Allergist Salary (2026): What Allergists and Immunologists Earn, and Whether the Fellowship Pays

What allergists earn in 2026

The figures span $50,000, and the order matters. Medscape is lowest; its average comes from a smaller, self-selected sample of its readers. Doximity estimates full-time pay from a large member survey and reports an average. SalaryDr is highest: its 40 reports skew toward physicians comparing offers, and about 43% of them (17 of 40) come from private practice, the best-paid setting. On SalaryDr, base salary makes up about 82.0% of total pay, and 67.0% of allergists report receiving a bonus.

The sources we could not use: the Bureau of Labor Statistics has no separate occupation for allergists (they fall under "physicians, all other"). MGMA and AMGA, the benchmarks employers use, sell their specialty tables, and the American College of Allergy, Asthma and Immunology's allergy compensation survey, run with MGMA, is available to members. The American Academy of Allergy, Asthma & Immunology publishes no free pay figure. Third-party pages that quote an "MGMA" allergist number without the report are not something we could verify, so we left them out. Our guide to MGMA salary data explains how employers use those benchmarks.

Allergist salary vs. other specialties

Allergy sits with the other cognitive internal medicine fellowships. On Doximity's averages it pays $14,200 more than rheumatology and $26,196 more than endocrinology, about the same as infectious disease, and $3,296 less than general internal medicine. Fellowships with procedures or ICU work, such as pulmonology and critical care, pay much more.

For pediatricians, the picture is different. Allergy pays $62,313 more than general pediatrics on Doximity's averages. Doximity reports one figure for all allergists, whichever residency they trained in, and allergy practices typically see both children and adults.

Allergist starting salary vs. experienced pay

No large survey publishes a verified starting salary for allergists, so we don't quote one. SalaryDr's experience figures are the closest public data: a median of about $338,577 for allergists in their first five years and about $389,429 for those with 10 or more years, a 15.0% difference. Its experience groups contain only a handful of reports each, so the shape matters more than the exact numbers.

The rise with experience is smaller than in many fields because most allergy pay is base salary rather than production. It is largest for allergists who become partners in a private practice, where profit from testing, immunotherapy and biologics is shared among the owners.

How allergists are paid

• Base plus bonus. Employed allergists usually get a base salary with a productivity or quality bonus. On SalaryDr, base is about 82.0% of total pay.
• A relatively high wRVU rate. SalaryDr's allergy reports show a median of $62 per wRVU (middle half $51 to $66; 29 reports), slightly above the $60 median for all physicians. At $62, the $360,000 median equals about 5,806 wRVUs a year. Our wRVU guide explains how those formulas work.
• Testing and immunotherapy. Skin and blood allergy testing, patch testing, preparing allergen extracts and giving allergy shots are billed as separate services. Much of that revenue is technical rather than physician work, so it shows up in practice profit, not wRVUs. Who keeps it is the key question in an allergy offer.
• Biologics and infusions. Allergists prescribe biologic drugs for asthma, eczema, chronic hives and food allergy. Practices that give injections or infusions in the office earn administration fees and, under buy-and-bill, a margin on the drug. Hospital-employed allergists usually don't share in either.
• Little call. Most allergy work is scheduled outpatient care, and on-call duties are typically light, which is why allergy rates well for lifestyle.

Allergist pay by setting and region

Private practice vs. academic

SalaryDr's private-practice allergists average $411,235 (17 reports), against $315,000 for academic allergists (8 reports): a gap of $96,235. Marit Health's self-reported salaries show the same pattern in every region:

Across the three regions, non-academic allergists earn between $87,048 and $142,250 more than academic ones. Regional differences in the all-allergist figures are smaller, about $25,030 from the highest region to the lowest, so setting matters more than geography.

Hospital and health-system employment

Health-system jobs pay a steadier salary, cover malpractice and overhead, and often include allergists who see complex immunology patients (immune deficiency, drug allergy, mast cell disease) referred from the rest of the system. The tradeoff is that testing and immunotherapy revenue goes to the employer. Academic and nonprofit health-system jobs usually qualify for PSLF.

Owning a practice

An allergy office needs little equipment beyond testing supplies and a shot room, which keeps the cost of starting or buying a practice lower than in procedural fields. Our guide to buying or starting a practice covers that decision.

