Physician Salary by Specialty in Anesthesiology: A Complete Guide

Understanding Physician Salary by Specialty in Anesthesiology

Physician compensation is one of the most frequently discussed—and misunderstood—topics for medical students and residents. Within anesthesiology, salary varies substantially depending on subspecialty, practice setting, geography, and experience. If you are targeting an anesthesiology residency and thinking ahead to the anesthesia match, understanding the financial landscape early can help you make intentional choices about training and career paths.

This guide focuses on physician salary by specialty within anesthesiology: how general anesthesiologists are paid compared with subspecialists, what factors influence income, and how anesthesiology compares to other physician specialties in the broader “highest paid specialties” conversation. All data ranges are approximate and based on recent surveys and market reports up to 2024; actual offers will vary by location and job market.

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Big Picture: Where Anesthesiology Fits in the Physician Salary Landscape

When students search “doctor salary by specialty” or “highest paid specialties,” anesthesiology consistently appears in the top tier. While exact rankings shift year to year, anesthesiology is regularly grouped among the higher-earning non-surgical specialties.

Typical compensation ranges

Approximate total compensation (base + bonus) for anesthesiologists in the United States:

• Early career (0–2 years after residency):
  • $350,000 – $450,000
• Mid-career (5–10 years):
  • $450,000 – $600,000+
• Senior/experienced (>10–15 years, partners or high-RVU producers):
  • $550,000 – $800,000+ (and in some regions/roles, more)

By comparison, generalized ballpark ranges for physician salary by specialty (high-level, non-anesthesiology specialties) include:

• Primary care (IM, FM, pediatrics): ~$230,000 – $320,000
• Hospitalist medicine: ~$275,000 – $375,000
• General surgery: ~$400,000 – $550,000
• Interventional cardiology, orthopedic surgery, neurosurgery: can exceed $700,000–$1M+ in some markets (among the true highest paid specialties)

These figures place anesthesiology in a high-earning tier, often above many internal medicine subspecialties and on par with or slightly below some procedure-heavy surgical subspecialties.

Why anesthesiology is well-compensated

Several structural factors support a strong anesthesiology physician salary:

• High procedure volume: Anesthesiologists contribute directly to procedural revenue in the OR, cath lab, endoscopy suite, radiology, and more.
• 24/7 services: Call, nights, and weekends often come with substantial differentials or stipends.
• Specialized skill set: Airway management, hemodynamic control, ICU-level resuscitation, and acute pain management are in constant demand.
• Workforce supply-demand dynamics: Many regions face anesthesiologist shortages, especially in community and rural hospitals.

From a residency applicant’s perspective, anesthesiology offers both clinical variety and a strong financial outlook—but compensation is far from uniform. Understanding subspecialty differences is crucial.

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General Anesthesiology vs. Subspecialty Tracks

Within anesthesiology, you can practice as a general anesthesiologist or pursue additional fellowship training. Each route shapes your earning potential, schedule, and practice profile.

Below, “salary” means total annual compensation (base + productivity + bonuses), in approximate U.S. ranges.

General/Community Anesthesiologist

Training path:
4-year anesthesiology residency (no fellowship required)

Typical work:

• OR anesthesia for general surgery, orthopedics, OB, ENT, urology, etc.
• Pre-op and PACU coverage
• Some intraoperative TEE, regional anesthesia, and basic pain management depending on training and facility needs
• Usually a mix of elective days and call

Compensation range:

• Early career: $350,000 – $450,000
• Established/partner: $450,000 – $650,000+ (private groups, high-volume practices, or underserved areas can exceed this)

Pros:

• Fastest path from residency to high income
• Broad case mix; high flexibility in job market
• Often competitive in smaller cities and rural areas with robust OR volume

Cons:

• Income can be heavily tied to call, nights, and case volume
• Private practice employment models and partnership tracks vary widely (and sometimes opaquely)
• Increasing presence of anesthesia care team models and CRNA/AA integration can affect negotiation power and role structure

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Subspecialty #1: Cardiac Anesthesiology

Training path:
4-year residency + 1-year adult cardiothoracic anesthesia fellowship (often + TEE certification)

Typical work:

• Cardiac surgery (CABG, valve repairs/replacements, LVADs, transplants in major centers)
• TEE use and hemodynamic management
• Structural heart cases (TAVR, MitraClip, Watchman, etc.)
• Complex vascular and thoracic procedures

Compensation range:

• Early career: $400,000 – $550,000
• Experienced in high-volume centers or partnerships: $550,000 – $750,000+

Cardiac anesthesiology is often among the highest-earning anesthesiology subspecialties, especially in busy cardiac programs or private practice. The trade-off is intensity: long cases, high stakes, and often more demanding call schedules.

