How Much Do Neurosurgeons Make? Neurosurgery is one of the most prestigious and highly compensated medical specialties, but the path to becoming a neurosurgeon is long and demanding. If you’re considering this career, you’re likely wondering: How much do neurosurgeons actually make?
This comprehensive guide covers:
✔ Average neurosurgeon salaries (by experience, location, and setting)
✔ Factors that impact earnings (subspecialties, private vs. academic practice)
✔ How neurosurgeon pay compares to other medical specialties
✔ Future job outlook and earning potential
Table of Contents
Neurosurgeon Salary Overview (2024 Data)
Neurosurgeons are among the highest-paid physicians in the world. In the U.S., their earnings far exceed the average for all physicians ($208,000).
Average Neurosurgeon Salaries
| Experience Level | Average Annual Salary |
|---|---|
| Entry-Level (0-3 years) | $450,000 – $600,000 |
| Mid-Career (5-10 years) | $600,000 – $900,000 |
| Senior (10+ years) | $900,000 – $1.5M+ |
| Top Earners (Private Practice, High-Volume) | $1.5M – $2.5M+ |
Sources: Medscape Neurosurgeon Compensation Report 2024, MGMA, Doximity
Salary Comparison by Work Setting
| Practice Type | Average Salary |
|---|---|
| Private Practice | $800,000 – $1.5M |
| Hospital Employed | $600,000 – $900,000 |
| Academic Medicine | $450,000 – $700,000 |
| Government (VA, Military) | $350,000 – $550,000 |
Key Takeaway:
- Private practice offers the highest earning potential.
- Academic neurosurgeons earn less but have research opportunities.
Highest-Paying Neurosurgery Subspecialties
Not all neurosurgeons earn the same. Some subspecialties command significantly higher salaries:
1. Complex Spinal Surgery
- Average: $900,000 – $1.8M
- Why? High demand for spine procedures (disc replacements, fusions)
2. Pediatric Neurosurgery
- Average: $500,000 – $1.2M
- Why? Fewer specialists, high malpractice costs
3. Neurovascular Surgery (Aneurysms, Strokes)
- Average: $700,000 – $1.5M
- Why? High-risk, technically demanding procedures
4. Functional Neurosurgery (Deep Brain Stimulation for Parkinson’s)
- Average: $600,000 – $1.3M
- Why? Cutting-edge, specialized field
Geographic Variations in Neurosurgeon Salaries
Location plays a massive role in earnings due to demand, cost of living, and malpractice laws.
Top-Paying States for Neurosurgeons
| State | Average Salary |
|---|---|
| California | $850,000+ |
| New York | $800,000+ |
| Texas | $750,000+ |
| Florida | $700,000+ |
Highest-Paying Cities
- Los Angeles, CA ($900K+)
- Houston, TX ($850K+)
- Chicago, IL ($800K+)
Note: Rural areas often pay more due to shortages (e.g., $1M+ in Alaska).
How Neurosurgeon Pay Compares to Other Specialties
| Specialty | Average Salary |
|---|---|
| Neurosurgery | $800,000 |
| Orthopedic Surgery | $600,000 |
| Cardiology | $500,000 |
| Anesthesiology | $450,000 |
| General Surgery | $400,000 |
Neurosurgeons earn ~2-3x more than primary care doctors (e.g., family medicine: $250K).
Factors That Affect Neurosurgeon Salaries
1. Experience & Reputation
- New grads start at $450K, while renowned surgeons earn $2M+.
- Publishing research can boost academic salaries.
2. Case Volume & Complexity
- High-volume spine surgeons earn 30-50% more.
- Rare procedures (e.g., brain tumor resections) command premium fees.
3. Malpractice Insurance Costs
- Varies by state (e.g., $100K/year in Florida vs. $40K in Texas).
- Impacts take-home pay significantly.
4. Bonuses & Incentives
- RVU-based bonuses add $50K-$200K annually.
- Profit-sharing in private groups can double earnings.
Job Outlook & Future Earnings Potential
The demand for neurosurgeons is growing due to:
✔ Aging population (more strokes, spinal disorders)
✔ Advances in minimally invasive techniques
✔ Shortage of specialists (only ~3,500 in the U.S.)
Projected Salary Growth:
- 5-7% annually due to rising healthcare costs.
- Telemedicine is creating new revenue streams (e.g., remote consults).
FAQs About Neurosurgeon Salaries
1. Do neurosurgeons really make over $1 million?
Yes—top private-practice neurosurgeons (especially spine specialists) exceed $1.5M.
2. How long does it take to become a neurosurgeon?
- 4 years college
- 4 years med school
- 7 years residency
- Optional 1-2 years fellowship
(Total: 15+ years)
3. Is neurosurgery the highest-paid medical career?
Yes, tied with orthopedic spine surgery and certain cardiology subspecialties.
4. Do neurosurgeons get paid during residency?
Yes, but much less ($60K-$80K annually).
5. Which country pays neurosurgeons the most?
U.S. salaries are the highest, followed by Canada, Australia, and Saudi Arabia.
How to Maximize Your Neurosurgery Earnings
1. Subspecialize
- Complex spine and neurovascular pay $300K+ more than general neurosurgery.
2. Join a High-Volume Practice
- Busier hospitals = more cases = higher bonuses.
3. Negotiate Better Contracts
- Seek RVU incentives, signing bonuses, and partnership tracks.
4. Relocate Strategically
- Texas, Florida, and Tennessee offer high pay with low malpractice costs.
Final Verdict: Is Neurosurgery Worth the Salary?
Pros:
✔ Highest-paid medical specialty ($800K+ average)
✔ Strong job security (growing demand)
✔ Intellectually rewarding work
Cons:
❌ 15+ years of training
❌ High stress & malpractice risk
❌ Grueling hours (60-80/week)
Bottom Line:
If you’re passionate about neurosurgery, the financial rewards are unmatched. However, the path is extremely demanding—only pursue it if you love the field.
Still interested? Focus on top med schools, research, and networking to match into a neurosurgery residency.
Have questions? Ask below! (Note: Salaries vary—always check latest MGMA/Doximity data.)