Orthopedic surgeons in the US earn an average of $373,570 a year according to BLS, and $696,852 in Doximity’s 2026 Physician Compensation Report, making orthopedics one of the highest-paid medical specialties. Spine surgeons and those with ASC ownership regularly exceed $1 million annually.
The real story: Orthopedics offers the rare combination of surgical income ($500k+ average) with tangible, often immediate patient outcomes — you fix what’s broken, and patients walk out better. The trade-off is one of medicine’s most demanding training paths (14+ years), heavy call, physically taxing work, and a career that takes a significant physical toll on your own body.
Pay at a Glance (BLS Data)
Bureau of Labor Statistics wage estimates for orthopedic surgeons, except pediatric, across all industries:
| Percentile | Annual Wage | Hourly Equivalent |
|---|---|---|
| 10th (entry level) | $84,170 | $40.47 |
| 25th | $180,610 | $86.83 |
| 50th (median) | $358,550 | $172.38 |
| 75th | $530,700 | $255.14 |
| 90th | $659,290 | $316.97 |
| Average (mean) | $373,570 | $179.60 |
Source: US Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025, for Orthopedic Surgeons, Except Pediatric (all industries). Hourly figures are annual wages divided by 2,080 hours. “Not published” means BLS withheld the estimate, usually because wages are above its top reporting limit.
What Orthopedic Surgeons Actually Do
Orthopedic surgeons treat musculoskeletal conditions:
| Procedure Type | Description | Complexity |
|---|---|---|
| Total joint replacement | Hip, knee, shoulder replacements | High |
| Spinal fusion | Stabilize vertebrae with hardware | Very High |
| Fracture fixation | Repair broken bones with hardware | Variable |
| ACL reconstruction | Rebuild knee ligaments | Moderate |
| Rotator cuff repair | Shoulder tendon surgery | Moderate |
| Arthroscopy | Minimally invasive joint surgery | Moderate |
Day-to-Day Reality by Subspecialty:
| Subspecialty | OR Days | Call Burden | Physical Demands |
|---|---|---|---|
| Total joints | 2-3/week | Moderate | High (positioning) |
| Spine | 2-4/week | Moderate | Very High (long cases) |
| Trauma | Variable | Heavy | Very High (emergencies) |
| Sports medicine | 2-3/week | Light-Moderate | Moderate |
| Hand | 3-4/week | Light | Moderate |
| Pediatric | 2-3/week | Moderate | Moderate |
The Physical Reality:
| Demand | Description | Long-Term Impact |
|---|---|---|
| Standing | 4-8 hours per case | Back/leg problems |
| Positioning | Leaning, holding retraction | Shoulder/neck strain |
| Hammering/drilling | Significant force required | Hand/wrist issues |
| Lead protection | Heavy vests during fluoroscopy | Spine strain |
| Night call | Emergency trauma cases | Sleep disruption |
Quick Answer: Orthopedic Surgeon Salary
| Metric | Amount |
|---|---|
| Average salary | $550,000-$650,000 |
| Entry-level | $450,000 |
| Experienced | $700,000+ |
| Spine surgery | $700,000-$1,000,000 |
| Private practice owner | $800,000-$1,500,000+ |
Orthopedic Surgeon Salary by Subspecialty
| Subspecialty | Average Salary |
|---|---|
| Spine surgery | $750,000-$1,000,000 |
| Orthopedic oncology | $650,000-$850,000 |
| Sports medicine | $600,000-$900,000 |
| Trauma | $550,000-$700,000 |
| Total joint replacement | $550,000-$750,000 |
| Hand surgery | $500,000-$650,000 |
| Foot & ankle | $475,000-$600,000 |
| Shoulder & elbow | $500,000-$700,000 |
| Pediatric orthopedics | $450,000-$550,000 |
| General orthopedics | $500,000-$600,000 |
Orthopedic Surgeon Salary by State
| Rank | State | Avg Salary | Starting Salary | Median Salary |
|---|---|---|---|---|
| 1 | Missouri | $624,070 | $114,340 | $842,800 |
| 2 | Minnesota | $592,220 | $79,080 | $537,830 |
| 3 | Arizona | $542,140 | $237,990 | $558,970 |
| 4 | Wisconsin | $535,750 | $78,800 | $572,060 |
| 5 | Mississippi | $523,450 | $209,620 | $544,130 |
| 6 | West Virginia | $522,050 | $64,120 | $597,740 |
| 7 | Montana | $509,240 | $207,000 | $560,820 |
| 8 | Georgia | $503,390 | $238,050 | $474,820 |
| 9 | Washington | $464,800 | $181,940 | $553,310 |
