OB/GYN Salary Guide 2026: Pay by Subspecialty — MFM, REI, Gyn-Onc, FPMRS & General OB

Obstetrics and gynecology spans one of the widest subspecialty income ranges in medicine — from general employed OB/GYNs at $330,000–$500,000 to reproductive endocrinology and infertility (REI) specialists running high-volume IVF programs at $600,000–$900,000+. The specialty combines obstetric call coverage (delivering babies at all hours) with gynecologic surgery, office-based procedures, and in advanced subspecialties, complex surgical oncology, high-risk maternal management, and fertility treatment. This guide covers 2026 salary benchmarks across all OB/GYN practice settings and subspecialties, with data on labor and delivery call structure, robotic gynecologic surgery income, in-office procedure revenue, and the economics of the IVF and fertility clinic market.

OB/GYN salary by setting and subspecialty

• Employed general OB/GYN (health system): $330,000–$500,000; salary + productivity bonus; obstetric delivery, prenatal care, well-woman care, office-based procedures, and gynecologic surgery; labor and delivery call coverage required; health system employment growing as OB/GYNs leave private practice due to call burden and malpractice cost; L&D call stipends often paid separately ($2,000–$6,000/month)
• Private practice OB/GYN: $380,000–$580,000; full professional fee retention; practice overhead (malpractice, billing, staff) is the primary cost; private OB/GYNs often share call with group partners to reduce individual burden; ASC ownership for gynecologic surgery cases adds facility fee income
• Maternal-fetal medicine (MFM / perinatology): $420,000–$620,000; management of high-risk pregnancies — preeclampsia, IUGR, multiple gestation, fetal anomalies, preterm labor, maternal medical comorbidities; advanced prenatal diagnosis (amniocentesis, CVS, fetal MRI); intrapartum fetal surveillance; telemedicine maternal consultation expanding access to rural and community hospitals; MFM physicians regularly consulted by OB/GYN practices on complex cases
• Reproductive endocrinology and infertility (REI): $420,000–$700,000; the highest-income OB/GYN subspecialty in most markets; IVF cycle management, egg retrieval, embryo transfer, ovulation induction, sperm retrieval (MESA/TESA/micro-TESE), egg freezing, gestational carrier; direct-pay component is significant (IVF cycles often $15,000–$20,000 per cycle direct-pay with variable insurance coverage); private equity-backed fertility clinic groups (USFF, RMA, Kindbody) have acquired many independent REI practices
• Gynecologic oncology: $480,000–$750,000; surgical management of cervical, uterine, ovarian, vulvar, and vaginal cancers; radical hysterectomy, cytoreductive debulking surgery, sentinel lymph node dissection; chemotherapy prescribing and infusion coordination (buy-and-bill potential for carboplatin/paclitaxel regimens and PARP inhibitors like niraparib, olaparib); one of the highest-paid OB/GYN subspecialties due to surgical complexity and oncology drug revenue
• Female pelvic medicine and reconstructive surgery (FPMRS / urogynecology): $420,000–$650,000; stress urinary incontinence (midurethral sling), pelvic organ prolapse repair, fistula surgery, mesh complication revision, sacral neuromodulation (InterStim); high ambulatory surgical volume; dual board certification through ABOG and AUGS; overlaps with urology (FPMRS urologists also trained in this area)
• Minimally invasive gynecologic surgery (MIGS fellowship): $380,000–$570,000; advanced laparoscopic and robotic surgery for endometriosis, fibroids, and complex gynecologic pathology; myomectomy, hysterectomy, endometriosis resection; AAGL fellowship-trained; robotic surgery certification and da Vinci experience central to practice
• Academic OB/GYN (medical school faculty): $280,000–$420,000; teaching, residency training, research; NIH-funded obstetric outcomes, preterm birth prevention, maternal mortality, reproductive health equity research; lower nominal pay offset by research time and subspecialty case complexity

Labor and delivery call economics

The call burden of obstetric practice is the primary reason many OB/GYNs transition from private practice to employed models:

• Private practice L&D call: In a solo or small group private practice, each physician covers labor and delivery continuously; 24/7 availability for laboring patients creates a lifestyle constraint that drives physician satisfaction data significantly
• Group practice call sharing: Groups of 4–6 OB/GYNs sharing call can achieve 1-in-4 or 1-in-5 call schedules; weekend and holiday call shared across the group; call nights add fatigue and scheduling complexity
• Call stipend (employed): Health systems often pay L&D call stipends separately from base salary: $2,000–$6,000/month for required obstetric call coverage; some large systems pay higher stipends to recruit OB/GYNs who would otherwise choose academic or subspecialty positions with reduced call
• OB hospitalist / laborist model: OB hospitalist programs (physicians dedicated exclusively to laboring patient management, 12–24 hour shifts, no outpatient continuity) pay $250,000–$360,000/year for shift-based coverage; eliminates on-call disruption for outpatient OB/GYNs who partner with OB hospitalists for L&D coverage

