing, allergic reaction monitoring protocol, and infusion space are required; practices managing 30+ ocrelizumab patients generate significant infusion revenue; some MS programs partner with infusion suites to handle logistics while retaining drug procurement margin

Geographic variation in neurology compensation

• Coastal academic centers (NYC, Boston, LA, San Francisco): $285,000–$420,000 employed/academic; highest neurology specialist density; subspecialty training program locations; research supplement for active investigators
• Sun Belt (FL, TX, AZ): $300,000–$470,000; aging population with high neurology demand; stroke program growth; private neurology group presence; no state income tax in FL and TX enhances take-home
• Midwest: $275,000–$420,000; strong academic neurology (Mayo Clinic, University of Minnesota, Northwestern, Ohio State); community neurology demand high in mid-size cities
• Rural / shortage markets: $290,000–$430,000 base + shortage-area premium; rural hospitals significantly underserved in neurology coverage; teleneurology has expanded stroke care access but not replaced in-person neurologist demand for movement disorders, epilepsy monitoring, and complex workups

What we see at Ava Health

General neurology is one of our higher-volume physician recruitment categories — demand is consistent across health systems of all sizes, and the subspecialty diversity within neurology means we regularly work with candidates ranging from general neurologists seeking their first post-residency position to subspecialty fellowship graduates (neurointerventional, movement disorders, epilepsy) in highly competitive markets. The EMG income differentiator is one we surface routinely for general neurologists evaluating offers — a position that actively supports EMG practice with appropriate time allocation and productivity recognition is worth $80,000–$150,000 more in annual income than a position that technically permits EMG but structures it as a productivity drain. We help candidates assess not just the offer headline but the operational conditions that determine whether the stated income potential is actually achievable.

Related: Internal Medicine Physician Salary Guide, Neurosurgeon Salary Guide, PM&R Physician Salary Guide, Psychiatrist Salary Guide.