| 10 | Florida | $462,360 | $228,800 | $473,750 |
| 11 | Nebraska | $456,110 | $219,210 | $507,770 |
| 12 | New Hampshire | $441,460 | $69,970 | $555,670 |
| 13 | Virginia | $432,290 | $151,810 | $478,710 |
| 14 | Michigan | $420,390 | $81,050 | $413,450 |
| 15 | Oklahoma | $419,180 | $156,300 | $530,070 |
| 16 | Illinois | $409,500 | $115,310 | $426,580 |
| 17 | Colorado | $374,610 | $180,610 | $385,410 |
| 18 | North Carolina | $372,620 | $75,510 | $323,630 |
| 19 | Massachusetts | $368,800 | $200,220 | $392,300 |
| 20 | New York | $364,520 | $77,150 | $414,290 |
| 21 | Pennsylvania | $363,580 | $87,640 | $354,020 |
| 22 | Texas | $363,410 | $75,580 | $200,780 |
| 23 | New Jersey | $347,890 | $215,640 | $341,430 |
| 24 | Tennessee | $341,820 | $139,100 | $325,520 |
| 25 | Arkansas | $332,090 | $155,250 | $262,470 |
| 26 | Kansas | $307,370 | $140,160 | $311,630 |
| 27 | Ohio | $299,520 | $67,300 | $323,480 |
| 28 | Iowa | $294,930 | $124,510 | $189,410 |
| 29 | Alabama | $287,150 | $114,990 | $324,570 |
| 30 | Indiana | $264,890 | $177,710 | $177,710 |
| 31 | California | $258,550 | $80,660 | $253,430 |
| — | National | $373,570 | $84,170 | $358,550 |
Source: US Bureau of Labor Statistics OEWS, 2025 estimates, fetched 2026-09-29. Figures cover Orthopedic Surgeons, Except Pediatric (cross-industry). Some states are omitted where BLS did not publish a reliable estimate. Note: Midwest and rural areas typically offer highest compensation.
Orthopedic Surgeon Salary by Setting
| Setting | Average Salary |
|---|---|
| Private practice (partner) | $800,000-$1,500,000+ |
| Private practice (employed) | $550,000-$700,000 |
| Hospital employed | $500,000-$600,000 |
| Large orthopedic group | $600,000-$800,000 |
| Academic medical center | $400,000-$550,000 |
| Ambulatory surgery center | $650,000-$900,000 |
| Locum tenens | $600,000-$800,000 |
Orthopedic Surgeon Salary by Experience
| Experience Level | Average Salary |
|---|---|
| New attending (1-2 years) | $450,000-$500,000 |
| Early career (3-5 years) | $550,000-$650,000 |
| Mid-career (6-10 years) | $650,000-$800,000 |
| Established (11-20 years) | $750,000-$1,000,000 |
| Senior partner | $900,000-$1,500,000+ |
Path to Becoming an Orthopedic Surgeon
| Stage | Duration | Typical Earnings |
|---|---|---|
| College (pre-med) | 4 years | -$100,000 (debt) |
| Orthopedic surgery residency | 5 years | $65,000-$90,000/yr |
| Fellowship (subspecialty) | 1 year | $75,000-$95,000/yr |
| Total training | 14-15 years |
Orthopedic Surgery Residency Competitiveness
| Metric | Data |
|---|---|
| Residency positions per year | ~850 |
| Applicants per position | 2.5-3 |
| Match rate | 67-75% |
| Average Step 1 score (historical) | 245+ |
| Research required | Significant |
Spine Surgeon Salary Deep Dive
Spine surgery is the highest-paid orthopedic subspecialty:
| Factor | Impact on Salary |
|---|---|
| Base salary | $600,000-$800,000 |
| Complex spinal fusion cases | +$200,000-$500,000 |
| Ambulatory surgery center ownership | +$200,000-$500,000 |
| Industry consulting | +$100,000-$300,000 |
| Medical device royalties | +$100,000-$1,000,000+ |
| Total potential | $1,000,000-$3,000,000+ |
Sports Medicine Surgeon Salary
| Employment Type | Annual Salary |
|---|---|
| Private practice | $600,000-$900,000 |
| Academic | $400,000-$600,000 |
| Professional sports team | $500,000-$1,500,000 |
| Team physician + practice | $800,000-$1,200,000 |
Orthopedic Surgeon After-Tax Income
| Gross Salary | Federal Income Tax | Social Security + Medicare | Take-Home Before State Tax | Monthly |
|---|---|---|---|---|
| $500,000 | $138,134 | $21,389 | $340,477 | $28,373 |
| $650,000 | $190,634 | $24,914 | $434,452 | $36,204 |
| $800,000 | $246,000 | $28,439 | $525,561 | $43,797 |
| $1,000,000 | $320,000 | $33,139 | $646,861 | $53,905 |
2026 federal income tax for a single filer taking the standard deduction ($16,100), plus Social Security and Medicare. Not included: state and local income tax, retirement contributions and other pre-tax deductions. For your own situation, use the take-home pay calculator.