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Subspecialty #2: Critical Care (Anesthesiology-Driven ICU)

Training path:
4-year residency + 1-year critical care medicine fellowship

Typical work:

• Medical/surgical ICU, CTICU, or neuro-ICU
• Management of ventilators, sepsis, ARDS, multi-organ failure, post-op cardiac and trauma patients
• Procedures: central lines, arterial lines, intubations, bronchoscopy (in some centers)

Compensation range:

• Early career ICU-focused: $330,000 – $450,000
• Dual practice (ICU + OR): $380,000 – $550,000

Pure ICU roles can pay slightly less than high-volume OR roles, particularly in academic centers, but combined ICU–OR hybrid jobs can be very competitive. This path suits those who like physiology, longitudinal critical care, and team leadership in high-acuity settings.

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Subspecialty #3: Pain Medicine

Training path:
4-year anesthesiology residency + 1-year pain medicine fellowship
(also open to PM&R, neurology, psychiatry, and others, but anesthesiology is a common route)

Typical work:

• Interventional procedures: epidural steroid injections, facet blocks, RF ablation, spinal cord stimulators, nerve blocks, etc.
• Chronic pain management with multimodal approaches
• Outpatient clinic-based practice with procedure suites

Compensation range:

• Employment model (e.g., academic): $350,000 – $500,000
• Private practice, high-volume, procedure-heavy: $450,000 – $800,000+ (can exceed these ranges in select markets)

Pain medicine can rank near the top end of anesthesiology-related incomes, especially in entrepreneurial or partnership-based outpatient practices. However:

• Reimbursement is sensitive to payer mix and policy changes.
• Business skills, marketing, and practice management become more important.
• Burnout from chronic pain complexity and administrative burden can be a factor.

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Subspecialty #4: Pediatric Anesthesiology

Training path:
4-year residency + 1-year pediatric anesthesia fellowship

Typical work:

• Anesthesia for neonates, infants, children, and adolescents
• Congenital heart cases in specialized centers (if dually trained or overlapping with cardiac)
• NICU/PICU procedures, pediatric pain service, sedation services

Compensation range:

• Academic/children’s hospitals: $320,000 – $450,000
• Non-academic or mixed practice: $350,000 – $500,000

Pediatric anesthesiology often pays somewhat less than adult general or cardiac anesthesia, particularly in academic settings, but offers:

• Deep subspecialty expertise
• A focus on a vulnerable, rewarding patient population
• A predictable elective case profile in many children’s hospitals (with notable exceptions for trauma and transplants)

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Subspecialty #5: Obstetric Anesthesiology

Training path:
4-year residency + 1-year OB anesthesia fellowship (though many anesthesiologists provide OB care without fellowship in community settings)

Typical work:

• Labor and delivery anesthesia: epidurals, C-sections, high-risk pregnancies
• Management of peripartum hemorrhage, preeclampsia, and obstetric emergencies
• Regional anesthesia and analgesia service leadership

Compensation range:

• Many OB anesthesiologists work as part of a general anesthesia group:
  • Overall range: $350,000 – $550,000
• Pure OB anesthesia in academic centers: can be modestly lower, often in the low-to-mid $400,000s depending on institution

Labor & Delivery is a high-volume, 24/7 environment. Compensation often reflects the constant availability and unpredictable hours, particularly in busy maternity centers.

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Other Subspecialties and Academic Roles

Additional fellowships and niches include:

• Regional anesthesia & acute pain: typically similar to general anesthesiology or slightly below in academic roles; can increase your value in practices emphasizing nerve blocks and enhanced recovery pathways.
• Neuroanesthesiology: varies widely; may align with academic salary scales.
• Transplant anesthesia: often embedded within tertiary referral centers, with compensation tied to institutional pay structures.
• Research- or education-focused roles:
  • Often lower base salary than pure clinical positions but may include protected time, funded projects, and academic promotion pathways.

