Anesthesiology Salary (2026): What Anesthesiologists Actually Earn

The median anesthesiologist salary in 2026 is $540,000 in total compensation — making it one of the highest-paid physician specialties in medicine for the fifth consecutive year. Anesthesiology ranked in the top five specialties for both compensation growth and average total pay in the 2026 Medscape Physician Compensation Report, driven by persistent workforce shortages, growing surgical volumes, and a labor market that has tilted decisively in favor of qualified anesthesiologists.

But the headline number hides a $150,000 to $200,000 swing that has nothing to do with how skilled you are as an anesthesiologist. Where you practice — specifically, whether your state allows CRNAs to practice independently of physician supervision — is now the single biggest variable in anesthesiologist compensation. An anesthesiologist in a care-team state earns meaningfully more than the same physician in an independent-CRNA state, even at identical surgical volumes.

This guide covers what anesthesiologists actually earn in 2026 by setting, subspecialty, state, and career stage — with real data from SalaryDr, Medscape, Doximity, and AMN Healthcare — plus an honest analysis of the CRNA scope issue that every anesthesiologist evaluating a job offer in 2026 needs to understand.

What the Data Shows: Anesthesiology Salary in 2026

Multiple compensation surveys report slightly different figures depending on methodology and sample size. Here is how the major 2026 sources compare:

The 25th percentile sits at $480,000 and the 75th percentile reaches $625,000, based on SalaryDr's verified 2026 database. Top earners at the 90th percentile earn $1,510,000 or more annually — a figure driven primarily by private practice partnership and subspecialty procedural volume.

The 5.5 percent year-over-year increase reported by AMN Healthcare reflects a labor market where anesthesiology is emerging as one of the most acutely constrained labor markets for hospital-based specialties. The workforce shortage is structural, not cyclical — more than 30 percent of currently practicing anesthesiologists are 55 or older, meaning a significant cohort will exit over the next decade while training pipelines cannot replace them at equivalent rates.

Anesthesiology Salary by Practice Setting

Practice setting is the most controllable compensation variable in anesthesiology. The gap between academic and private practice is larger in this specialty than in almost any other — and the partnership track is where the most significant wealth is built.

Private Practice and Anesthesia Groups: $450,000 – $700,000+

Private practice anesthesiologists earn the highest compensation of any employment structure, typically ranging from $450,000 to $590,000 for non-partner positions. Partners in private anesthesiology groups typically earn full partner distributions of $500,000 to $700,000 or more, sharing in profits and having voting rights on group decisions. Partners often earn $150,000 to $250,000 more annually than employed anesthesiologists.

The partnership track in anesthesiology typically runs 2 to 3 years:

• •Year 1–2 (Associate): Salary of $380,000–$420,000 with standard call obligations
• •Year 2–3 (Buy-in): Equity purchase typically ranging $50,000–$200,000 paid over 1–3 years
• •Year 3+ (Partner): Full distributions of $500,000–$700,000+ plus ownership in group revenue streams

The buy-in is an important consideration most anesthesiology residents underestimate when evaluating offers. A group requiring a $150,000 buy-in paid over two years is essentially asking you to fund your own equity stake from your first-year salary. Negotiate the terms of the buy-in — payment timeline, valuation methodology, and what happens to your equity if the group is acquired — before signing.

Hospital and Health System Employment: $400,000 – $525,000

Hospital-employed anesthesiologists are the largest segment of the workforce. Large hospital systems and academic medical centers typically offer anesthesiologists $400,000 to $525,000 annually, with comprehensive benefits including malpractice coverage, CME allowances, and retirement contributions.

The trade-offs versus private practice are real: more predictable income, better benefits, and less administrative burden — at the cost of lower total compensation ceiling and less autonomy. For anesthesiologists in markets where private practice groups are being absorbed by hospital systems, the employed model has become the primary option regardless of preference.

Call pay is a meaningful compensation variable in hospital employment that deserves scrutiny in any contract review. Call stipends typically run $1,000–$2,500 per call day. An anesthesiologist taking 10 overnight calls per month at $1,500 each earns $180,000 in call pay annually on top of their base salary — a figure that can materially close the gap with private practice compensation.

