Urology Salary (2026): The $590,000 Median and What ASC Ownership Adds

What the 2026 Data Actually Shows

Based on 88 approved, self-reported salary reports on SalaryDr through September 24, 2026, the median urology salary is $590,000 per year. The average is $602,041. The 25th percentile is $560,000 and the 75th percentile is $630,000; the 10th to 90th percentile range runs from $500,000 to $717,600. Bonus or incentive pay shows up in 88 percent of reports, with a median bonus of $90,000.

Marit Health provides a larger dataset from 349 self-reported salaries as of September 26, 2026: average $646,500, median $625,000, 25th percentile $520,600, and 75th percentile $750,000. The Doximity 2026 Physician Compensation Report (2025 survey data) puts the urology average at $566,740, and the Medscape Physician Compensation Report 2026 puts it at $535,000.

FastRVU's 2026 urology benchmark sits lower: a median of 7,500 wRVUs at a $60 per wRVU planning rate, or about $450,000. FastRVU describes these as survey-based planning references, not MGMA data, and they model wRVU-based pay before ASC distributions, partnership income, and other private practice economics enter the picture.

The spread between the planning benchmark and the self-reported medians is partly ownership income. Marit notes that public estimates tend to track W-2 or advertised base pay and miss surgery center distributions and other ancillary revenue. The practice-setting averages are closer together than that suggests, though: on SalaryDr, private practice urologists average $686,172 (29 reports) against $641,609 for hospital-employed urologists (38 reports) and $475,000 for academic urologists (14 reports). On Marit, self-employed urologists average $664,000, medical groups $648,000, and hospital or health system roles $647,000. The ASC mechanism is covered in the next section.

The Mechanism: What ASC Ownership Adds to Private Practice Pay

The income differential between private practice and employed urology is generated by the same facility fee capture model that drives income in gastroenterology, orthopedics, and ophthalmology — and it is worth understanding precisely before evaluating any urology job offer.

When a hospital-employed urologist performs a robotic prostatectomy in the hospital operating room, two bills are generated:

• •Professional fee (physician): CPT 55866 — 21.90 wRVUs, with a 2026 national Medicare payment of $1,081.86 before geographic adjustment
• •Facility fee (hospital): an illustrative $15,000 to $25,000 for use of the operating room, surgical team, robotic equipment, and facility

The physician's Medicare fee is about $1,082. In this example, the hospital collects $15,000 to $25,000. Medicare's own 2026 national facility rate for CPT 55866 is $10,860 in a hospital outpatient department, according to Medtronic's 2026 urology surgery reimbursement guide (January 2026), which lists CMS's 2026 hospital outpatient and ASC rates.

When a private practice urologist performs the same robotic prostatectomy at a physician-owned surgical facility or ambulatory surgical center where they hold equity:

• •Professional fee: the same fee to the physician
• •Facility fee: flows to the physician-owned ASC, distributed to physician equity holders (Medicare's 2026 national ASC rate for CPT 55866 is $5,121, per the same Medtronic guide)

Illustrative facility fees on common urology procedures:

These ranges are illustrative, not a published fee schedule; actual facility payments vary by payer, market, and site of service. Open radical nephrectomy (CPT 50230) is on Medicare's inpatient-only list in Medtronic's 2026 guide, so it stays in the hospital and earns an ASC owner nothing; the ASC share applies to the outpatient cases above it.

A urologist with 25 percent equity in an ASC performing 400 annual cases at an average facility fee of $3,000 per case has a claim on: $3,000 × 400 × 25% = $300,000 a year in facility revenue, before the center's operating costs come out of it.

That share sits on top of professional fee income for the same clinical work. It comes from ownership rather than extra clinical productivity, and it describes a busy center, not the typical gap.

The survey averages are much closer. SalaryDr's private practice urologists average $686,172, about $44,600 above the $641,609 hospital-employed average, and Marit's self-employed average of $664,000 is $17,000 above hospital and health system roles. Marit's explanation is that surgery center distributions and other ancillary income tend to sit inside sizable groups rather than solo practice, and don't always show up in the salary a solo owner reports.

The wRVU Framework: What Urology Procedures Actually Generate

Urology is the most procedurally diverse specialty on this site — combining office-based procedures (cystoscopies, biopsies, injections), minimally invasive stone procedures, complex oncological surgery, robotic prostatectomy, and a growing men's health office-based practice. The wRVU production model differs dramatically between subspecialties and practice models.

