Interventional Radiology Salary Insights: A Guide for Residents & Students

Understanding Physician Salary by Specialty in the Context of Interventional Radiology

Interventional radiology (IR) consistently ranks among the highest paid specialties in medicine, but the full picture is more nuanced than a single number. For residency applicants and early trainees, understanding where interventional radiology fits in the broader landscape of physician salary by specialty is critical for setting realistic expectations, planning loan repayment, and making informed career decisions.

This guide focuses on how interventional radiology residency, practice models, and subspecialty choices shape earnings—while also comparing IR with other specialties commonly considered by the same applicant pool (diagnostic radiology, surgery, cardiology, anesthesia, and others).

Throughout this article, keep in mind that compensation data are approximate, vary by region and year, and are based on surveys and large datasets such as MGMA, Medscape, and specialty society reports through around 2024.

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1. Where Interventional Radiology Fits in the Physician Salary Landscape

When people search for “doctor salary by specialty” or “highest paid specialties,” interventional radiology is almost always near the top. But how high depends on the comparison group and the specific practice environment.

1.1 Big-Picture Comparison: IR vs Other Major Specialties

Approximate median annual physician salary by specialty (attending level, full-time, U.S.):

• Interventional Radiology (IR):
  • Common range: $550,000–$800,000+
  • In high-volume private groups or partnership: can exceed $1 million
• Diagnostic Radiology:
  • Typical: $450,000–$650,000
• Orthopedic Surgery:
  • Typically: $600,000–$900,000+
• Cardiology (Invasive/Interventional):
  • Approximately: $550,000–$900,000+
• Gastroenterology:
  • Typically: $500,000–$750,000
• Anesthesiology:
  • Typically: $450,000–$650,000
• Emergency Medicine:
  • Typically: $350,000–$500,000
• General Surgery:
  • Typically: $400,000–$600,000
• Internal Medicine (General):
  • Typically: $250,000–$325,000
• Family Medicine:
  • Typically: $230,000–$300,000
• Pediatrics (General):
  • Typically: $220,000–$280,000

Takeaway: Interventional radiology is solidly in the top tier of highest paid specialties, often above diagnostic radiology and comparable to high-earning procedure-based specialties like orthopedics, cardiology, and gastroenterology.

1.2 Why Interventional Radiology Is So Well Compensated

Several structural factors drive IR compensation:

• Highly technical procedures with substantial RVU (Relative Value Unit) weight
• Complex case mix: embolizations, TIPS, ablations, trauma interventions, endovascular procedures
• 24/7 call with emergent coverage (stroke, hemorrhage, trauma, PE, etc.)
• Revenue generation for hospitals: IR often drives downstream revenue (admissions, oncology services, follow-up imaging, surgery avoidance)
• Shortage of interventional radiologists in many regions, increasing negotiating leverage

For applicants evaluating the IR match, it’s helpful to recognize that the demanding training pathway and lifestyle intensity are partly compensated by higher potential earning power.

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2. Interventional Radiology Training Pathways and Their Financial Implications

Your residency and fellowship choices directly affect when you start earning an attending salary. Interventional radiology has a relatively long and complex training pathway, which has changed significantly with the advent of the Integrated IR/DR residency.

2.1 Common Pathways into Interventional Radiology

1. Integrated IR/DR Residency (6 years)

   • 1 year: Clinical Internship (Transitional Year / Preliminary Medicine or Surgery)
   • 5 years: IR/DR integrated training
   • Board-eligible in both IR and Diagnostic Radiology
   • You start as an attending roughly 6–7 years after medical school graduation (depending on prelim/internship setup).

2. Independent IR Residency (Traditional DR → IR)

   • 1 year: Internship
   • 4 years: Diagnostic Radiology residency
   • 1–2 years: Independent IR residency (fellowship-equivalent)
   • Total: 6–7 years post-medical school.

3. Legacy Pathways (Less common now)

   • DR residency + IR fellowship; slowly being replaced by the independent residency model.