Orthopedic Surgeon Lifestyle
| Factor | General Ortho | Spine Surgery |
|---|---|---|
| Call frequency | Heavy | Moderate-heavy |
| Surgery hours | Long | Very long |
| Physical demands | High | Very high |
| Work-life balance | Fair | Challenging |
| Career longevity | 25-30 years | 20-25 years |
| Burnout risk | Moderate | Higher |
Ancillary Income Opportunities
| Income Source | Typical Amount |
|---|---|
| ASC ownership | $100,000-$500,000/yr |
| Medical device consulting | $50,000-$300,000/yr |
| Expert witness | $500-$1,500/hr |
| Speaking/teaching | $5,000-$25,000/engagement |
| Device royalties | $50,000-$1,000,000+/yr |
| IME evaluations | $500-$2,000/case |
Orthopedic Surgery Job Outlook
- Job growth: 4% (2025-2035)
- Residency competitiveness: Very high
- Demand: Strong and growing
- Musculoskeletal trauma: Always needed
Is Orthopedic Surgery a Good Career?
Orthopedic surgery offers top-tier surgical income with tangible patient outcomes — here’s the complete picture.
The Case FOR Orthopedic Surgery
| Advantage | Reality | Long-Term Impact |
|---|---|---|
| Highest surgical income | Among the best-paid specialties | Very high lifetime earnings |
| Immediate outcomes | Fix fracture today, patient walks tomorrow | High satisfaction |
| Variety of procedures | Joint replacement, trauma, sports, spine | Prevents boredom |
| Job security | Aging population = more joints/fractures | Guaranteed demand |
| Practice ownership viable | Private groups still highly profitable | Wealth building |
| Professional recognition | Elite surgical specialty | Prestige |
| Exit opportunities | Device industry, consulting, medtech | Career flexibility |
| Diverse subspecialties | Can specialize based on interest | Career customization |
The Case AGAINST Orthopedic Surgery
| Challenge | Reality | Honest Assessment |
|---|---|---|
| 14+ years training | College + med school + residency + fellowship | Massive time investment |
| Very competitive match | 25-33% don’t match | High-stakes process |
| Heavy call burden | Trauma doesn’t wait | Life disruption |
| Physically demanding | Standing, hammering, positioning | Body breakdown over time |
| Career longevity issues | Many surgeons scale back by 50s | Shorter peak earning years |
| Work-life balance | Fair at best, poor for trauma/spine | Family sacrifice |
| High malpractice | Surgical complications, complications | Legal stress |
| Intense residency | 80+ hour weeks, brutal call | 5 years of hardship |
Who Should Become an Orthopedic Surgeon
| Trait | Why It Matters for Orthopedics |
|---|---|
| Loves using hands | Surgery is physical, mechanical work |
| Thrives under pressure | Trauma cases, emergencies, complications |
| Physically strong | Cases require stamina and force |
| Competitive achiever | Residency match requires excellence |
| Delayed gratification tolerance | 14+ years before attending-level pay |
| Enjoys tangible outcomes | Fixing what’s broken is immediately visible |
| Works through exhaustion | Training and call are grueling |
| Wants top income | Ortho delivers if you can survive training |
Who Should NOT Become an Orthopedic Surgeon
| Trait | Why Orthopedics Will Break You |
|---|---|
| Values work-life balance above all | Heavy call, long cases, unpredictable |
| Physically limited | Stamina and strength required |
| Prefers non-procedural medicine | This is action-based surgery |
| Not competitive enough | Match is high-stakes, rejects are common |
| Impatient with training length | 14 years is non-negotiable |
| Conflict-averse | OR dynamics can be intense |
