The PhysEmp Salary Report: June 2026 — A Cross-Specialty Market Overview
Opening
The single most interesting signal this month is geographic arbitrage: small‑metro and Midwest markets are repeatedly outbidding the coasts. From an interventional cardiology posting in Sterling, IL that lists up to $990,000 to a radiology role in Normal, IL at $850,000, the highest checks are increasingly written in places most physicians wont expect. That pattern shows up across specialties: the Midwest and select underserved states are where scarcity is being paid with real dollars.
Across the 37 specialty slices PhysEmp tracks, two broader facts hold. First, compensation remains highly specialty‑specific: procedural subspecialties continue to carry higher ceilings. Second, disclosure practices are wildly inconsistent between specialties and states, which means published averages are often shaped more by who chooses to publish than by the true national distribution.
Primary Care & General
Primary care remains a mass market with meaningful internal divergence. See the full state breakdowns for Family Medicine, Internal Medicine, Med‑Ped, Primary Care Physician, Geriatrics, Hospitalist, and Urgent Care.
Range and pressure points: Family Medicine listings span roughly $110,000 to $800,000 but most credible offers sit $200k$300k (national averages $257,667$289,094). Internal Medicine averages cluster near $263k$302k but the ceiling can reach $600,000 in secondary metros. Hospitalists show a $210k$600k band with a practical average near $312k$346k; crucially, Hospitalist listings disclose pay only ~10.7% of the time, hampering candidate triage. Urgent care sits mid‑market (average range $292,644$320,653) but the single Sunnyvale outlier at ~$395k highlights how tech‑adjacent markets still skew the top end.
Outliers within the bucket: Geriatrics a small market with only four disclosed salaries tops at $325k in Sun City, FL, underscoring demographic gravity rather than prestige. Med‑Ped and Primary Care show that low-volume states (and territories) will pay premiums; disclosure is the gating variable for candidate flow.
Medical Specialties
Key examples: Cardiology (avg range $473,172$553,296), Interventional Cardiology (avg $665,484$735,358; ceiling $990k), Dermatology (full $120k$1,000k; avg $419k$546k), Gastroenterology (avg $489,765$543,204), Emergency Medicine (avg $460,164$489,327), Psychiatry (avg $294,975$336,366), Radiology (avg $548,086$619,794), Physiatry (avg $344,548$394,106), and Pulmonology (avg $328,645$361,935).
Highest and lowest earners: procedural fields dominate ceilings—Interventional Cardiology (up to $990k), Radiology (up to $850k), and specialized GI postings (up to $955k) are at the top. Cognitive specialties, like Psychiatry and Geriatrics, cluster in the mid‑three‑hundreds with tighter bands. Dermatology is notable for bifurcation: board‑certified dermatologists commonly land $350k$550k, while APP roles and single extraordinary listings create $120k floors and $1M ceilings within the same specialty.
Procedural vs. cognitive: the procedural premium persists, but with caveats. Radiology and interventional subspecialties show high locum and small‑market premiums; cardiology demonstrates that Midwest small metros (Quincy, IL) can outpay coastal centers. Cognitive specialties show more price discovery and narrower bands, but exceptions (e.g., psychiatric roles at $400k in low‑volume states) confirm geography trumps title.
Surgical Specialties
Within surgical specialties that reported, compare Surgery (avg $393,540$455,033), Neurosurgery (reported ceiling $1,000,000 but only 4 disclosures), Otolaryngology (avg $507,541$561,713), and Urology (avg $479,335$516,737).
Surgical pay generally sits at the top, but the surprise is where the tops are located. The highest disclosed neurosurgery and ENT figures live in the Midwest rather than major coastal academic hubs. Surgery shows the familiar three‑figure swings by zip code: Smithtown, NY at $575k vs. Lompoc, CA at $300k. Low disclosure rates (Surgery ~10.9%, Neurosurgery ~7.5%) mean surgeons must ask early or assume the worst.
Advanced Practice Providers
The NP (report) and PA (report) markets are separate economies. NPs average roughly $143,947$186,390 nationally, with a ceiling outlier reported at $1,250,000 (likely ownership/entry error); PAs average $150,881$191,561. Both roles show major geographic variance: Tennessee/Kentucky/North Carolina appear as high‑pay states for APPs, while coastal metro cores (MA, NY, CO) frequently underpay relative to cost of living. PAs and NPs are not competing with physicians for the same dollars; they operate under their own supply dynamics and state‑by‑state scope regimes.
Cross‑Cutting Observations
1) Transparency is fracturing the market. Some buckets publish often (Primary Care Physician ~73.6% disclosure; Physiatry ~51.2%; NP ~41.0%), while many high‑value procedural markets remain silent (Radiology 6.4%; Emergency Medicine 5.7%; Neurosurgery 7.5%; Interventional Cardiology 9%). That distribution means published averages overstate the visible marketand candidates are increasingly routing to the few employers that post numbers.
2) Geography beats prestige. Repeatedly, midwest and small‑metro markets (Sterling/Dekalb/Quincy/Normal/Springfield) are writing the largest checks. Coastlines still dominate volume, but volume does not equate to the highest compensation: Florida and New York recur as high‑volume, low‑pay markets across specialties.
3) Two markets are stapled together in many specialties: a part‑time/locum band (floor distorters) and a full‑time guaranteed band (real market). Pulmonology, Emergency Medicine, Gastroenterology and Radiology all show this split. Read job descriptions for FTE and scope before benchmarking.
4) Procedural upside is increasingly portable. The premium for procedural skill is migrating to wherever systems are short, not necessarily to large academic centers. That creates strategic mobility for physicians willing to live outside coastal metros.
5) Expect disclosure pressure to rise. Employers that publish numbers are winning attention. Next month, watch whether high‑volume, low‑pay states (Florida, New York, Pennsylvania) begin posting ranges to avoid losing candidates at the top of funnel. If disclosure rates tick up in Emergency Medicine, Radiology, and Hospitalist postings, the candidate routing problem will materially shift hiring timelines.
Watch next month for whether the Midwest premiums hold and whether the largest silent markets respond by publishing — the economics of hiring are changing faster than many job descriptions suggest.
