Vascular Surgeon Salary Guide 2026: Compensation by Setting, Subspecialty & Region

Vascular surgery is one of the most acutely undersupplied surgical specialties in American medicine. The specialty manages the full spectrum of arterial and venous disease — from outpatient venous ablation and dialysis access maintenance to emergency ruptured aortic aneurysm repair. The combination of high case complexity, demanding call coverage, and a training pipeline that produces fewer than 200 vascular surgeons per year nationally has pushed compensation consistently upward, particularly in rural and community markets where a vascular surgeon is the only one available for hundreds of miles. This guide covers what vascular surgeons earn in 2026.

Vascular surgeon compensation by setting

Employed vascular surgery (hospital or health system)

Most newly trained vascular surgeons enter health system employment, where they receive a base salary, call support from the hospital's infrastructure, and access to a hybrid operative suite for complex endovascular procedures.

• Base salary (community hospital): $380,000–$520,000
• Total comp with productivity and call stipend: $480,000–$680,000
• wRVU threshold: Typically 6,500–8,500 wRVU/year
• Compensation per wRVU above threshold: $48–$68
• Call stipend: Vascular call is high-acuity — ruptured AAA, acute limb ischemia, and aortic dissection are true surgical emergencies. Call stipends run $2,000–$8,000/week at hospitals where vascular surgeons cover primary emergency vascular. Sole-coverage markets command the upper range.
• Sign-on: $50,000–$150,000; rural and sole-coverage positions frequently exceed $150,000

Private practice vascular surgery

Private vascular surgery practices — particularly those with office-based lab (OBL) or ASC access for endovascular procedures — capture facility fees that generate income well above the professional fee alone. The in-office endovascular lab has transformed vascular surgery practice economics over the past decade.

• Associate / first year: $420,000–$580,000
• Partner (established group, no OBL): $580,000–$780,000
• Partner (established group with office-based lab): $700,000–$1,000,000+
• High-volume dialysis access + OBL practice: $750,000–$1,100,000
• OBL/ASC facility fee distributions: Angioplasty, stenting, dialysis access procedures done in an OBL rather than a hospital generate facility fees for physician owners — per-procedure economics are substantially better than hospital-based equivalent

Academic vascular surgery

• Assistant professor: $380,000–$520,000
• Associate professor: $450,000–$600,000
• Division chief / department chair: $650,000–$900,000
• Major academic vascular (thoracic aortic program, level I trauma with complex vascular): $700,000–$1,100,000

Open vs endovascular: the two-practice economics

Modern vascular surgery is a hybrid discipline — vascular surgeons perform both open surgical reconstruction and catheter-based endovascular procedures. The compensation economics differ:

• Open procedures: High wRVU per case (open AAA repair: 30–50 wRVU; femoral-popliteal bypass: 15–25 wRVU; carotid endarterectomy: 12–18 wRVU). Long OR time, high technical complexity, significant malpractice exposure for complications.
• Endovascular procedures: Moderate wRVU per case (EVAR: 25–40 wRVU; peripheral angioplasty/stenting: 8–15 wRVU). Shorter procedure time, fluoroscopy exposure, radiation protection concerns. In OBL setting, facility fees dramatically increase total revenue per case.
• Office-based endovascular (lower extremity interventions): The fastest-growing segment of vascular surgery economics. A vascular surgeon with an OBL performing 5 peripheral angioplasty cases per week in their own facility generates $200,000–$400,000/year in additional facility fee income versus the same cases done at a hospital.

Dialysis access surgery

Dialysis access — arteriovenous fistula creation, AV graft placement, and maintenance interventions (thrombectomy, angioplasty) — is a high-volume component of vascular practice that drives consistent revenue through procedure repetition. The US ESRD (end-stage renal disease) population generates perpetual demand for access interventions.

• Fistula creation (office/outpatient OR): 7–15 wRVU; scalable procedure with short OR time
• Graft thrombectomy + angioplasty (OBL): Recurring revenue as grafts repeatedly clot and require intervention; high-volume practices see the same patients multiple times per year
• Practices with high dialysis access volume + OBL: Add $200,000–$400,000/year in procedure volume vs hospital-only access surgeons

wRVU benchmarks for vascular surgery

Vascular surgery generates high wRVU from complex open procedures and moderate wRVU from high-volume endovascular cases. MGMA benchmarks:

• 25th percentile: ~7,000 wRVU/year
• Median (50th percentile): ~9,500 wRVU/year
• 75th percentile: ~12,500 wRVU/year

Compensation per wRVU in employed vascular surgery: $50–$68. The high per-wRVU rate reflects the specialty's seniority premium and the genuine supply shortage that gives practicing vascular surgeons negotiating leverage.

Locum tenens vascular surgery

Vascular locums are among the highest-compensated in medicine, second to neurosurgery in per-hour rates. The specialty's emergency coverage requirement — ruptured AAA is a true surgical emergency with mortality measured in minutes without intervention — means hospitals must maintain vascular coverage and will pay premium rates for locum coverage during vacancies.

• Elective vascular locum (outpatient + OR, no emergency call): $200–$320/hour
• Hospital vascular with emergency call: $300–$500/hour
• Rural sole-coverage vascular with 24/7 call: $400–$650/hour; $5,000–$9,000/day
• Housing, travel, malpractice: Covered for all placements of 1+ week

Contract red flags in vascular surgery

• Call burden without explicit stipend or cap: Vascular surgery call at a Level I or II trauma center with vascular emergencies is among the most demanding call in surgery. Contracts that don't specify call frequency, per-call stipend, and maximum calls per month leave physicians exposed to unlimited emergency obligation.
• OBL/endovascular lab rights excluded from employment: Health system employers increasingly prohibit employed vascular surgeons from owning or participating in an OBL. If you want OBL access and ownership, clarify this before signing — employment contracts that prohibit OBL participation foreclose the highest-yield economic opportunity in vascular surgery.
• Non-compete covering all vascular services in a multi-county region: In markets where you're one of two or three vascular surgeons, a broad non-compete effectively prevents you from practicing anywhere accessible to your established patient population for years.
• Productivity threshold that assumes full case mix without emergency call credit: Emergency vascular call takes time — being called at 2 AM for a ruptured AAA consumes a full operative day. Contracts should credit emergency call volume in productivity calculations or provide a separate call stipend that compensates for lost elective operative time.

What we see at Ava Health

Vascular surgery is one of our highest-urgency recruiting specialties. The combination of a small training pipeline, high retirement rate among senior vascular surgeons trained before endovascular became standard, and rapidly growing demand from the aging population has created a genuine crisis at community hospitals across the Southeast, Midwest, and rural markets nationwide. Hospitals with unfilled vascular surgery positions lose not just elective vascular revenue but emergency coverage capability — they must transfer ruptured AAA patients to regional centers with each transfer costing the community hospital significant revenue and reputation. For candidates willing to consider non-urban markets, the combination of base salary, call stipend, sign-on, and relocation frequently totals $800,000–$1,100,000+ in first-year compensation.

Related: General Surgeon Salary Guide, Cardiology Salary Guide, Orthopedic Surgeon Salary Guide, Locum Tenens Physician Salary Guide.