| Risk-averse | Surgical complications happen |
| Wants lifestyle specialty | Ortho isn’t ophthalmology or dermatology |
Building Wealth as an Orthopedic Surgeon
| Wealth Strategy | Application | Annual Impact |
|---|---|---|
| Spine fellowship | Highest-paid ortho subspecialty | Higher income |
| ASC ownership | Facility fees are massive in ortho | +$100-500k/year |
| Private practice partnership | Highest compensation model | Higher income |
| Device consulting | Industry relationships | +$50-300k/year |
| Device royalties | Invent/develop products | $100k-$1M+/year |
| Live like a resident year 1 | Aggressive debt payoff | $300k debt eliminated |
| Midwest/rural location | Shortage premium | +20-30% income |
| Expert witness work | $500-1,500/hour | +$30-100k/year |
Wealth Projections by Career Path:
| Career Path | Year 5 Net Worth | Year 10 Net Worth | Year 20 Net Worth |
|---|---|---|---|
| Academic orthopedics | $400k | $1.5M | $5M |
| Hospital-employed | $600k | $2.5M | $8M |
| Private practice (general ortho) | $800k | $4M | $12M |
| Spine private practice | $1M | $6M | $18M |
| Private practice + ASC | $1.2M | $7M | $20M+ |
Career Earnings Comparison:
| Specialty | Training | Age First $500k | 30-Year Net Earnings |
|---|---|---|---|
| Orthopedic surgery | 14-15 yrs | 34-36 | $20-40M |
| Neurosurgery | 15-17 yrs | 35-38 | $22-35M |
| Cardiology | 14 yrs | 34-36 | $15-25M |
| Primary care | 11 yrs | Never (avg $250k) | $7-10M |
The Bottom Line
Orthopedic surgeons earn $550,000-$650,000 on average, with spine surgeons reaching $750,000-$1,000,000 and private practice partners with ASC ownership exceeding $1.5 million. This is consistently one of medicine’s highest-paid specialties.
-
Spine surgery pays most — $750k-$1M base, with device royalties and consulting potentially adding $500k+
-
ASC ownership is the wealth multiplier — Facility fees in orthopedics are substantial; ownership can add $100-500k annually
-
Residency match is very competitive — 25-33% of applicants don’t match; requires top grades, research, and connections
-
Physical demands limit career longevity — Many orthopedic surgeons scale back or exit surgery by their 50s due to body wear
-
Private practice still dominates income — Hospital employment offers stability but caps income; partnership in busy groups reaches $800k-1.5M
-
Training is brutal — 14+ years, 5-year residency with heavy call, fellowship often required for competitive subspecialties
-
Tangible outcomes = high satisfaction — Unlike many medical specialties, you fix what’s broken and patients improve visibly
The honest bottom line: Orthopedic surgery delivers on the promise of top surgical income ($550k → $1M+) with immediate, tangible patient outcomes. The cost is one of medicine’s longest and most competitive training paths, heavy call, and physical demands that shorten career longevity. If you can survive the training, have the physical stamina, and accept the lifestyle trade-offs, ortho offers elite compensation with genuinely satisfying work.
Related Guides
- How much do surgeons make?
- How much do doctors make?
- How much do anesthesiologists make?
- US Income Percentile Calculator
Related Salary Guides
See every profession in our salary by profession guides.
Sources
- U.S. Bureau of Labor Statistics. “Occupational Employment and Wage Statistics, May 2024.” bls.gov/oes
The content on Wealthvieu is for informational purposes only and should not be considered financial, tax, or investment advice. Consult a qualified professional before making financial decisions. Full disclaimer · Editorial policy