2026 Transplant Surgeon Salary Guide: Liver, Kidney & Pancreas Transplant Compensation

Transplant surgery is one of the most demanding and most compensated surgical subspecialties in medicine. Abdominal organ transplant surgeons — focused on kidney, liver, and pancreas transplantation — operate under a combination of on-call surgical urgency (deceased donor organs become available unpredictably, requiring immediate procurement and implantation), technical complexity (hepatobiliary and vascular reconstructions in the setting of portal hypertension and coagulopathy), and the weight of recipient care that begins with organ evaluation and continues years post-transplant. Total cash compensation in 2026 runs from $450,000 to $900,000+, with the range driven by transplant volume, academic vs. community setting, call intensity, and whether the surgeon's scope includes procurement surgery (which requires travel to procuring hospitals).

Salary overview by practice setting

• Academic transplant center (major volume program): $450,000–$700,000; NIH NIDDK/NIAID transplant research funding; ASTS fellowship training; transplant immunology and outcomes research; PSLF-eligible employment; programs at UCSF, Pittsburgh, Northwestern, Mayo, Houston Methodist, Emory, and Michigan anchor the academic transplant landscape
• Community transplant center (hospital-employed, high volume): $550,000–$900,000; UNOS-certified program without academic affiliation; higher compensation floor to offset lack of research/academic mission; wRVU-based incentive on top of base; strong call stipend structure; some programs offer productivity bonuses tied to program volume growth
• Multi-organ transplant (liver + kidney + pancreas scope): $600,000–$900,000; surgeons with breadth across all three abdominal organ transplant types command the highest compensation; organ-specific subspecialization (kidney-only) at lower end of range; hepatobiliary + liver transplant scope is most valued by program medical directors building comprehensive abdominal transplant services
• Deceased donor procurement surgeon (organ procurement organization): $400,000–$650,000; OPO-employed or hospital-contracted procurement surgeons; national and regional travel for recovery procedures; 24/7 on-call model; different lifestyle than implanting surgeon; key role in the transplant ecosystem

Fellowship pathway

Abdominal organ transplant surgery requires completion of a general surgery residency (5 years), typically followed by a hepatobiliary surgery or transplant fellowship (1–2 years). ASTS (American Society of Transplant Surgeons) fellowship accreditation is the benchmark, with transplant surgery fellowship typically covering kidney, liver, and pancreas transplantation plus living donor surgery (living donor nephrectomy for kidney, hepatic lobe resection for living donor liver transplant). Fellowship-trained transplant surgeons are credentialed by UNOS (United Network for Organ Sharing) for transplant surgery at UNOS-certified transplant centers — a credentialing requirement that can create switching friction when changing programs.

Procedures and CPT billing

Transplant surgery billing combines procurement procedures, implantation surgery, and post-transplant follow-up. Key codes:

