Anesthesiologist Salary (2026): Pay Guide for All 50 States

Board-certified anesthesiologists in the United States earn a national median of $409,107 per year — among the highest of any U.S. occupation tracked by the Bureau of Labor Statistics. Anesthesiology consistently ranks alongside cardiology, orthopedic surgery, plastic surgery, and neurosurgery as one of the top-paid physician specialties, supported by persistent demand for surgical and obstetric coverage, expanding ambulatory and non-OR anesthesia volume, and a constrained pipeline of new graduates from accredited residency programs.

The national median is only the middle of the distribution. Three numbers describe the real range of anesthesiologist compensation:

• Entry-level anesthesiologists (10th percentile): $106,026/year — typically newly board-eligible or board-certified physicians in their first 1–2 years out of residency, often in academic centers or as employed staff at large hospital systems.
• Median anesthesiologist (50th percentile): $409,107/year — the working ABA-board-certified anesthesiologist with 3–10 years of practice, frequently in an Anesthesia Care Team (ACT) model at a community or regional hospital or in private-practice group employment.
• Top-earning anesthesiologists (90th percentile): $582,201/year — senior physicians in high-demand metros, partner-track anesthesiologists at independent groups, cardiac and cardiothoracic anesthesia subspecialists, pediatric anesthesiologists at quaternary children's hospitals, and interventional pain physicians whose practices generate procedural revenue independent of OR caseload.

Geographic location matters, but practice model and subspecialty matter more for anesthesiologists than for almost any other physician specialty. Anesthesiologists in Bellevue, WA earn a median of $682,667, while colleagues in Chicago, IL earn around $81,270. Independent private-practice partners and locum-tenens anesthesiologists in rural critical-access markets routinely out-earn academic peers by $150,000–$400,000+. State physician supervision rules — particularly whether CRNAs require physician supervision for Medicare billing (opt-in vs opt-out states) — also push pay in measurable ways.

Anesthesiologist Salary vs Anesthesiology Physician Salary — Are They the Same?

Yes. Anesthesiologist Salary and Anesthesiology Physician Salary describe the same paycheck. An anesthesiologist is a Doctor of Medicine (MD) or Doctor of Osteopathy (DO) who has completed a 1-year internship plus a 3-year clinical anesthesia (CA-1 through CA-3) residency in a program accredited by the Accreditation Council for Graduate Medical Education (ACGME), passed the United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA), and obtained board certification from the American Board of Anesthesiology (ABA). Most also hold membership in the American Society of Anesthesiologists (ASA), the specialty's professional society. Many anesthesiologists pursue a 1-year ACGME-accredited fellowship after residency:

• Cardiothoracic anesthesiology — heart, lung, and great-vessel surgery
• Pediatric anesthesiology — children and infants, often at quaternary children's hospitals
• Obstetric anesthesiology — labor analgesia and obstetric anesthetics
• Pain medicine — interventional and chronic pain management
• Regional anesthesia and acute pain medicine
• Critical care medicine — ICU practice alongside or instead of OR practice

All of these reference SOC code 29-1211 in the Bureau of Labor Statistics Occupational Employment and Wage Statistics survey — the data source used throughout this site. Note that certified registered nurse anesthetists (CRNAs, SOC 29-1151) are tracked under a separate SOC code; the two professions often work alongside one another but compensation structures differ markedly.

Compensation Structure: Base, Bonus, Call, and Partnership

Anesthesiologist compensation rarely fits a single number. Most physicians receive base salary plus multiple variable components, and the structure varies sharply by practice model:

• Employed anesthesiologists (hospital, large group, ACT model): base salary plus wRVU-based productivity bonus and a fixed call-coverage stipend; total compensation commonly $375,000–$475,000.
• Private-practice group associates (pre-partner track): typically W2 base salary 60–75% of partner compensation during a 2–3 year buy-in period.
• Private-practice group partners: distribution-based compensation — the highest reliable income tier — often $450,000–$700,000+ in independent groups serving busy surgical hospitals.
• Locum tenens anesthesiologists: $200–$350+/hour at critical-access hospitals and ASCs, paid by 1099 contract; full-time annualized locum work commonly reaches $500,000–$700,000+ with housing and travel stipends.
• Academic anesthesiologists: base salary 15–30% below community private practice, but with structured benefits, retirement match, sabbatical eligibility, and protected time for teaching and research.

Total compensation typically includes ABA recertification (MOCA), state license fees, DEA registration, ASA dues, $5,000–$15,000 CME stipends, and full malpractice tail coverage on top of base pay.