Allergist take-home pay in Texas and California

At the Doximity average, an allergist keeps about $31,522 more a year in Texas than in California. Our take-home pay guide covers every state, and our physician salary by state guide covers regional pay.

Hours, lifestyle and allergist pay per hour

SalaryDr's allergists report about 40 hours a week (40 reports), including charting and administrative time. At the $360,000 median, that is about $173 an hour over a 52-week year. General internists on SalaryDr report 47 hours a week at a $328,000 median, about $134 an hour. Measured per hour, an allergist earns about 29.0% more than a general internist, even though their yearly averages are close.

Is the allergy fellowship worth it financially?

Allergy and immunology is a two-year fellowship after a three-year residency in internal medicine or pediatrics (four years for combined medicine-pediatrics). Board certification through the American Board of Allergy and Immunology requires prior certification in internal medicine or pediatrics. The fellowship years are paid at PGY-4 and PGY-5 stipends ($77,593 and $81,807 in the AAMC's 2025 survey) instead of a generalist's salary.

For an internist, the answer depends on the survey. On Doximity's averages, allergists earn $3,296 a year less than general internists, so the $349,766 given up during fellowship is never recovered in salary. On SalaryDr's medians, it takes about 16.7 years. Internists who choose allergy do so for the work and the hours, which, as the section above shows, are worth more per hour than the yearly figures suggest.

For a pediatrician, the fellowship pays back in about 6.9 years on Doximity's averages, among the better returns of any pediatric fellowship. Our fellowship worth-it guide compares 20 internal medicine and pediatric fellowships with the same method, including discounting and PSLF.

Demand for allergists

• A small workforce. The American College of Allergy, Asthma and Immunology counts about 6,309 board-certified allergists in the U.S. as of 2021, of whom 4,623 were maintaining certification.
• An uneven training pipeline. The same ACAAI analysis counts 102 allergy and immunology training programs in 35 states, leaving 15 states with no program to train local allergists.
• What it means for pay. A small, unevenly spread workforce gives allergists leverage in underserved areas, mostly on signing bonuses, schedule and practice support. It also makes starting a practice in an underserved market less risky than in most specialties.

Student loans and PSLF for allergists

The AAMC's median education debt for indebted 2025 graduates is $215,000. Paid over 10 years at 6.5%, that is about $2,441 a month, or 12.3% of a Texas allergist's take-home at the Doximity average, before interest that accrues during five years of residency and fellowship.

Those five training years count toward PSLF if you make qualifying payments while employed by a nonprofit or public hospital, and an academic or nonprofit health-system allergy job can carry the rest of the 10 years. The private-practice path, where allergists earn the most, does not qualify, so the choice of setting and the loan plan go together. Our PSLF guide and physician student loan guide show how to run that comparison.

Negotiating an allergy offer

1. Ancillary revenue. Ask who keeps testing, immunotherapy and biologic administration revenue, and whether any of it reaches your bonus or partnership share.
2. Partnership track. In a private group, get the timeline, the buy-in price and how profits are divided after partnership.
3. The wRVU rate. Compare it with SalaryDr's $62 median (middle half $51 to $66), and ask whether shot-room and testing visits count toward your total.
4. Support staff. An allergy clinic depends on nurses or medical assistants for testing and shots. Confirm staffing ratios, because they set how many patients you can see.
5. Satellite clinics and call. Many practices run clinics in several towns. Get the travel and any call expectations in writing.
6. Non-compete. Allergy practices compete locally; check the radius and length (our non-compete guide).

Use our contract analyzer to compare offers, and read our salary negotiation guide before you reply.

Sources

1. Doximity Physician Compensation Report 2026 (2025 data).
2. Medscape Physician Compensation Report 2026.
3. SalaryDr: allergy and immunology salaries (40 reports, September 2026; experience and setting figures) and wRVU rates by specialty. Self-reported; accessed October 27, 2026.
4. Marit Health allergist salary pages for the Northeast, Midwest and West (self-reported salaries), accessed October 2026.
5. Pathways to Practice: rationale, American College of Allergy, Asthma and Immunology (workforce and training program counts).
6. American Board of Allergy and Immunology: certification requirements.
7. AAMC 2025 Survey of Resident/Fellow Stipends and Benefits (PGY-4 $77,593, PGY-5 $81,807), as tabulated in our resident salary guide; AAMC median education debt, class of 2025.