2026 CPT codes and wRVU values for core urology procedures:

Work RVUs and payments are from the CMS 2026 Physician Fee Schedule relative value file (PPRRVU2026_Apr_nonQPP, $33.4009 conversion factor) as listed on FastRVU's CPT pages, last verified May 1, 2026. Payments are national, before geographic adjustment; a single figure means FastRVU lists one rate for both settings.

The daily production model — busy general urologist:

A productive general urologist with 3 OR days and 2 clinic half-days per week:

OR day (3 per week):

• •2 robotic prostatectomies: 2 × 21.90 = 43.80 wRVUs
• •3 cystoscopies with biopsy: 3 × 2.53 = 7.59 wRVUs
• •OR day total: approximately 51 wRVUs

Clinic half-day (2 per week):

• •15 established visits (99213/99214): approximately 25 wRVUs
• •3 cystoscopies: 3 × 1.49 = 4.47 wRVUs
• •2 urodynamics studies: 2 × 2.45 = 4.90 wRVUs
• •Clinic half-day total: approximately 34 wRVUs

Weekly production: (3 × 51) + (2 × 34) = 153 + 68 = 221 wRVUs per week

At 46 clinical weeks annually: 10,166 wRVUs. At $60/wRVU: about $610,000 in wRVU-based compensation for a high-volume general urologist.

FastRVU wRVU benchmarks for urology (2026):

Marit's self-reported data runs higher: a median of 9,500 wRVUs a year, with the 25th to 75th percentile between 8,215 and 11,000, paid at a median of $62 per wRVU.

At 21.90 wRVUs, the robotic prostatectomy is one of the highest-value common urological procedures. A urologist performing 150 robotic prostatectomies per year generates 3,285 wRVUs from that procedure alone — about 44 percent of FastRVU's 7,500 wRVU median. This procedural density is why robotic surgery fellowship training commands a compensation premium and why hospital systems investing in da Vinci programs actively recruit fellowship-trained robotic surgeons.

The Robotic Surgery Revolution: The Income Premium That Changed Urology

Robotic-assisted laparoscopic surgery — led by Intuitive Surgical's da Vinci Surgical System — has transformed urological oncology and created a bifurcation in urologist compensation that did not exist 15 years ago.

All Star Healthcare Solutions' 2026 urologist salary guide (May 2026) estimates $580,000 to $650,000 a year for robotic and minimally invasive surgery urologists, compared to $400,000 to $580,000 for general urology. These are recruiter estimates; the SalaryDr and Marit urology pages don't report a separate robotic group.

The premium reflects two simultaneous market forces: the technical expertise required to perform complex robotic surgery, and the limited supply of fellowship-trained robotic surgeons in the current market. Hospitals that have invested in a da Vinci Surgical System need a fellowship-trained robotic urologist to maximize utilization of that capital investment — and they pay meaningfully more to recruit one.

The robotic prostatectomy volume driver: Prostate cancer is the most common non-skin cancer in American men, with about 333,830 new cases estimated for 2026 by the American Cancer Society. The overwhelming majority of patients who undergo surgical treatment choose robot-assisted radical prostatectomy — the procedure's combination of precise oncological control, reduced blood loss, shorter hospital stay, and faster recovery has made open radical prostatectomy largely obsolete at centers with robotic capability. A urologist with a strong robotic prostatectomy reputation builds a self-reinforcing referral network: oncologists refer patients, patients refer family members, and primary care physicians refer all their prostate cancer diagnoses to the established robotic surgeon.

The fellowship decision: The Society of Urologic Oncology (SUO) and the Endourological Society each run fellowship programs in urologic oncology and endourology/stone disease respectively. Robotic surgery training is increasingly available as a standalone fellowship or integrated into oncology fellowship. All Star estimates that fellowship training in urologic oncology, robotic surgery, or female pelvic medicine adds 15 to 25 percent to pay, or $50,000 to $150,000 a year.

Urology Subspecialty Income Comparison

The gender pay gap that must be addressed: Marit's data (240 men, 28 women) shows male urologists earning $656,500 versus $564,000 for female urologists — a $92,500 gap, or about 16 percent. Marit cautions that the sample of women is small. For the complete analysis of gender compensation disparities in medicine and strategies for closing them, see our Physician Contract Negotiation guide.