Academic Medical Centers: $350,000 – $480,000

Academic anesthesiology pays the least of any practice setting — typically $350,000 to $480,000 — reflecting the trade-offs of protected research time, teaching responsibilities, and academic prestige over pure clinical revenue generation. Anesthesiologists working in academic settings earn a median total compensation of $450,000 compared to $500,000 in nonacademic roles, according to Marit Health data.

For anesthesiologists at qualifying nonprofit academic medical centers, PSLF eligibility creates real economic value that partially offsets the salary discount. A physician with $280,000 in student loans receiving PSLF forgiveness after 120 qualifying payments is receiving tax-free forgiveness worth $200,000 to $350,000 in remaining balance — equivalent to supplemental annual compensation of $20,000 to $35,000 over the qualifying period.

Ambulatory Surgery Centers (ASCs): $380,000 – $530,000

ASC-based anesthesiology sits between hospital employment and full private practice. Anesthesiologists at ambulatory surgery centers typically earn $380,000 to $480,000 in pure employment arrangements, though many ASC anesthesiologists participate in physician ownership of the facility itself — which adds distributions beyond clinical salary and significantly increases total compensation.

Ownership in an ambulatory surgery center is one of the most lucrative non-clinical income streams available to anesthesiologists. ASC distributions are proportional to ownership percentage and facility revenue, and can add $50,000 to $200,000 annually for anesthesiologists with meaningful equity stakes.

Locum Tenens: $242/hour average ($350,000–$550,000+ annualized)

Locum tenens anesthesiology commands the highest gross hourly rate of any employment structure. SalaryDr Career Intelligence data shows locum tenens anesthesiologists command $242 per hour on average, with rural and shortage-area positions reaching $300–$400 per hour all-in with housing and travel stipends.

The self-employment tax, benefits gap, and administrative burden of multi-state licensure reduce the net advantage over permanent employment — but for experienced anesthesiologists who manage the complexity well, locum tenens can produce total compensation at the top of the specialty range.

Anesthesiology Salary by Subspecialty

Fellowship training in the right subspecialty is the most reliable way to reach the top quartile of anesthesiology compensation. Not all subspecialties produce equal financial returns, and the ROI calculation depends heavily on what you give up in an additional fellowship year versus what you gain in career income.

Cardiac Anesthesiology: $550,000 – $900,000+

Cardiac anesthesiologists earn the highest compensation of any anesthesiology subspecialty. The combination of procedural complexity, case length, limited supply of fellowship-trained cardiac anesthesiologists, and the fact that cardiac cases cannot be delegated to CRNAs creates a sustained premium for this subspecialty. Cardiac anesthesiologists earn the highest average compensation among all anesthesiology subspecialties, according to Marit Health data.

The one-year cardiac anesthesiology fellowship translates to an $80,000 to $150,000 annual salary premium in most markets — a return on the one-year training investment that is among the best in all of medicine.

Pain Medicine: $450,000 – $700,000

Pain medicine fellowship has emerged as the most strategically significant subspecialty in anesthesiology in 2026. Pain medicine has become the best hedge in anesthesiology — it creates a practice model immune to CRNA substitution, with median compensation exceeding $500,000.

A pain medicine anesthesiologist does procedures — spinal cord stimulation, interventional injections, nerve blocks for chronic pain — that CRNAs cannot perform independently. In any market, regardless of scope-of-practice laws, the pain medicine anesthesiologist's procedural practice is structurally protected.

The cash-pay component of pain management further improves the compensation picture. Patients paying out of pocket for procedures like regenerative therapies and certain neuromodulation treatments create revenue streams independent of insurance reimbursement, which has been trending downward for anesthesia base units since 2019.

Critical Care Medicine: $400,000 – $600,000

Dual certification in anesthesiology and critical care medicine allows a physician to practice in both the ICU and the OR, creating employment flexibility that other subspecialties cannot match. Compensation for dual-boarded anesthesia/critical care physicians depends heavily on how their time is split between the two settings.

Pediatric Anesthesiology: $430,000 – $650,000

Pediatric anesthesiologists with fellowship training earn a consistent premium over general anesthesiologists in pediatric hospital settings. Like cardiac anesthesia, pediatric cases represent high-complexity scenarios that physician anesthesiologist involvement is standard for.

