The PhysEmp Salary Report: June 2026 — A Cross-Specialty Market Overview
The single most interesting signal in this month’s dataset is geographic inversion: the highest published pay across multiple specialties is not on the coasts but in small‑ and mid‑market zip codes — Normal, IL ($850k radiology); Sterling/Dekalb, IL (interventional cardiology up to $990k); Springfield, MO ($700k urology); and several Kentucky listings punching $900k for cardiology noninvasive and pulmonary roles. That pattern repeats enough to be structural, not anecdotal: scarcity in second‑ and third‑tier metros is buying seven‑figure checks and dragging national averages in ways that candidates and recruiters still routinely miss.
Overall the market remains bifurcated: a visible, high‑pay tail driven by procedural scope, locum/hourly premiums, and rural scarcity — and a wide, quiet middle where most employed roles cluster and where transparency is still the limiting factor in candidate flow. Below I synthesize the cross‑specialty contours that you will not see reading single reports in isolation, and I hyperlink each specialty’s detailed report the first time it’s discussed so you can drill down.
Primary Care & General
Primary care and generalist medicine remain abundant but unevenly paid. Family Medicine (2,636 listings) sits with a national average band around $257,667–$289,094, while Internal Medicine averages roughly $263,431–$301,591 across 1,559 listings. The broader primary‑care bucket — including Primary Care Physician listings — clusters at $265,509–$306,113. Hospitalists (Hospitalist) tilt higher: disclosed averages center near $311,947–$346,352, but ceilings in underserved regional markets (Corning, NY listed up to $600k) create large intra‑state spreads.
Urgent care (Urgent Care) and Med‑Peds (Med‑Ped) sit between traditional primary care and procedural work, with urgent care averaging about $292,644–$320,653 and Med‑Peds ~ $248k–$287k. Geriatrics is small and opaque (67 listings, four disclosures; national avg ~ $212,500–$268,750).
Pressure points: (1) volume ≠ premium — high listing counts in CA, NY, FL often pay at-or-below the national midpoint; (2) rural/secondary markets consistently pay premiums when systems must recruit; (3) transparency matters most in primary care because candidates can compare across hundreds of listings quickly.
Medical Specialties
The medical bucket is the widest and most instructive. Procedural specialties and those with high revenue capture remain at the top of the visible distribution: Radiology shows an average band of $548,086–$619,794 with the top disclosed listing at $850,000 (Normal, IL). Interventional cardiology (Cardiology‑Interventional) posts an average of ~$665,484–$735,358 and a published ceiling near $990,000 (Sterling, IL). Gastroenterology centers around $489,765–$543,204 with repeat $600k+ listings in scarcity markets; general Cardiology averages $473,172–$553,296.
On the cognitive side, averages compress: Psychiatry runs near $294,975–$336,366 while Physiatry clusters tightly at $344,548–$394,106. Emergency Medicine (avg ~ $460,164–$489,327) and Dermatology (avg ~$419,266–$546,223) are instructive hybrids: dermatology shows extreme bifurcation (APP floors near $120k, physician ceilings up to $1M in Arizona) while emergency medicine’s band centers near half a million but is very poorly disclosed (5.7% disclosure).
Key divides: procedural scope still buys premium pay, but not always in expected places; locum/hourly arrangements and ownership/ASC participation are inflating ceilings in radiology, GI, and dermatology; cognitive specialties are more price‑stable but show large inter‑state variance tied to scarcity (e.g., Kentucky/Idaho psychiatric listings at $400k vs. low outliers in ND).
Surgical Specialties
Surgical pay remains top‑tier but the map flips expectations. Overall surgery averages near $393,540–$455,033, Neurosurgery shows an elevated published average ($756,250–$818,750) driven by four disclosed listings (Illinois/Missouri/Ohio) and therefore not representative of the silent majority, and Otolaryngology averages $507,541–$561,713. Urology sits around $479,335–$516,737 with the top listing in Springfield, MO at $700k.
Surprise: the highest disclosed surgical checks are often in the Midwest or smaller metros (Long Island and select NY towns aside), not coastal academic centers. Transparency is low in surgery (≈11% disclosed), which amplifies the “call us” employers and advantages whoever posts a number first.
Advanced Practice Providers (NPs & PAs)
The APP markets are large, distinct, and internally bifurcated. Nurse Practitioners (1,748 listings; disclosed avg ~ $143,947–$186,390) and Physician Assistants (1,229 listings; disclosed avg ~ $150,881–$191,561) occupy adjacent bands, yet both show wide regional arbitrage: Tennessee NP listings top at $291,200 while Alabama NP listings can start near $90,000. PAs report ceilings into the mid‑six figures and isolated $400k outliers (likely procedural/locum/ownership), but the modal APP job remains six figures in the $120k–$200k band.
Context: APPs are not mini‑physicians — their markets are driven by scope laws, system staffing strategies, and specialty overlays. Expect continued divergence where procedural APP roles and rural incentives produce outlier ceilings while coastal saturation compresses baselines.
Cross‑Cutting Observations (what to watch)
1) Geographic inversion is real and repeatable. Multiple specialties show the same pattern: the top published pay frequently sits in Midwest/secondary‑market zip codes (IL, MO, KY, ID, TN) rather than in NYC, SF, or Boston. That’s active arbitrage — systems in less desirable places are buying talent with cash.
2) Transparency remains a structural choke point. Many specialties publish salary on <20% of listings (Radiology 6.4%, Emergency Medicine 5.7%, Surgery ~10.9%, Interventional Cardiology 9%, Hospitalist 10.7%). The visible sample overweights employers comfortable advertising high numbers and biases candidate perception of the market.
3) Volume ≠ pay. High listing counts (CA, NY, FL) often correlate with mid‑ or lower‑range disclosed pay; the rare state that combines volume and pay (e.g., North Carolina for NPs, Florida/GI in some segments) is the exception, not the rule.
4) Procedural premium persists but is nuanced. Radiology, interventional cardiology, GI, and procedural dermatology cluster at the top — yet locum hourly structures and ownership economics are inflating ceilings. Always read structure: W‑2 base vs. hourly/ASC share are different markets.
5) Part‑time/locum entries distort floors. Several specialties show artificially low floors driven by part‑time or locum listings (GI $25k floor; Radiology and Emergency Medicine low‑end hourly artifacts). Treat extreme lows as listing‑type artifacts, not full‑time benchmarks.
Watch next month whether employers in high‑volume coastal markets begin to publish compensation more consistently. If transparency rates tick up, we’ll see whether those markets truly respond with higher posted wages — or whether the premium continues to live in the places most systems cannot staff without paying more.
— PhysEmp Market Intelligence