The Men's Health Cash-Pay Model: Urology's Emerging Income Diversifier

The most undercovered income development in general urology over the past five years is the men's health subspecialty — testosterone replacement therapy, erectile dysfunction treatment, male fertility, and penile prosthesis implantation — that creates a cash-pay revenue stream for general urologists without additional fellowship training.

Men's health clinics that operate on a direct-pay membership or fee-for-service cash basis are generating revenue streams for urologists that parallel the cosmetic dermatology and premium IOL models in other specialties.

Testosterone replacement therapy (TRT): Testosterone deficiency (hypogonadism) becomes more common as men age. TRT management — laboratory monitoring, dosage adjustment, symptoms management — generates recurring clinic visits. Some urology practices structure TRT as a cash-pay service with a monthly fee for monitoring and prescription management. As an illustration, a practice with 200 TRT patients at $200 per month would bring in $480,000 per year in cash-pay revenue that is not subject to insurance fee schedules.

Erectile dysfunction and penile prosthesis: Penile prosthesis implantation (CPT 54405) generates 14.16 wRVUs — a high-value procedure with a 2026 national Medicare payment of about $729. The penile implant market has a significant cash-pay component: patients who do not have insurance coverage for the implant pay cash for what is a life-quality-improving but often non-covered procedure. Urologists with high penile implant volume build a referral network from sexual medicine, urogynecology, and primary care that is self-reinforcing and cash-pay-amplified.

Vasectomy volume at scale: Vasectomy (CPT 55250) generates only 3.29 wRVUs — relatively low procedural value. But vasectomies are 30-minute outpatient procedures often performed outside the OR in a dedicated procedure room. At an illustrative cash price of $750 to $1,000, a urologist performing 10 vasectomies per week would bring in $7,500 to $10,000 per week in high-margin, quick-turnover cash revenue. At 46 weeks annually: $345,000 to $460,000 in annual vasectomy revenue from a single procedure type.

The men's health cash-pay model is the urologist's equivalent of what cosmetic services are for dermatology and plastic surgery — a revenue stream that stacks on the insurance-based practice without being subject to the fee schedule constraints that cap professional fee income. For the complete cash-pay model analysis in physician practice, see our Physician Side Income guide.

Academic vs. Private Practice: The Urology Income Gap

Academic urology: $622,000 average on Marit; $475,000 on SalaryDr

Academic urologists at major medical centers — Mayo Clinic, Johns Hopkins, MD Anderson, University of Michigan — perform the highest-complexity urological surgery in medicine: multi-organ resection for bladder cancer, complex pelvic exenteration, urinary diversion reconstruction, and complex robotic surgery on patients whose anatomy has been altered by prior surgery or radiation. The clinical environment is intellectually demanding and the oncological subspecialty expertise required is genuine.

Across 309 urologist salaries on Marit, those in non-academic settings earn $31,500 (5.1 percent) more than those in academic settings, averaging $653,500 versus $622,000. SalaryDr's much smaller academic sample shows a wider gap: $475,000 across 14 reports.

In Marit's larger sample, the academic penalty is modest — about $31,500 a year — because academic urologists maintain procedural volumes that generate meaningful wRVU production. The research protected time that significantly reduces academic compensation in cognitive specialties does not eliminate urological procedural income in the same way.

Private practice urology: $686,172 average on SalaryDr

The private practice premium in urology is driven by ASC ownership, partnership distributions, and access to the cash-pay revenue streams (men's health, vasectomy) that hospital employment often restricts. SalaryDr's private practice average covers 29 reports. On Marit, self-employed urologists earn the most at $664,000, but only just ahead of medical groups ($648,000) and hospital or health system roles ($647,000). Marit attributes the narrow gap partly to ancillary income sitting inside sizable groups rather than solo practice.

Geography: Where Urologists Earn the Most and the Shortage Market Opportunity

On Marit (September 2026), urologist pay is highest in the Southwest Region at $746,500, followed by the Mid-Atlantic ($674,500) and Plains ($664,500) regions. The Great Lakes Region averages $638,500, while the Rocky Mountain ($588,000), New England ($584,500), and West & Pacific Islands ($579,500) regions sit at the low end.

Marit finds no clean urban-rural split, but pay tends to run higher in smaller markets: urologists in small metros average $674,000 and those in rural areas $613,500, against $655,500 in mega metros and $607,500 in large metros. Marit cautions that a strong number in a small market can reflect scarcity and call burden as much as favorable economics.

