Medical salaries vary widely by specialty, and if you're wondering which doctors make the most money, this article breaks down the highest paid medical specialties of 2025. We rank the top 10 top-earning doctors in the United States based on average annual income, including base salary plus total compensation (bonuses, profit-sharing, and private practice earnings). For context, physician pay has been rising modestly – the average U.S. doctor earned about $376,000 in 2024, up ~3.6% from the prior year. However, the specialties below far exceed that average. These doctor salaries in the US reflect the high demand, skill, and complexity associated with each field.

Note: All figures are average annual compensation (2025) for each specialty, which includes both salary and other earnings. As you'll see, procedural and surgical specialists dominate the top of the list, illustrating how factors like advanced training, procedural volume, and reimbursement rates drive higher incomes for certain doctors.

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1. Neurosurgery – $764,000

What Neurosurgeons Do: Neurosurgeons perform operative procedures on the brain, spinal cord, and nervous system. This includes removing brain tumors, treating spinal cord injuries, and relieving pressure from trauma. They often handle complex, life-saving surgeries on the central and peripheral nervous system. Neurosurgeons typically undergo one of the longest training paths – at least a 7‑year residency after medical school – to develop the expertise needed for such delicate work.

Why They Earn So Much: Neurosurgery is frequently cited as the highest-paid medical specialty due to its extreme complexity and responsibility. These physicians treat critical, high-risk conditions where outcomes can be life‑altering, justifying high insurance reimbursements for their procedures. Demand is strong and supply is limited – relatively few doctors complete the rigorous training, so experienced neurosurgeons are in short supply. Many neurosurgeons work long hours and take emergency call (for strokes, head injuries, etc.), and their specialized skill set commands premium compensation.

2. Thoracic Surgery – $721,000

What Thoracic Surgeons Do: Thoracic surgeons (often cardiothoracic surgeons) operate on organs in the chest – primarily the heart, lungs, esophagus, and major blood vessels in the thorax. They perform procedures like coronary bypass surgeries, heart valve replacements, lung tumor removals, and repairs of aortic aneurysms. Training usually involves general surgery plus specialized fellowships, totaling 6–8 years post‑medical school. These surgeons manage life‑threatening conditions such as heart disease and lung cancer, often working in high‑pressure operating room environments.

Why They Earn So Much: Thoracic surgery is a highly demanding surgical specialty with significant patient mortality risk if errors occur, which contributes to high compensation. The complexity of open‑heart surgeries and other chest procedures requires exceptional skill and large multidisciplinary teams, driving up the cost of care. Thoracic surgeons also deal with an aging population's needs – e.g., heart disease remains the #1 killer, keeping demand for cardiac surgeries high. They often perform lengthy, intricate operations, and the reimbursement for these major procedures is substantial.

3. Orthopedic Surgery – $655,000

What Orthopedic Surgeons Do: Orthopedic surgeons specialize in the musculoskeletal system – bones, joints, ligaments, tendons, and muscles. They treat fractures, sports injuries, arthritis, spinal disorders, and more. Common procedures include joint replacements (like hip or knee arthroplasty), repairing torn ligaments (e.g., ACL reconstructions), and fixing broken bones with pins/plates. Orthopedics also encompasses subspecialties like spine surgery, hand surgery, and sports medicine. The residency is typically 5 years, often followed by a fellowship in a subspecialty. Orthopedic surgeons improve patients' mobility and quality of life by restoring function to injured or degenerated body parts.

Why They Earn So Much: Orthopedics has consistently ranked at or near the top of physician earnings due to several factors. First, high procedure volume – an orthopedic surgeon might perform multiple surgeries per day, each reimbursed at a high rate. The demand is robust: an aging population needs more joint surgeries, and younger athletes sustain injuries requiring repairs. Orthopedic devices and implants are big business, and surgeons often collaborate with device companies. Moreover, orthopedists in private practice can boost income by owning outpatient surgery centers or imaging facilities. Orthopedic surgery is also physically taxing work with long hours, and the field carries significant malpractice risk, which pushes compensation higher.

4. Plastic Surgery – $620,000

What Plastic Surgeons Do: Plastic surgeons perform reconstructive and cosmetic surgeries across the body. This can range from repairing injuries or deformities to purely aesthetic procedures (facelifts, rhinoplasty, liposuction). They often work on the skin, face, hands, and body to improve form and function. Plastic surgery training is one of the longest for physicians – typically 6 years of residency, sometimes starting after another surgical residency. Many plastic surgeons further subspecialize in areas like hand surgery or craniofacial surgery.

Why They Earn So Much: Plastic surgeons command high incomes in part because many procedures are elective and cash‑paid, especially cosmetic surgeries. In private practice, a successful plastic surgeon can set high fees for surgeries like tummy tucks or breast augmentations, directly boosting their earnings. Reconstructive procedures, while often covered by insurance, are complex and time‑intensive, justifying high reimbursement as well. Additionally, the skill set is highly specialized – achieving excellent cosmetic results is as much an art as a science, and top surgeons are in demand. The field also involves costly malpractice insurance, which tends to correlate with higher pay.

5. Radiation Oncology – $569,000

What Radiation Oncologists Do: Radiation oncologists treat cancer using radiation therapy. They plan and deliver targeted radiation treatments with advanced equipment to destroy cancer cells while sparing healthy tissue. Radiation oncologists develop treatment plans, calculate radiation doses, and oversee therapy across multiple sessions. They also monitor patients for side effects and adjust treatments as needed. Training includes a 4‑5 year residency in radiation oncology.