In general, academic anesthesiology salaries tend to be lower than private practice or hospital-employed roles, sometimes by $50,000–$150,000 annually, but can be offset by:

• Job stability and benefits
• Academic promotion and leadership stipends
• Predictable structures for teaching and research

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Key Factors That Drive Anesthesiology Salaries

Beyond subspecialty choice, several consistent variables shape anesthesiology compensation. Understanding these before and during your anesthesiology residency helps you make deliberate career decisions.

1. Practice Setting: Academic vs. Private vs. Employed

Academic centers:

• Lower base physician salary relative to private practice, often $350,000 – $500,000 for general anesthesiology.
• More predictable salary structure; less dependent on personal productivity.
• Opportunities for leadership roles (e.g., division chief, program director) with incremental stipends.
• Strong non-monetary benefits: teaching, research, integrated teams, institutional prestige.

Private practice groups:

• Often at the higher end of the compensation range. Established partners in strong markets can surpass $600,000–$800,000+.
• Income may depend on:
  • Partnership track
  • Share of group profits
  • Call burden and case volume
• Less job security if contracts shift; more business risk and upside.

Hospital-employed / health system-employed:

• Frequently offer:
  • Guaranteed base salary + RVU-based or quality incentives
  • Good benefits and malpractice coverage
  • Range: roughly $400,000 – $650,000 depending on region and demand
• Often a middle ground between academic structure and private-practice upside.

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2. Geographic Region and Cost of Living

Geography is one of the most powerful determinants of anesthesiology compensation.

• Rural and underserved areas:

  • Often pay significant salary premiums to attract anesthesiologists.
  • Sign-on bonuses, loan repayment, and generous call stipends are common.
  • Total packages can exceed $600,000–$700,000 relatively early in your career.

• Suburban and mid-sized cities:

  • Generally strong and stable markets; competitive pay with balanced lifestyle options.

• Major coastal metros (e.g., NYC, SF, LA, Boston):

  • Higher cost of living but not always commensurately higher salaries.
  • More competition, more academic centers; base salaries may lag behind rural/underserved markets.

When comparing offers, doesn’t just look at headline physician salary; you must weigh:

• State income tax
• Housing costs
• Loan repayment options
• Growth potential, partnership track, and lifestyle

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3. Call, Nights, and Weekends

Call structure can be a major driver of compensation differences:

• Q2–Q3 call (every 2nd or 3rd night) with heavy in-house coverage often commands higher pay and/or stipends.
• Home call with predictable volumes may be less burdensome but still compensable.
• 24-hour in-house shifts, OB coverage, trauma calls, and transplant services can significantly boost total annual income.

As you progress through anesthesiology residency and approach the anesthesia match, pay careful attention to actual call schedules when reviewing job offers—not just the base salary.

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4. Partnership Track and Productivity

Private groups may offer a lower initial salary during a “trial” or “associate” period, with a substantial bump at partnership:

• Example:
  • Years 1–2: $350,000 – $450,000 as an associate
  • After partnership: $600,000 – $800,000+, plus profit sharing

Key questions to ask when evaluating partnership opportunities:

• How long is the partnership track, and how many actually make partner?
• Is there a buy-in, and how is it structured?
• How transparent are financials (operative revenue, overhead, distributions)?
• How is productivity measured (e.g., ASA units, RVUs, shifts worked)?

Productivity-based systems (RVU- or unit-based) create the potential for very high earnings for motivated clinicians but can also increase pressure to maintain high case volumes.

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5. Non-Clinical and Leadership Roles

Some anesthesiologists diversify their income by taking on additional roles:

• Medical directorships (OR, pain clinic, ASC): added stipends
• Department or division leadership: administrative compensation
• Committee work, quality improvement leadership, informatics, perioperative medicine leadership
• Consulting, speaking, and industry collaboration

These may not always rival clinical income but can meaningfully augment earnings while broadening your career portfolio.

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Practical Advice for Residents and Students Targeting Anesthesiology

If you’re still in medical school or early in anesthesiology residency, you’re thinking ahead not only to the anesthesiology residency match, but also to your longer-term financial trajectory. Here are actionable steps to align your training with your desired compensation profile.