Regional Anesthesiology: $450,000 – $650,000

Regional anesthesiology and acute pain medicine fellowship training has grown substantially as ultrasound-guided nerve block techniques have expanded. Regional anesthesiologists in high-volume orthopedic and sports medicine programs can generate significant supplemental wRVUs from nerve blocks in addition to their primary anesthetic work.

The CRNA Issue: What Every Anesthesiologist Needs to Know

No topic has more financial impact on anesthesiologist compensation planning than the expanding scope of practice for Certified Registered Nurse Anesthetists. This is not a political statement — it is a documented market reality that affects compensation in approximately half the country.

The current landscape: Federal law allows states to opt out of the physician supervision requirement for CRNAs in Medicare-participating facilities. As of 2026, roughly half of U.S. states have exercised this opt-out, allowing CRNAs to practice independently without physician oversight. Independent CRNA states include California, Alaska, Oregon, Washington, Iowa, Nebraska, and Idaho, among others.

The compensation impact: CRNA independence laws in 27 states are compressing anesthesiologist salaries by 15 to 20 percent compared to care-team model states. In states where CRNAs practice independently, hospital systems have reduced reliance on physician anesthesiologists for lower-acuity cases — reducing both the number of positions and the compensation leverage physicians previously held.

What this means in practice:

In ACT model states — where anesthesiologists medically direct CRNAs in teams of 1:3 or 1:4 — an anesthesiologist directing four concurrent cases billed at the medically directing rate generates significantly more revenue per unit of physician time than solo practice. This model actually amplifies physician compensation relative to CRNA-only staffing. Anesthesiologists in team-model markets commonly earn $450,000 to $550,000 with strong job security.

In CRNA-independent states — where CRNAs can practice without physician supervision — hospitals have substituted CRNAs for physician anesthesiologist coverage in lower-acuity cases, reducing the demand for physician anesthesiologists and compressing their compensation leverage. Anesthesiologists in these markets who do not subspecialize are increasingly competing with CRNAs earning $200,000–$250,000 for similar case types, which fundamentally changes the employer's calculus on physician staffing.

The practical advice for anesthesiologists evaluating markets: Research your target state's scope-of-practice laws before accepting any position. A hospital employment contract in a CRNA-independent state with no subspecialty protection is a materially different career trajectory than the same contract in a care-team state. The scope-of-practice map is a required part of your geographic due diligence.

Anesthesiology Salary by State

Geographic variation in anesthesiologist compensation is larger than in most specialties — driven by the CRNA scope issue, state income tax, malpractice costs, and surgical volume variation.

Highest-Compensating States

Texas leads anesthesiology compensation among verified SalaryDr submissions at a median of approximately $600,000 — driven by no state income tax, high surgical volumes in Houston, Dallas, San Antonio, and Austin, and a strongly ACT-model practice environment with physician-led anesthesia groups. Texas has developed a robust anesthesiology private practice market anchored by its large hospital systems and major urban centers.

Indiana is specifically cited by multiple compensation analyses as the best state for anesthesiology malpractice costs. Premiums in Indiana can be 50 to 60 percent below New York for comparable coverage. Combined with a low-moderate state income tax and strong hospital employment market, Indiana represents one of the best overall financial environments for anesthesiologists nationally.

Florida, Georgia, Tennessee, and North Carolina round out the top-performing states — combining no or low income tax (Florida and Tennessee), high surgical volumes, and care-team model practice environments that protect physician anesthesiologist compensation.

States with Compressed Compensation

California, Oregon, Washington, and Iowa — all CRNA-independent states — show lower physician anesthesiologist compensation relative to their nominal cost of living. California's high nominal salary is further eroded by the 13.3 percent top marginal state income tax.

For the full state-by-state salary analysis across all physician specialties, see our Physician Salary by State guide.

Anesthesiology Salary by Career Stage

Anesthesiology has a relatively compressed early-career income curve compared to surgical specialties — most of the salary growth comes from partnership track and subspecialty premium rather than experience alone.