Why They Earn So Much: Cancer treatment is in steady demand, and radiation therapy is a cornerstone of curative cancer care for many common cancers. Radiation equipment and facilities are extremely expensive to operate; as such, the services are billed at high rates, and specialists overseeing these treatments are well‑compensated. Radiation oncologists often split time between clinic consults and planning in‑office procedures, allowing them to manage a large caseload. The field also tends to have fewer practitioners relative to need, keeping salaries elevated.

6. Cardiology – $565,000

What Cardiologists Do: Cardiologists specialize in diseases of the heart and circulatory system. They diagnose and treat conditions like coronary artery disease, heart failure, arrhythmias, and hypertension. Within cardiology, there are subspecialties such as interventional cardiology (angioplasty, stent placements) and electrophysiology (heart rhythm management). Training requires internal medicine residency plus cardiology fellowship, with additional years for subspecialties.

Why They Earn So Much: Heart disease remains extremely prevalent, keeping cardiology in high demand. Cardiologists who perform procedures generate significant revenue. Even non‑invasive cardiologists bill for advanced imaging and tests. Many interventions are urgent and lifesaving, which commands premium payment rates. New technologies and therapies allow cardiologists to expand services and income streams, and ownership of cath labs or imaging equipment can further boost pay.

7. Vascular Surgery – $556,000

What Vascular Surgeons Do: Vascular surgeons treat diseases of the blood vessels (arteries and veins) throughout the body, except those of the heart and brain. They manage conditions like aneurysms, carotid artery disease, peripheral arterial disease, and varicose veins, performing open surgeries and minimally invasive endovascular procedures.

Why They Earn So Much: Vascular surgery addresses high‑risk conditions, and many procedures are complex, justifying high reimbursement. The aging population increases demand for vascular interventions. Surgeons with both open and endovascular expertise are scarce, commanding premium pay. Ownership in outpatient centers and catheter‑based labs can also raise compensation.

8. Radiology – $532,000

What Radiologists Do: Radiologists interpret medical images (X‑ray, CT, MRI, ultrasound) to diagnose diseases. Some perform minimally invasive, image‑guided procedures as interventional radiologists. Training includes residency and optional fellowships in subspecialties like neuroradiology or pediatric radiology.

Why They Earn So Much: Radiology is central to nearly all patient care, resulting in a large volume of billable studies. Interventional radiologists perform high‑revenue procedures. Radiology practices can scale efficiently through teleradiology, increasing productivity. The combination of advanced skills and high demand for imaging services drives compensation.

9. Urology – $529,000

What Urologists Do: Urologists treat conditions of the urinary tract and male reproductive system. They perform surgeries such as kidney stone removal, prostatectomy, and bladder tumor resection, and conduct office procedures like cystoscopy. Training typically spans 5–6 years.

Why They Earn So Much: Urologic issues are widespread, ensuring steady patient volume. Many procedures are well reimbursed, and ownership of outpatient surgery centers can increase income. Technological advances such as robotic surgery add value and revenue. Emergency call coverage and subspecialty demand further boost earnings.

10. Gastroenterology – $514,000

What Gastroenterologists Do: Gastroenterologists focus on the digestive system, performing diagnostic and therapeutic endoscopies such as colonoscopy and upper GI endoscopy. Training involves internal medicine residency followed by gastroenterology fellowship, with optional subspecialization.

Why They Earn So Much: Endoscopies are high‑volume, high‑revenue procedures, especially screening colonoscopies recommended for adults. Ownership of endoscopy suites allows GI doctors to collect facility fees. The prevalence of digestive disorders and the need for routine screenings maintain strong demand and steady revenue streams.

Overpaid or Underpaid?

In 2025, the highest paid doctors are largely surgical and procedure‑oriented specialists. Fields like neurosurgery, cardiothoracic surgery, orthopedics, and others dominate the pay scale, continuing a long‑running trend in physician compensation. These specialties involve complex procedures that generate significant revenue, while primary care and pediatric specialties remain on the lower end of the income spectrum.

Physician incomes have risen modestly, but top earning doctors still make well above $500,000 per year on average. High compensation often comes with trade‑offs: lengthy training, demanding workloads, and high stress. Prospective medical professionals should weigh income alongside passion, lifestyle, and the desire to impact patients’ lives. Nevertheless, mastering a highly specialized, procedurally focused field remains the surest route to becoming one of the highest paid medical specialists in the United States.

FAQ

What is the highest paid medical specialty in 2025?

Neurosurgery tops the list, averaging about $764 k in total compensation, making neurosurgeons the highest paid doctors in the US for 2025.

Why do neurosurgeons and cardiothoracic surgeons earn so much?

These specialties involve complex, high-risk surgeries on the brain, heart, and spine, require the longest training, and command the highest insurance reimbursements.

Are surgical specialists always the highest paid doctors?

Generally yes—procedure-heavy fields dominate earnings—but non-surgical specialties like cardiology and radiology still rank high due to high-volume, reimbursable services.

How long does it take to train for the top-earning specialties?

Training can exceed a decade: 4 years of medical school plus 6–8 years of residency/fellowship for neurosurgery or cardiothoracic surgery, reflecting their complexity.

Do doctor salaries vary by state or region?

Yes. Doctor salaries in the US differ by cost of living, payer mix, and demand; rural states often pay more to attract specialists, while urban hubs offer higher patient volume.