Robotic gynecologic surgery revenue

Da Vinci robotic surgery has become central to gynecologic surgical practice, particularly for hysterectomy, myomectomy, and endometriosis resection:

• Robotic-assisted hysterectomy (CPT 58572–58573): Total laparoscopic/robotic hysterectomy; $1,500–$3,000 professional fee; ASC or hospital-based; high-volume robotic gynecologic surgeons attract patient referrals from referring OB/GYNs and family practitioners
• Robotic myomectomy: Fibroid removal with uterine preservation; technically demanding; robotic credential required; $1,800–$3,500 professional fee per case depending on fibroid number and size
• Advanced endometriosis resection: Segmental bowel resection, ureterolysis, bladder resection for deeply infiltrating endometriosis; surgical complexity drives high wRVU; concentrated at MIGS fellowship-trained specialist centers

IVF and REI practice economics

Reproductive endocrinology and infertility is the highest-income OB/GYN subspecialty, driven by the direct-pay and insurance-covered IVF market:

• IVF cycle economics: A fresh IVF cycle (ovarian stimulation, egg retrieval, fertilization, embryo transfer) costs $15,000–$20,000 for self-pay patients; state-mandated IVF coverage (19 states + DC as of 2026) expands insurance-covered volume; practices in high-mandate states have more consistent revenue but lower per-cycle margin than direct-pay markets
• Egg freezing (elective oocyte cryopreservation): $6,000–$10,000 per cycle direct-pay; growing social egg freezing market, especially employer-benefit-funded cycles; add-on storage fees generate recurring revenue
• Embryo banking and genetic testing (PGT-A): Preimplantation genetic testing for aneuploidy adds $3,000–$6,000 per cycle; comprehensive chromosomal screening standard in many U.S. IVF practices; laboratory partner arrangements for PGT
• Private equity in fertility: Large REI practice acquisitions by private equity-backed MSOs (US Fertility, Inception Fertility, RMA, Kindbody) have created a new employment model for REI physicians — typically structured as a combination of employment guarantee, production bonus, and equity rollover; acquisition valuations for established IVF programs have been 6–10× EBITDA

In-office procedure revenue in general OB/GYN

• IUD insertion and removal (CPT 58300/58301): High volume in women's health practices; $150–$400 professional fee per procedure; consistent patient demand drives recurring revenue
• Colposcopy with biopsy (CPT 57454): Cervical cancer screening follow-up; $300–$600 professional fee; common in high-volume OB/GYN practices managing abnormal Pap results
• LEEP (CPT 57461): Loop electrosurgical excision procedure for cervical dysplasia; $600–$1,200 professional fee; office-based or ASC; significant procedure in cervical cancer prevention programs
• Endometrial ablation (CPT 58563): NovaSure, Minerva, or Genesys Gold; in-office or ASC; abnormal uterine bleeding treatment alternative to hysterectomy; $800–$1,500 professional fee plus device cost pass-through
• Office hysteroscopy: Diagnostic and operative hysteroscopy for polyps, submucous fibroids (Myosure), intrauterine adhesions; CPT 58558; office-based with local anesthesia; adds procedural revenue to OB/GYN office

Geographic variation in OB/GYN compensation

• Sun Belt (FL, TX, AZ, GA): $380,000–$620,000; high birth rate, growing population, strong private practice culture; FL and TX no state income tax; fertility clinic demand high in major metros
• Northeast / Mid-Atlantic: $360,000–$560,000; academic medical center presence; strong state-mandated IVF coverage market (NY, CT, NJ, MA expand REI demand); high malpractice costs partially offset higher income
• Midwest: $330,000–$520,000; strong multispecialty group and academic OB/GYN presence; stable demand in mid-size markets
• Rural / underserved: OB/GYN shortage is severe in rural markets — over 60% of U.S. rural counties are "maternity care deserts" with no OB/GYN or hospital obstetric services; some rural hospitals offering $150,000+ in sign-on and relocation support to recruit OB/GYN coverage for L&D reopening programs

What we see at Ava Health

OB/GYN is one of the most consistently urgent physician recruitment categories across our health system clients — L&D call coverage shortages lead to obstetric unit closures at rural and community hospitals, creating direct patient safety consequences that escalate recruiting urgency. For OB/GYN physicians in our network who are evaluating their career options, the subspecialty path (MFM, REI, gyn-onc) is almost universally associated with higher income and lower direct obstetric call burden — but requires an additional 3-year fellowship commitment. For general OB/GYNs seeking employment, understanding the L&D call stipend structure, group call sharing arrangements, and OB hospitalist partnership at prospective employers is often more important than base salary in determining daily quality of life.

Related: Family Medicine Physician Salary Guide, Internal Medicine Physician Salary Guide, Nurse Practitioner Salary Guide, Physician Assistant Salary Guide.