From a financial timeline perspective, nearly all modern IR pathways involve at least 6 years of post-MD training. This is longer than some other high-paying specialties, but still similar to:

• General surgery → surgical subspecialty fellowships
• Internal medicine → cardiology / GI fellowships

2.2 Resident and Fellow Salaries: Financial Reality During Training

Across specialties, U.S. resident and fellow salaries are relatively standardized:

• PGY-1: ~$60,000–$70,000
• PGY-2 to PGY-6/7: Gradual increases, often ending in the $70,000–$85,000 range

For interventional radiology residency, your pay during IR years is similar to other hospital-based specialties, but your work intensity, call responsibilities, and procedural risk are high. From a financial standpoint, the “payoff” is delayed but quite strong once you finish training.

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3. Practice Models in Interventional Radiology and How They Shape Income

Physician salary in interventional radiology is highly sensitive to practice setting. Two IR attendings with similar skills might earn $450,000 and $1.0 million respectively, purely based on their employment model, case mix, and geography.

3.1 Academic vs Private Practice IR

Academic Interventional Radiology

• Common compensation range: $350,000–$550,000
• Sometimes lower in highly desirable cities; higher at senior rank or leadership roles
• Trade-offs:
  • Pros: Teaching, research, subspecialty practice (IR oncology, neurointerventions), job stability, benefits, academic prestige
  • Cons: Lower base pay compared with private practice; more committee/admin work; salary often less tied to productivity

Private Practice Interventional Radiology

• Common range: $550,000–$900,000+
• In strong groups with partnership track: mid-career partners may earn $800,000–$1.2 million+
• Trade-offs:
  • Pros: Higher income, more direct link between productivity and pay, often more autonomy
  • Cons: Longer hours, heavier call burden, business and partnership risk, more pressure to maintain volume

Hybrid Models

• Hospital-employed IR with some productivity incentives
• Radiology groups contracting with hospitals
• Pay often falls between academic and full private practice levels.

3.2 IR Practice Composition: Pure IR vs IR/DR Mix

Compensation also depends on how much of your time is:

• IR procedures (interventions, consults, clinics, inpatient rounds), vs
• Diagnostic radiology (reading CT, MRI, ultrasound, fluoroscopy exams)

Three common models:

1. Pure IR (little or no diagnostic reading)

   • Common in academic centers and large private groups
   • Often higher per-hour revenue but may involve intense call and procedural load
   • Frequently at the top end of the salary range if volume is strong.

2. Mixed IR/DR (e.g., 50–70% IR, 30–50% DR)

   • Very common in community practice
   • Offers income stability and workload flexibility
   • Compensation aligns with robust diagnostic radiology pay plus IR uplift—frequently $600,000–$800,000+ for partners.

3. IR-Light or Evolving Practice

   • In smaller hospitals or rural settings, IR may be limited by case mix and referral patterns
   • Compensation still strong but may be closer to diagnostic radiology levels if procedural volume is low.

3.3 Call Responsibilities and Income

Interventional radiology call can be:

• In-house in large level I trauma centers
• Home call with return for emergent cases (GI bleeding, trauma, acute limb ischemia, stroke in some centers, massive PE, etc.)

Call may be compensated by:

• Stipends (e.g., $1,000–$3,000 per 24-hour call)
• Bonus based on procedures performed
• Inclusion in overall salary/partnership profits

More call usually means higher total compensation, but can also impact burnout and lifestyle. Many of the highest paid specialties, including IR, surgery, and cardiology, share this trade-off.

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4. Interventional Radiology vs Other High-Paying Specialties: A Salary-Focused Comparison

Applicants considering the IR match are often also interviewing in fields like diagnostic radiology, anesthesiology, general surgery, vascular surgery, or cardiology. Understanding how IR income compares helps put the specialty in context.

4.1 IR vs Diagnostic Radiology

Diagnostic Radiology

• Typical attending salary: $450,000–$650,000, higher in rural/high-need markets
• Less call-associated overnight procedural work; call is reading studies remotely or on-site
• Hardware and procedure-related complications are not a factor; malpractice risk profile is different (mostly interpretive errors)

Interventional Radiology

• Higher median pay: $550,000–$800,000+
• Procedural risk, time in angio suite, immediate life-threatening emergencies
• More direct patient contact, clinic visits, longitudinal care

In essence, IR offers:

• Higher earning potential, but
• Higher workload and procedural risk, compared with pure DR.