• Kidney transplantation (deceased donor): CPT 50360; professional fee $4,000–$8,000; 20.5 wRVU; standard renal allograft implantation; vascular anastomosis to iliac vessels (end-to-side or end-to-end); ureteroneocystostomy; 3–4 hour case; Medicare reimburses at the highest-wRVU tier for transplant
• Kidney transplantation (living donor): CPT 50360 (recipient) + separate procurement code; professional fee $5,000–$9,000 for the recipient procedure; living donor nephrectomy (CPT 50547 laparoscopic) or open (CPT 50300) generates separate professional fee for procurement surgeon
• Donor nephrectomy — laparoscopic (living): CPT 50547; professional fee $2,500–$5,000; 16.2 wRVU; minimally invasive procurement from living donor; standard of care at high-volume programs; robotic-assisted living donor nephrectomy emerging
• Liver transplantation (deceased donor — whole organ): CPT 47135; professional fee $8,000–$15,000; 40.5 wRVU; one of the highest-wRVU procedures in all of surgery; 6–12+ hour case; piggyback vs. conventional (caval replacement) technique; venovenous bypass at some programs; hepatic artery, portal vein, inferior vena cava, and bile duct reconstruction; biliary reconstruction (Roux-en-Y choledochojejunostomy, CPT 47760, for duct-to-duct unavailable situations)
• Liver transplantation (living donor — recipient procedure): CPT 47135 with living donor modifier; professional fee $8,000–$16,000; right or left lobe graft; more complex vascular and biliary reconstruction than deceased donor; requires two surgical teams operating simultaneously (donor hepatectomy + recipient hepatectomy)
• Living donor hepatectomy (right lobe): CPT 47122; professional fee $4,000–$8,000; 28.2 wRVU; right hepatectomy from living donor; highest-risk living donor procedure in transplantation; requires experienced hepatobiliary surgical team; ethical constraints on donor selection are stringent
• Pancreas transplantation (simultaneous pancreas-kidney, SPK): CPT 48554 (pancreas transplant allograft); professional fee $5,000–$10,000; 35.0 wRVU; typically simultaneous with kidney transplant (SPK) for type 1 diabetic patients with end-stage renal disease; bladder-drained vs. enteric-drained exocrine drainage; systemic vs. portal venous drainage; complex multisystem operative planning
• Organ procurement (kidney, liver) — deceased donor recovery: CPT 01990 (physician services for organ procurement); professional fee varies by organ and procurement organization contract; procurement surgeons may be OPO-employed or on fee-for-service contract; travel to procuring hospital required; night/weekend call generates the majority of procurement volume
• Post-transplant follow-up E&M: CPT 99213–99215 (outpatient), 99232–99233 (subsequent hospital); transplant surgeons co-manage recipients through the early post-transplant period (tacrolimus dosing, rejection surveillance, biopsy interpretation); transplant hepatology or transplant nephrology handles long-term outpatient management in most programs
• Liver biopsy (post-transplant): CPT 47000 (percutaneous liver biopsy); professional fee $500–$900; rejection surveillance; some transplant surgeons perform their own biopsies; others defer to interventional radiology
• Arteriovenous fistula creation (pre-transplant): CPT 36821; professional fee $1,500–$2,500; kidney transplant surgeons at some programs perform AV fistula creation for dialysis access to maintain their vascular skillset and supplement income

Call structure and lifestyle implications

Transplant surgery has the most demanding call structure of any surgical subspecialty. Deceased donor organs become available at any hour, with procurement and implantation logistics requiring immediate mobilization. A busy transplant program performing 100–200 kidney transplants and 50–100 liver transplants per year generates transplant calls 2–4 nights per week. Compensation structures accommodate this reality:

• Call stipend: $50,000–$150,000 annually added to base for transplant call coverage; exact amount depends on program volume, call share among attending surgeons, and number of transplant surgeons sharing call
• Call sharing: Programs with 3–5 transplant surgeons share call (1 in 3 or 1 in 5); smaller programs (1–2 transplant surgeons) impose crushing call burden; surgeons evaluating new positions weight call share heavily
• Geographic proximity: Transplant surgeons must live within 30–60 minutes of the transplant center to respond to emergency calls; this geographic constraint limits residential flexibility

Geographic variation

• Major volume academic transplant centers (UCSF, Pittsburgh, Northwestern, Mayo, Emory, Houston Methodist, Michigan, Vanderbilt): $460,000–$720,000; highest-complexity case mix; research infrastructure; fellowship training prestige
• Regional community transplant centers (non-academic, high volume): $600,000–$900,000; better compensation than academic; mission focused on volume and outcomes; growing investment in liver transplant programs by large regional health systems
• Emerging transplant programs (new UNOS certification or building volume): $650,000–$900,000+; higher compensation offered to attract established transplant surgeons to build or grow programs; higher risk (program maturity and volume) but higher upside

What we see at Ava Health

Transplant surgeons are among the most difficult subspecialists to recruit because of UNOS credentialing friction (established volume requirements tied to the surgeon's specific transplant history), call structure constraints (must be within 30–60 minutes of the center), and the intense relationship between transplant surgeons and the multidisciplinary team (transplant hepatology, transplant nephrology, transplant coordinators, transplant pharmacists) that takes years to build. The physicians most open to outreach are those at programs where call burden is excessive (1 or 2 attending surgeons sharing all transplant call at a busy program), where research support is absent but the surgeon has academic interests, or where a program is growing and the surgeon's leadership role and compensation have not kept pace with program volume growth.

Related: General Surgeon Salary Guide, Hepatologist Salary Guide, Vascular Surgeon Salary Guide, Colorectal Surgeon Salary Guide.