OB/GYN Salary by State 2026: Subspecialty Pay, Call Burden, and Top Markets
Ava Health Team||8 min read
OB/GYN remains one of the most demanding medical specialties — with one of the most variable compensation structures, driven primarily by call volume. Median OB/GYN salary reached $362,000 in 2026, with subspecialty fellowships commanding 15-30% premiums.
OB/GYN Subspecialty Benchmarks (2026)
| Subspecialty | Median Base | Top Quartile | Typical Sign-On |
|---|---|---|---|
| General OB/GYN | $362,000 | $445,000 | $40,000–$80,000 |
| Maternal-Fetal Medicine (MFM) | $425,000 | $520,000 | $60,000–$125,000 |
| Gynecologic Oncology | $495,000 | $605,000 | $75,000–$150,000 |
| Reproductive Endocrinology (REI) | $445,000 | $575,000 | $50,000–$125,000 |
| Urogynecology / FPMRS | $415,000 | $505,000 | $50,000–$100,000 |
| Gynecology-Only (no OB) | $310,000 | $385,000 | $25,000–$60,000 |
| Pediatric & Adolescent Gynecology | $340,000 | $415,000 | $30,000–$75,000 |
Top 10 Highest-Paying States for OB/GYN (2026)
| Rank | State | Median Base |
|---|---|---|
| 1 | Wisconsin | $425,000+ |
| 2 | Indiana | $412,000+ |
| 3 | Nebraska | $405,000+ |
| 4 | Oklahoma | $395,000+ |
| 5 | Kentucky | $392,000+ |
| 6 | Iowa | $388,000+ |
| 7 | Missouri | $385,000+ |
| 8 | South Dakota | $382,000+ |
| 9 | North Dakota | $378,000+ |
| 10 | Mississippi | $375,000+ |
Call Structure — The Biggest Pay Lever
OB/GYN call is the most-negotiated item in 2026 contracts. Typical structures:
- 1:3 call (every 3rd night): Premium +$40K-$75K vs 1:6. Brutal but common at small community hospitals.
- 1:5 or 1:6 call: Standard at mid-size hospitals. Sustainable long-term.
- 1:7 or 1:8 call: Large academic centers or big private groups.
- Laborist/nocturnist model: No call; scheduled shifts. $400K-$475K base for experienced OBs. Growing model.
- GYN-only practice: No OB call. Lower base but much higher quality of life.
Private Group vs Hospital-Employed
| Model | Typical Comp |
|---|---|
| Hospital-employed | $360K-$420K base + wRVU bonus |
| Private group (associate → partner) | Year 1-2: $340K-$400K, partner: $450K-$625K |
| Academic OB/GYN | $310K-$380K + teaching time |
| Laborist-only (hospital) | $400K-$475K |
| Subspecialty academic (MFM/GynOnc) | $400K-$510K |
Sign-On + Loan Repayment
- General OB/GYN (urban): $40K-$80K sign-on + $20K relocation
- General OB/GYN (rural): $75K-$150K sign-on + HRSA loan repayment up to $200K
- Subspecialty: $50K-$125K sign-on depending on fellowship
What OB/GYNs Negotiate in 2026
- Call frequency (the #1 lever)
- Malpractice with tail coverage (OB/GYN malpractice is in the top 3 specialties for premium)
- Patient cap per clinic day
- Delivery volume expectations
- Access to OR block time
- RVU bonus threshold and rate
- CME stipend + board recertification
- Parental leave (notably important — OB/GYN has highest % female physicians)
- Productivity thresholds during maternity leave
Ava Health places OB/GYNs across practice models nationwide. Contact us for current openings.