4.2 IR vs Surgical Specialties (Vascular, General, Orthopedics)

• Vascular Surgery

  • Similar endovascular skill set; typical pay $450,000–$700,000+
  • Often more open surgery and OR time; IR may have more minimally invasive focus and shorter procedures
  • Many hospitals use both IR and vascular surgery; local dynamics can affect case mix and revenue.

• General Surgery

  • Typically $400,000–$600,000
  • Broader clinical scope, more frequent admissions and in-person rounds
  • IR tends to have higher ceiling for income, particularly in private practice.

• Orthopedic Surgery

  • Among the highest paid specialties: $600,000–$900,000+
  • Very high RVU procedures (joint replacements, spine surgery)
  • Longer OR days and similar call complexity; IR and ortho often compete in the same top income strata.

4.3 IR vs Cardiology and Anesthesiology

• Interventional Cardiology

  • Often $600,000–$900,000+, high RVU and intense call
  • Similar procedural lifestyle and risk profile to IR
  • Salary levels are broadly comparable; local pay can favor either specialty.

• Anesthesiology

  • Typically $450,000–$650,000
  • High earnings but under reimbursement pressure in some markets
  • IR often has a higher initial median, though top-tier anesthesiology groups may rival IR incomes.

4.4 Lifestyle-Adjusted Financial Perspective

Money is only one piece of the puzzle. When evaluating IR vs other high-paying specialties, consider:

• Physical demands: standing in lead, long procedures, radiation exposure
• Call type: emergent interventions vs interpretive or consultative call
• Autonomy and scope: IR often balances procedure and clinic, interventional cardiology leans more to CV disease, ortho to MSK surgery
• Burnout risk: tied to call load, work culture, and support staff

From a lifestyle-adjusted perspective, many physicians view IR, radiology, anesthesiology, and some surgical subspecialties as having higher pay but also higher intensity relative to primary care or cognitive specialties.

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5. Factors That Drive Income Variation Within Interventional Radiology

Beyond specialty choice, several controllable and uncontrollable factors influence physician salary by specialty within IR specifically.

5.1 Geographic Location

Location remains one of the largest determinants of IR income:

• Rural and underserved areas

  • Fewer specialists → higher demand
  • Often offer significant salary premiums, loan repayment, signing bonuses
  • IR physicians in such areas may earn top-quartile incomes with strong negotiating power.

• Major coastal cities (New York, San Francisco, Boston, LA, DC)

  • High desirability → saturated markets
  • Academic centers often dominate
  • Salaries can be lower than national averages while cost of living is higher.

• Mid-sized cities and suburbs

  • Often provide optimal balance: strong compensation, reasonable COL, growing demand for complex IR.

5.2 Subspecialization and Case Mix in IR

IR is heterogeneous. Different procedure portfolios generate different revenue:

• High-RVU, complex procedures:

  • Trauma and hemorrhage control
  • TIPS, portal interventions, complex embolizations
  • EVAR/TEVAR and some peripheral vascular interventions
  • Y-90 radioembolization, tumor ablation, advanced interventional oncology

• Lower-RVU or less complex procedures:

  • Basic angiograms and venograms
  • Paracentesis, thoracentesis, biopsies, drainages (though these may be high volume)
  • Dialysis access maintenance

IR physicians whose practice emphasizes complex, high-RVU interventions in high-volume centers tend to be at the upper end of the income spectrum.

5.3 Employment Structure and Partnership Track

In private IR or IR/DR groups, the compensation trajectory often looks like:

• Early years (Employee/Associate):

  • Base salary: $400,000–$600,000 plus bonus
  • Restricted equity or no partnership yet.

• Partnership (Typically 2–5 years in):

  • Share of practice profits, buy-in often required
  • Total compensation commonly $700,000–$1,000,000+ depending on group performance

In hospital-employed IR roles:

• Compensation leans more toward:

  • Guaranteed salary + RVU bonus
  • Less exposure to group profit but more stable base pay
  • Caps may limit top-end earnings compared to private groups.

5.4 Non-Clinical and Supplemental Income

Some interventional radiologists augment their physician salary by specialty with:

• Medical device consulting (stents, catheters, embolic agents)
• Speaking and teaching honoraria
• Clinical trials and research grants
• Medical directorships (e.g., IR service line director, stroke program director)
• Equity in outpatient IR centers or OBLs (office-based labs)

These can add tens to hundreds of thousands of dollars annually for some physicians, though they require additional time and often business acumen.