1. Use Training to Explore Subspecialty Interests

During residency:

• Rotate through cardiac, ICU, OB, pediatrics, regional, and pain with an eye toward:
  • What energizes you?
  • What lifestyle trade-offs feel acceptable?
  • How do attendings in each area talk about their careers and satisfaction?

Even if your initial priority is income, alignment with your interests is crucial to avoid long-term burnout.

2. Learn the Business Side of Medicine Early

Build literacy in:

• How anesthesiology billing works (ASA units, modifiers, facility vs. professional fees)
• Basic concepts of private practice: overhead, collections, payer mix
• How hospital contracts and anesthesia care team models are structured

You do not need to become an MBA, but understanding how money moves in perioperative care will help you evaluate offers intelligently.

3. Treat Salary as One Component of Job Fit

When comparing offers or planning a subspecialty, consider both quantitative and qualitative elements:

Quantitative:

• Base pay and bonus structure
• Call pay, overtime, and holiday differentials
• Partnership details and growth trajectory
• Benefits, retirement, malpractice coverage

Qualitative:

• Culture of the group
• OR efficiency and staffing
• Autonomy and scope of practice
• Geography, family needs, and lifestyle

A slightly lower physician salary with a supportive team and sustainable schedule may be worth more in the long run than a marginally higher income with high burnout risk.

4. Understand How Loan Burden and Timing Interact

If you have substantial educational debt:

• Early high-income years (post-residency, post-fellowship) are critical for aggressive loan repayment.
• Choosing a fellowship that delays full attending pay by 1–2 years should be balanced against:
  • The likely lifetime earning differential
  • Your interest and enjoyment of that subspecialty
• Programs in underserved regions may offer loan repayment incentives that effectively raise your real compensation.

5. Keep an Eye on Workforce and Policy Trends

Anesthesiology is evolving:

• Expanded use of CRNAs and AAs in anesthesia care teams
• Growth in outpatient surgery centers and office-based anesthesia
• Technological advances (e.g., improved monitors, AI-assisted perioperative management)
• Shifts in reimbursement and value-based care models

These factors will influence job structure and compensation models over the coming decade. Staying informed helps you anticipate where the highest paid specialties within anesthesiology may move and how your skills remain in demand.

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FAQs: Physician Salary by Specialty in Anesthesiology

1. Is anesthesiology one of the highest paid specialties?

Anesthesiology is consistently among the higher-compensated medical specialties, though typically below certain highly procedural fields like orthopedic surgery, neurosurgery, and interventional cardiology. Within non-surgical areas, anesthesiology is often near the top. Subspecialties like pain medicine and cardiac anesthesia can sometimes rival or exceed many other specialties, particularly in private practice.

2. Do anesthesiology subspecialties always pay more than general anesthesiology?

Not always. While cardiac anesthesia and pain medicine often exceed typical general anesthesia incomes, other fellowships (pediatric, OB, critical care, academic-focused roles) may offer similar or even slightly lower compensation, especially in academic centers. The main reasons to pursue a fellowship should be clinical interest, career goals, and practice type, with salary as one important—but not exclusive—factor.

3. How much does location affect anesthesiologist salary?

Location can change your physician salary by six figures or more. Rural and underserved regions, as well as some smaller cities, often offer dramatically higher compensation, signing bonuses, and loan repayment incentives. Large coastal urban centers can have lower relative salaries after adjusting for cost of living. Always compare after-tax income and cost of living rather than salary alone.

4. What can I do during residency to maximize my future earning potential?

During anesthesiology residency:

• Seek strong rotations in high-demand areas (cardiac, regional, OB, ICU, pain).
• Consider fellowships that align with both your interests and market demand.
• Develop a basic understanding of billing, RVUs, and practice finances.
• Network with attendings in different practice types (academic, private, hospital-employed) to understand real-world compensation.
• Focus on becoming clinically excellent—your reputation, reliability, and skill set will directly impact the quality of offers you receive.

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By understanding how physician salary by specialty operates within anesthesiology—across subspecialties, practice settings, and geography—you can approach the anesthesia match and your early career choices with clarity and intentionality. The field offers a rare combination of intellectual challenge, procedural variety, and strong earning potential; your task is to shape those broad opportunities into a career that fits your values, lifestyle, and long-term goals.