What will you actually take home?
Pre-tax contributions
Estimate for W-2 income only, using projected 2026 federal brackets and the standard deduction. State tax uses an effective rate typical at physician income; local taxes (NYC, Maryland counties) and 1099 income are not modeled.
Clinical Context & Calculation Details
How to Use This Calculator
Enter your Gross Annual Salary, Filing Status, and approximate State Tax profile. Then input your pre-tax payroll deductions, such as your annual 401k/403b contribution, HSA contribution, and monthly health insurance premiums.
The calculator instantly computes your estimated federal taxes, FICA (Social Security and Medicare), and state taxes to provide a realistic monthly and bi-weekly net take-home pay.
Why Doctors Need This
When transitioning from residency to an attending physician salary, the jump in income is substantial, but so is the tax burden. Many new attendings make financial commitments—like buying a home or an expensive car—based on their gross salary, without realizing that federal taxes, state taxes, and FICA can consume 30% to 40% of their gross pay.
Knowing your exact take-home pay is the first step in building a sustainable budget, aggressively paying down student loans, and mapping out a path to financial independence.
The Math Behind It
Federal Taxes: Calculated using the progressive marginal tax brackets, applied to your taxable income (Gross Salary minus pre-tax deductions minus the standard deduction).
FICA (Social Security & Medicare): Social Security is 6.2% up to the annual limit. Medicare is 1.45% on all wages, plus an additional 0.9% for high earners.
State Taxes: Approximated using an effective flat rate based on your state's tax burden.
Pearls & Pitfalls
- Pearl: Maximize your pre-tax deductions. Fully funding your 401k/403b and HSA not only accelerates your retirement savings but also significantly reduces your current-year federal and state tax liability.
- Pitfall: Assuming a flat percentage for taxes. The U.S. tax system is progressive, meaning your last dollar earned is taxed much higher than your first. Your effective tax rate (total taxes divided by gross income) will always be lower than your marginal tax rate (the bracket your highest dollar falls into).
- Pearl: Pay attention to the Social Security phase-out. Once you earn above $168,600 (in 2024), you stop paying the 6.2% Social Security tax, which means your take-home pay will actually be slightly higher in the later months of the year once you hit the cap.
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Editorial Credibility
Joshua Dunigan, DO | Family Medicine Physician & Founder
I founded MedMoneyGuide to provide physicians with unbiased, specialty-specific financial guidance. My goal is to add transparency and credibility to your financial journey.
Frequently Asked Questions
How does this calculator handle Social Security and Medicare taxes?
Social Security tax is capped at the annual wage base limit ($168,600 for 2024), meaning income above that limit is not subject to the 6.2% tax. Medicare tax is uncapped at 1.45%, and high earners are subject to an additional 0.9% Medicare surtax on income over $200k (Single) or $250k (Joint).
Do my 401k and HSA contributions reduce my FICA taxes?
It depends. Pre-tax 401k or 403b contributions reduce your Federal and State income taxes, but they DO NOT reduce your FICA (Social Security & Medicare) taxes. However, HSA contributions and health insurance premiums deducted from payroll DO reduce your FICA taxable wages.