The shortage market opportunity across all geographies:

The AUA's workforce data is the most compelling financial argument for considering community and shortage market practice in urology. Its 2025 census puts the median age of practicing urologists at 54, with one-third aged 65 or older, which the AUA says raises questions about future workforce capacity, and finds that 62 percent of U.S. counties have no practicing urologist. Barton Associates (June 2026) puts locum tenens urology rates at $200 to $500 per hour: standard clinic coverage lands near the low end, while emergency call, rural assignments, and extended surgical blocks push toward the top of the band.

All Star Healthcare Solutions estimates full-time locum urology work at the equivalent of $360,000 to $570,000 a year, with housing and travel covered separately, and says hard-to-fill rural assignments have reached the equivalent of $625,000 or more. For the complete locum tenens income analysis including the S-Corp election and Solo 401(k) setup that maximizes after-tax locum income, see our Locum Tenens Tax guide.

Highest-paying states on Marit (September 2026):

State averages built on 13 to 23 salaries move as new reports arrive. Texas and Florida also have no state income tax, which adds to their advantage after tax. Use the take-home pay calculator above to run a specific offer, and for the complete after-tax physician salary analysis by state, see our Physician Salary After Taxes guide.

PSLF and Urology: The Academic Calculation

Academic urologists at nonprofit medical centers — and community urologists at nonprofit hospital systems — qualify for PSLF. The training duration creates a favorable PSLF accumulation period.

A urologist completing 5 years of urology residency (including internship year) accumulates 60 qualifying PSLF payments during training before their first attending paycheck. At a qualifying nonprofit employer, they need only 60 more payments — 5 years of attending service — to reach complete PSLF forgiveness.

The dollar calculation:

Profile: Academic urologist, $560,000 attending salary at a nonprofit academic medical center, $295,000 in federal student loans, IBR enrolled from PGY-1.

• •Estimated IBR attending payment: approximately $3,000 per month
• •Remaining qualifying payments needed at attending level: 60 (given 60 accumulated during training)
• •Total attending-year PSLF payments: $3,000 × 60 = $180,000
• •Remaining loan balance forgiven tax-free: approximately $320,000 to $340,000
• •Refinancing alternative, the same $295,000 at 5.5% over 7 years: approximately $356,000 total paid

PSLF advantage: approximately $176,000 in total cost reduction plus complete elimination of the remaining balance.

For a urologist comparing a $560,000 academic position to a $700,000 private practice group partnership track, the $140,000 nominal annual gap is partially offset by PSLF value over 5 attending years — narrowing the effective annual gap to about $105,000 when the PSLF advantage is annualized. Use our PSLF vs. Refinancing Calculator to model the exact forgiveness value at your specific loan balance and training duration.

Urology by Career Stage: The Income Trajectory

Related reading: See where urology ranks in physician wealth in our Physician Net Worth by Specialty rankings.

In SalaryDr's reports, average urologist pay rises from $535,000 at 0 to 2 years of experience (6 reports) to $625,000 at 3 to 5 years (17), $655,806 at 6 to 10 years (31), $645,000 at 11 to 15 years (23), and $725,000 at 16 or more years (11) — driven by ASC partnership access, robotic surgery volume maturation, and deepening referral networks. Marit's larger sample shows the same early climb, from $519,000 at 0 to 2 years to $655,000 at 6 to 10 years, then levels off at $657,500 for urologists with 11 or more years.

Residency (5 years post-MD)

Urology residency — one of the most competitive matches in medicine — provides 5 years of broad surgical training including open surgery, endoscopy, robotic surgery, oncological procedures, and pediatric urology. Residents who demonstrate robotic surgery aptitude and build research records during training enter a highly competitive fellowship matching pool.

New attending, years 0 to 2: $535,000 average (SalaryDr, 6 reports)

All Star Healthcare Solutions notes that underserved rural and Midwest markets often compete for urologists with signing bonuses and loan repayment. The ramp period for surgical volume — building the referral network from urologists' primary source, primary care physicians and oncologists — takes 12 to 24 months before operating room schedules reach full capacity.

Mid-career, years 3 to 10: $625,000 to $655,806 average (SalaryDr)

The partnership transition — where ASC equity access typically becomes available — occurs in this window for private practice urologists. Marit notes that urologists usually begin as employees or guaranteed-salary associates, and that the bigger raise arrives at partnership, with a share of the group's surgery center and ancillary income. As an illustration, a urologist moving from employed associate at $540,000 to private practice partner with 20 percent ASC equity generating $200,000 in annual distributions effectively receives a $200,000 raise from structural change rather than clinical productivity change.