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6. Financial Planning and Career Strategy for Future Interventional Radiologists

For medical students and residents targeting an interventional radiology residency and eventual practice, salary potential is only one part of a lifetime financial picture. Strategic planning early in training can dramatically improve long-term outcomes.

6.1 Managing Debt During Long Training Pathways

Given IR’s 6–7 year training arc, many incoming attendings carry substantial debt:

• Typical medical school debt: $200,000–$350,000+
• During residency/fellowship: partial payments, IDR plans, or forbearance

Practical steps:

• Explore Public Service Loan Forgiveness (PSLF) if planning an academic or non-profit hospital career.
• Use income-driven repayment (IDR) during training while ensuring payments count toward PSLF if eligible.
• If PSLF is unlikely (private practice plans), consider refinancing with lower interest rates as you near or enter attendinghood.

6.2 Evaluating Offers: Beyond the Dollar Amount

When you start receiving offers, don’t compare just the headline physician salary. Analyze:

• Base salary vs RVU/production bonus
• Sign-on bonus and relocation assistance
• Call pay and weekend differentials
• Partnership track: terms, buy-in, realistic timeline
• Benefits: retirement match, health insurance, malpractice coverage, CME funds, parental leave
• Non-compete clauses and restrictions if you change jobs

Example:

• Offer A: $700,000 base, no partnership, heavy call, urban high-cost city
• Offer B: $550,000 starting, partnership after 2 years with projected $900,000, moderate call, mid-cost city

A simple salary figure comparison may favor Offer A, but lifetime earnings and quality of life might clearly favor Offer B.

6.3 Aligning Career Goals with Practice Type

Ask yourself:

• Do I want to be heavily involved in research and teaching?

  • Academic IR might be more fulfilling, even with somewhat lower pay.

• Do I prioritize maximizing income and am I comfortable with business risk and heavier call?

  • Private or hybrid IR/DR groups could be ideal.

• Do I value geographic flexibility or having a say in program development?

  • Smaller markets and community hospitals may offer leadership roles and negotiation leverage.

The strength of IR is that the specialty offers a wide spectrum of salary and lifestyle profiles, from high-income private IR/DR partners to academically-focused IR oncologists with robust research portfolios.

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FAQs: Physician Salary by Specialty and Interventional Radiology

1. Is interventional radiology one of the highest paid specialties?
Yes. Interventional radiology consistently falls into the upper tier of highest paid specialties, often comparable to orthopedic surgery, interventional cardiology, and gastroenterology. Typical full-time attending salaries range from roughly $550,000 to $800,000+, with partners in some private groups exceeding $1 million annually.

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2. How does interventional radiology pay compare to diagnostic radiology?
Interventional radiology generally pays more than diagnostic radiology because of:

• Procedural complexity and risk
• 24/7 emergent call coverage
• Higher RVU weights for many IR procedures

While diagnostic radiologists frequently earn $450,000–$650,000, interventional radiologists often earn $100,000–$200,000+ more, especially in high-volume private or hybrid practices.

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3. Does choosing the integrated IR/DR residency affect my long-term salary?
Your long-term earnings will be driven less by whether you did an integrated IR/DR residency vs the independent IR track, and more by:

• Practice setting (academic vs private vs hospital-employed)
• Geographic region
• Case mix and procedural volume
• Partnership opportunities and call structure

The integrated IR/DR residency mainly affects your training experience and the timeline to becoming an attending, not your maximum earning potential.

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4. What can I realistically expect to earn as a new IR attending right out of training?
New interventional radiology attendings in the U.S. commonly see:

• Academic positions: $350,000–$500,000 starting
• Hospital-employed or hybrid roles: $450,000–$650,000
• Private practice associate positions: $500,000–$700,000 (with potential to rise significantly after partnership)

Exact numbers depend heavily on region, call demands, and group structure, but even starting salaries place IR solidly within the upper band of specialty compensation.

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Understanding how physician salary by specialty applies to interventional radiology will help you navigate the IR match, evaluate residency programs, and eventually negotiate your first attending contract with confidence. Interventional radiology offers a rare combination of complex procedures, direct patient impact, and high earning potential—making it an attractive choice for many residency applicants who value both clinical challenge and financial reward.