• •CA-1 through CA-3 Resident: $68,000–$82,000 depending on program and geographic location. Training program stipends have grown modestly over the past five years. AMN Healthcare's 2025 resident salary data shows the median CA-3 stipend approaching $80,000 at higher-cost programs.
• •Fellowship year (optional): Fellowship stipends are similar to senior residency pay — $75,000–$90,000. The income sacrifice of a fellowship year is real but the long-term return for cardiac, pain, or pediatric subspecialty is significant.
• •Early attending (years 1–3): $380,000–$450,000 in most employed or associate positions. Early career anesthesiology physicians in years 0–5 earn a median salary of approximately $544,449, while those with 10 or more years of experience earn around $593,952.
• •Mid-career attending (years 4–8): Partnership track is the dominant financial event in this window. Physicians who reach full partner status in well-run private anesthesia groups typically see income jump $150,000–$250,000 in the transition year.
• •Senior physician (10+ years): $500,000–$800,000+ for private practice partners. Academic anesthesiologists with leadership roles reach $500,000–$600,000 at the senior level. The highest-earning anesthesiologists make up to $1,510,000 annually.

How Anesthesiology Compensation Is Structured

Unlike most physician specialties where compensation centers on wRVU productivity, anesthesiology uses a unique billing framework based on base units plus time units.

Base units are assigned to each procedure type by the American Society of Anesthesiologists Relative Value Guide. A coronary artery bypass carries more base units than a routine hernia repair because of clinical complexity.

Time units are added at one unit per 15 minutes of anesthesia time.

The 2026 Medicare anesthesia conversion factor is $20.44 per unit — modest and essentially unchanged since 2022, which has been a persistent reimbursement headwind. The CMS 2026 Final Rule provides negligible Medicare reimbursement increases for anesthesia providers, with the anesthesia conversion factor increasing only 0.88 percent compared to the 3.26 percent increase for non-anesthesia specialties.

Supplemental Income Components

Call pay: $1,000–$2,500 per call day. Verify whether in-house call carries a different rate than home call, and whether post-call clinical obligations are compensated separately.

Medical direction fees: When medically directing 3–4 CRNAs concurrently, billing is at a reduced rate per case but applied across multiple simultaneous cases. Supervising 3 to 4 CRNAs can effectively double total wRVU generation for an anesthesiologist compared to solo practice.

Hospital stipends: Many hospital anesthesia groups receive subsidy payments from the facility above collections — typically $50,000–$200,000 per physician annually — to maintain adequate coverage for low-revenue services.

Pain procedures: Anesthesiologists with pain medicine training can generate additional wRVU income from clinic-based procedures.

Anesthesiology vs. CRNA Salary

The most searched anesthesiology compensation question in 2026 is not about subspecialties or state comparisons — it is the anesthesiologist versus CRNA comparison. Medical students deciding between the two pathways search this regularly, and anesthesiologists fielding CRNA scope-of-practice arguments in their workplace need to understand the financial facts.

CRNAs earn an average of $214,000 annually, according to 2026 data — approximately 40 percent of the median physician anesthesiologist's compensation. In independent-practice states, experienced CRNAs with high-demand subspecialty skills can earn $230,000–$280,000. Locum tenens CRNAs in shortage areas command even higher rates.

The physician premium reflects several genuine differences: 4 additional years of medical training, broader scope of independent diagnosis and treatment, the ability to manage complex multi-system medical conditions that arise in the perioperative period, and departmental leadership and supervisory roles. The financial case for the anesthesiology physician pathway has narrowed in CRNA-independent states — making subspecialty training, particularly in cardiac and pain medicine, an increasingly important differentiator.

Is Anesthesiology Still Worth It Financially in 2026?

The honest answer is yes — with meaningful caveats. 91 percent of anesthesiologists would choose the specialty again, according to SalaryDr Career Intelligence data. The financial rewards remain substantial by any measure.

The qualification is geography and subspecialty. An anesthesiologist in a care-team state with cardiac or pain medicine fellowship training has one of the most financially secure and well-compensated positions in medicine. An anesthesiologist who is a generalist in a CRNA-independent state is in a meaningfully more competitive market where subspecialty differentiation becomes increasingly important over a career.

The training investment is significant — 12 to 15 years total from undergraduate through residency and optional fellowship. The ROI over a 30-year career at median compensation remains strongly positive. But where you practice and what you subspecialize in will determine whether you are at the median or at the top quartile.