2026 Anesthesiologist Salary Projection

Anesthesiologist pay has grown at a compound annual rate of 4.50% over the past five years, driven by sustained surgical volume, expansion of non-OR anesthesia (endoscopy, interventional radiology, cardiology procedures), persistent rural and critical-access coverage gaps, and the structural supply constraint of a 12+ year training pipeline (4 years medical school + 4 years residency + optional fellowship). The Bureau of Labor Statistics projects employment for Anesthesiologists to continue growing in line with overall surgical demand through 2033, keeping strong upward pressure on wages, especially for cardiac, pediatric, and pain-medicine subspecialists.

A partner-track private-practice anesthesiologist in a busy Texas surgery center can earn nearly double what a same-experience academic colleague at a metropolitan medical center takes home. Four factors explain almost all of that gap: practice model, subspecialty, location and state CRNA supervision rules, and call and coverage burden.

1. Practice Model: The Single Largest Pay Driver

For anesthesiologists, practice model dominates the compensation conversation:

• Independent private-practice partner — the historical top of the anesthesiologist pay scale. Partners share distribution from a group's collected revenue minus overhead and associate-physician costs. Groups serving busy ambulatory surgery centers (ASCs) and orthopedic-heavy surgical hospitals routinely pay partners $500,000–$750,000+.
• Anesthesia Care Team (ACT) model — physician anesthesiologists supervising CRNAs and AAs (Anesthesiologist Assistants) under medical-direction billing rules. Common at large hospital systems; produces predictable mid-six-figure compensation with moderate call burden.
• Employed staff anesthesiologist — W2 employment at a hospital or large MSO-owned group. Strong benefits, structured retirement, predictable schedule; base compensation typically $375,000–$475,000.
• Locum tenens — short-term 1099 contracts at critical-access hospitals and ASCs; $200–$350+/hour all-in.
• Academic anesthesiologist — university or quaternary-care hospital employment. Lower base pay than community private practice but with sabbatical eligibility, academic appointments, and research support.

2. Subspecialty: Cardiac and Pain at the Top

Cardiothoracic anesthesiologists and interventional pain physicians consistently lead the pay scale within anesthesiology. Cardiac fellowship adds 1 year of training and unlocks high-acuity cases (CABG, valve, transplant, ECMO management) that command premium pay at quaternary-care hospitals. Interventional pain physicians generate procedural revenue (epidural steroid injections, facet ablations, spinal cord stimulator implants) that diversifies income away from OR caseload. Pediatric anesthesiologists at Level-4 children's hospitals also reliably earn above the median for the specialty. Obstetric anesthesiologists and regional/acute-pain fellowship holders fill important high-volume roles with strong compensation though slightly below the cardiac and pain top tiers.

3. Location, State Opt-Out Rules, and Rural Premium

Metropolitan academic centers in high-cost cities (Boston, San Francisco, New York) pay competitive base salaries but rarely top the national pay scale once cost of living is considered. The highest-paying U.S. markets for anesthesiologists are typically rural and suburban communities in opt-out states — those where CMS has accepted state-level certification that physician supervision is not required for CRNA Medicare billing:

• Opt-out states — Iowa, Nebraska, Idaho, Minnesota, New Hampshire, New Mexico, Kansas, North Dakota, Washington, Alaska, Oregon, Montana, South Dakota, Wisconsin, California, Colorado, Kentucky — change the local market structure for anesthesia coverage in ways that often favor physician compensation in critical-access settings.
• Health professional shortage areas (HPSAs) — rural and underserved markets frequently offer $50,000–$150,000 sign-on bonuses, paid relocation, and federal student-loan repayment for anesthesiologists willing to anchor a community's surgical coverage.
• Ambulatory surgery centers (ASCs) — high-volume outpatient surgery centers, particularly those owned in part by physician groups, often produce the highest per-FTE anesthesiologist incomes in their region.

4. Call Burden, Holiday Coverage, and Productivity

Anesthesiologist total compensation routinely includes call pay, weekend differentials, holiday premiums, and procedure-based productivity bonuses that can add 15–30% to base salary. Hospitals structure call differently — some pay a flat per-hour rate for in-house call whether or not the anesthesiologist is activated, others pay only when called in. Busy trauma rotations, OB epidural coverage, and cardiac cases on call can substantially expand total compensation. When comparing offers, the all-in number — base + call + productivity + partnership distribution + benefits + retirement match — matters far more than headline base salary.

For a complete city-by-city breakdown of anesthesiologist salaries — including BLS percentile data (10th, 25th, 50th/median, 75th, 90th), local cost-of-living adjustments, and 2026 salary projections — browse the 1,661+ metro areas tracked in our dataset below.