The highest-paying orthopedic surgeon listing in America is in Cape Girardeau, Missouri — a city of 40,000 people along the Mississippi River — offering up to $890,000 annually. Meanwhile, positions in New York and Maryland start as low as $350,000, proving once again that prestige and population density do not pay the mortgage. The national market includes 217 active listings spanning 42 states, with compensation data disclosed in just 32 of them. What emerges is a specialty where geography matters more than reputation, and where a willingness to operate in smaller markets can deliver a quarter-million-dollar premium.
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The Orthopedics Job Market at a Glance

Total listings: 217
Listings with salary data: 32
Full salary range: $350,000 to $975,000
Average salary range: $563,328 to $624,109

The $625,000 spread between floor and ceiling reflects a market segmented by practice setting, subspecialty focus, and willingness to serve underserved areas. The average range sits comfortably above half a million dollars, but the top quartile stretches well into the $700,000s — a gap wide enough to fund a vacation home or a medical school loan payoff in a single year. The data skews toward higher compensation in mid-volume states, where scarcity and patient demand intersect without the overhead drag of major metro markets.

States represented: New York, California, Ohio, Missouri, Florida, Maryland, New Mexico, Pennsylvania, Indiana, Arizona, Maine, Georgia, Kansas, New Hampshire, Wisconsin, Arkansas, North Carolina, Oregon, Michigan, New Jersey, Oklahoma, Minnesota, Idaho, Wyoming, Iowa, Texas, Virginia, Illinois, Kentucky, Washington, South Carolina, Massachusetts, South Dakota, Nevada, Tennessee, Mississippi, Louisiana, Vermont, Alabama, Colorado, West Virginia, and North Dakota.
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How States Stack Up

Overperformers:

Missouri leads the nation with an average range of $737,500 to $757,500, proving that the Midwest can outbid the coasts when it wants your ACL expertise. Kansas offers a flat $700,000 average based on limited disclosure, but the signal is clear: rural need translates to rural pay. Oregon averages $680,000 to $705,000 across two salary-reporting listings, blending quality of life with top-decile compensation. Illinois averages $650,000 to $687,500, a respectable showing for a state that also offers direct flights to anywhere. Kentucky averages $650,000, though only one of its 14 listings disclosed salary — a transparency problem masking what may be a stronger market than the data suggests. New York averages $579,792 to $671,108 across 12 salary-disclosing listings, combining volume with above-average pay in a rare dual threat.

Near-average performers:

California averages $522,667 to $581,333, slightly below the national mean but still within striking distance for physicians prioritizing weather and proximity to venture capital. Florida averages $450,000 based on a single disclosed listing out of 11 total, a figure that undershoots the national average but may appeal to those valuing no state income tax and year-round golf.

Underperformers:

Maryland and Vermont both average $350,000 to $400,000, each based on a single listing — a floor that sits more than $213,000 below the national average low. Ohio averages $383,000 to $449,600, a disappointing showing for a state with five total listings and a cost of living that should allow for better. New Jersey averages $400,000 to $500,000, trailing the national benchmark despite its proximity to high-cost northeastern metros.

Volume leaders:

New York leads all states with 21 listings. Kentucky posts 14. Maine, Florida, and North Carolina each report 11. Oregon and New Mexico each have 10. High volume does not guarantee high pay: Florida’s single disclosed salary sits at $450,000, and Maine disclosed none at all, while Missouri — with just six listings — offers the highest average compensation in the country.
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What This Means If You’re a Physician

If your priority is maximum compensation: Target Missouri, Kansas, and Oregon, where average salaries exceed $680,000 and top listings approach $890,000. The highest-paying position identified is in Cape Girardeau, Missouri, offering $850,000 to $890,000 annually — a figure that reflects both scarcity value and the willingness of rural health systems to pay for stability. Illinois and Kentucky also clear $650,000 on average, though Kentucky’s transparency rate is concerningly low.

If your priority is maximum optionality: New York offers 21 listings and above-average pay, giving you the volume to be selective and the compensation to be comfortable. Kentucky provides 14 listings, though salary opacity means you will need to negotiate blind in most cases.

If your priority is balance: Oregon combines strong compensation ($680,000 to $705,000 average) with 10 available listings and a reputation for livability. California offers eight listings and near-average pay in exchange for climate and cultural access, though the cost-of-living mismatch is real and should be modeled carefully.
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What This Means If You’re a Recruiter

Salary transparency rate: 14.7% (32 of 217 listings disclosed compensation). This is a pipeline problem. Orthopedic surgeons are in demand, highly compensated, and accustomed to clarity. A transparency rate below 15% means you are asking candidates to engage without the information they need to prioritize your opportunity, and in a market this competitive, that is a losing strategy.

Volume-pay misalignments are pronounced. Florida has 11 listings but discloses salary in only one, and that figure sits at $450,000 — well below the national average. Maine has 11 listings and discloses nothing. Kentucky has 14 listings but only one salary data point. If you are recruiting in high-volume, low-transparency states, you will need to lead with lifestyle, partnership track, or surgical volume, because compensation alone will not close the deal if candidates cannot see it.

Missouri, Kansas, and Oregon prove that smaller markets can win on price. If you are recruiting for a rural or mid-sized system, your edge is compensation transparency and speed. Advertise the number, streamline the interview process, and do not assume candidates will wait for you to outbid a metro offer.
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What’s Driving the Numbers

Geography commands a larger premium than prestige. Missouri, a mid-volume state with six listings, offers the highest average compensation in the country, while New York — the volume leader — pays less on average despite higher costs of living. This inversion reflects the scarcity value of orthopedic surgeons willing to practice outside major metros, and it suggests that rural and suburban markets are pricing in retention risk more aggressively than urban systems.

High volume does not correlate with high pay. Florida, Maine, North Carolina, and Kentucky all rank in the top five for job volume, yet none crack the top tier for disclosed compensation. Florida’s single disclosed salary is $450,000. Maine disclosed none. This pattern suggests that volume leaders are either relying on non-compensation differentiators or are underpricing their market and losing candidates to higher-paying competitors.

Transparency is a competitive weapon in high-paying states. Missouri, Kansas, Oregon, Illinois, and New York all disclose salary data at higher-than-average rates relative to their listing volume, and all rank above the national average for compensation. The correlation is not coincidental: when you are paying well, you advertise it. When you are not, you hide it and hope candidates do not notice until the offer stage.

The floor is unstable and likely reflects part-time or limited-scope roles. The $350,000 to $400,000 range reported in Maryland, Vermont, Ohio, and New Jersey sits far enough below the national average to suggest either part-time arrangements, early-career positions, or practices with restricted surgical privileges. Without additional context, these listings risk being ignored by experienced surgeons who know their market value.

The Bottom Line

The orthopedic surgery job market is geographically diffuse, highly compensated, and structurally tilted toward physicians willing to leave the coasts. Missouri, Kansas, and Oregon are paying top dollar. New York offers the most options. Florida, Maine, and Kentucky have the most listings but the least transparency, a combination that will cost them candidates. The highest offer in the country is in a city of 40,000 people, and the lowest offers are in markets that should know better.

There is a lot of money available for fixing bones, but you will make more of it in places you have never thought to live.

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Salary data based on 32 listings with disclosed compensation. Figures may reflect part-time or specialized roles. This report is informational and should not replace professional judgment or financial planning.