Senior physician, 11+ years: $645,000 to $725,000 average (SalaryDr)

Established private practice urologists with ASC equity, mature robotic surgery volumes, and men's health cash-pay revenue streams reach peak income in this window. SalaryDr's highest experience band, 16 or more years, averages $725,000 across 11 reports.

Lifestyle and Satisfaction: The Surgical Specialty That Doesn't Keep You Up at Night

In SalaryDr's reports, 93 percent of urologists say they would choose the specialty again (86 reports), and average job satisfaction is 4.1 out of 5 (87 reports). Marit's figure is close: 92 percent would choose urology again.

The lifestyle case for urology relative to other high-income surgical specialties is genuine and physician-reported:

• •Urology call is meaningful but not crushing. Urologic emergencies — testicular torsion, obstructing infected ureteral stones, urethral trauma — require after-hours response. But the frequency and physical intensity of urology emergency call is substantially lower than general surgery call (no ruptured abdominal aortic aneurysms at 3 AM, no massive trauma, no fulminant bowel obstructions requiring immediate laparotomy). A urologist covering call at a community hospital will be called in on some nights — demanding, but not the every-night intensity of surgical trauma call.
• •The average work week is about 53 hours in SalaryDr's reports (about 50 on Marit) — a long week, though the call behind it is lighter than general surgery call.
• •The procedural diversity sustains career engagement. The urologist who begins their career performing robotic prostatectomies and kidney surgeries evolves over a career to add stone disease management, pelvic floor reconstruction, men's health, and increasingly neuromodulation and functional urology. The procedural variety prevents the stagnation that single-procedure specialists sometimes experience — and is likely part of why 93 percent would choose the specialty again.

FastRVU's specialty analysis describes urology's work-life balance as better than most surgical specialties — a fact that surprises many residents who assume surgical income requires surgical sacrifice.

Contract Terms for Urologists: What to Negotiate

The ASC partnership timeline — specify it before signing: The most financially consequential contract provision for any private practice urologist is the path to ASC equity. A urologist who builds robotic prostatectomy volume, cystoscopy throughput, and stone procedure efficiency for 4 years toward ASC partnership and discovers the buy-in formula is prohibitive has built ASC revenue for the partnership without capturing any of it personally. Get the specific timeline, buy-in formula, ownership percentage, and eligibility criteria in the signed employment agreement before your first day. For the complete partnership evaluation framework, see our Medical Practice Partnership Buy-In guide.

The wRVU threshold negotiation: All Star Healthcare Solutions puts most urologists at 8,000 to 12,000 wRVUs per year, paid $60 to $80 per wRVU above threshold; Marit's self-reported rates run $59 to $65 (25th to 75th percentile), with a median of $62. The threshold — the production level above which bonus activates — is the single most important number in any employed urology contract. A threshold set well above median production requires above-average production before a single bonus dollar is earned. Negotiate the threshold at or below median production (7,500 wRVUs in FastRVU's benchmark, 9,500 in Marit's reported data) and a conversion factor at or above $60 per wRVU for a market-competitive arrangement. Use our Contract Analyzer to benchmark any offer.

Robotic surgery credentialing: If you are fellowship-trained in robotic surgery and the hospital has a da Vinci program, your credentialing for robotic procedures should be specified in the contract. A hospital that recruits you for your robotic surgery expertise and then delays credentialing for 6 to 12 months — a documented occurrence — costs you both wRVU production and the premium compensation your robotic training commands. Specify the credentialing timeline and the hospital's obligation to complete the process.

The men's health and cash-pay provision: For urologists interested in building a men's health or cash-pay component to their practice, confirm whether the employment contract restricts outside clinical activities or cash-pay services. Some health system employment agreements prohibit urologists from operating a cash-pay men's health clinic, maintaining TRT patient panels outside the employed practice, or moonlighting in any clinical capacity. Know this before signing. See our Physician Contract Red Flags guide for the complete list of provisions to evaluate.

Malpractice tail provision: Tail coverage on a claims-made policy is priced as a multiple of the annual premium and lands as a one-time bill when you leave. Negotiating employer-paid tail for without-cause termination is high-value in any urology contract. For the complete analysis, see our Tail Coverage Explained guide.

Frequently Asked Questions