What is the average salary of an ER doctor in the US?

Emergency medicine physicians in the United States earn an average total compensation of approximately $399,000 to $421,000 per year.

Compensation Breakdown

• Average / Median Salary: Around $399,000–$421,000 annually.
• Hourly Pay Rates: Typically range from $190 to $300+ per hour, depending heavily on the location and distance from major metro areas.
• Bonuses and Incentives: Many positions include performance or RVU (Relative Value Unit) bonuses, with median bonus packages averaging around $65,000.
• Locum Tenens & Independent Contractors (1099): Independent or locum tenens roles often command higher total compensation, frequently ranging from $585,000 to $880,000 annually for heavier or flexible shift work.

Factors Affecting Pay

• Geography: Desirable urban locations with short commutes often see lower hourly rates ($190–$220/hr), whereas rural or remote areas and certain states like Texas and Florida pay significantly higher.
• Practice Setting: Private practice setups often report higher average total compensation compared to standard hospital-employed positions.
• Job Market: Resources like the American College of Emergency Physicians provide ongoing updates on contract offerings and regional trends.

The highest-paid emergency room (ER) doctors typically work in Anesthesiology Critical Care Medicine or specialized critical care subspecialties, earning upwards of $500,000 per year.

Highest-Paying ER Subspecialties and Roles

• Anesthesiology Critical Care Medicine: $393,000 to $532,000+ per year.
• Internal Medicine-Critical Care (Intensivists): $341,000 to $444,000+ per year.
• Pediatric Emergency Medicine: $359,000 to $486,000 per year.
• Emergency Medical Services (EMS) Subspecialists: $293,000 to $393,000+ per year.

Factors Impacting ER Pay

• Standard ER Salary: General emergency medicine physicians average around $421,000 annually according to recent Weatherby Healthcare data, with top earners in the 90th percentile clearing $500,000.
• Practice Structure: Independent contractors, private democratic groups, and partnership-track positions yield higher hourly and total compensation than standard hospital-employed or academic roles.
• Location: States like Florida, Texas, and California often report higher nominal pay and lucrative shift bonuses.

Several surgical and medical specialists average $500,000 or more per year in total annual compensation.

Highest-Paid Specialties

According to recent data from the Medscape Physician Compensation Report, the medical specialties that average over $500,000 annually include:

• Neurosurgeons: ~$749,000 to $764,000 per year
• Thoracic / Cardiothoracic Surgeons: ~$700,000 to $721,000 per year
• Orthopedic Surgeons: ~$624,000 to $655,000 per year
• Plastic Surgeons: ~$571,000 to $620,000 per year
• Oral and Maxillofacial Surgeons: ~$614,000 per year
• Radiation Oncologists: ~$569,000 per year
• Cardiologists: ~$565,000 per year
• Vascular Surgeons: ~$556,000 per year
• Radiologists: ~$532,000 per year
• Urologists: ~$529,000 per year
• Gastroenterologists: ~$450,000 to $600,000 per year

Key Factors Impacting Pay

• Surgical Training: Highly complex surgical fields require lengthy residencies and technical precision, driving up pay.
• Demand and Procedures: High demand for procedures (like joint replacements or heart care) increases revenue potential.
• Location and Practice: Salaries vary widely based on geographic region, private practice vs. hospital employment, and productivity bonuses.

Yes, ER (emergency room) doctors generally make more than "regular" primary care doctors (like family medicine or internal medicine), but less than high-paying surgical and procedural specialists.

ER Doctor Pay vs. Primary Care

• ER Doctors: Earn an average annual total compensation of around $380,000 to $421,000.
• Primary Care Doctors: Typically earn less, often averaging between $250,000 and $280,000 a year.
• Training Advantage: According to the White Coat Investor, ER residency training is often 3 years (similar to primary care), meaning ER doctors start earning high salaries earlier than doctors who train for 5 to 7 years.

ER Doctor Pay vs. Other Specialists

• Middle of the Pack: In national specialty pay rankings, emergency medicine sits solidly in the middle.
• Higher Earners: Surgical and medical subspecialties—such as orthopedics, cardiology, and radiology—regularly average over $500,000 per year.

Factors That Affect ER Pay

• Hourly Rates: Many ER doctors are paid an hourly rate ranging from $150 to over $300 per hour, depending on the facility and shift times.
• Location: Rural and underserved community hospitals often pay higher hourly rates to attract staff compared to desirable urban academic centers.
• Work Structure: Independent contractor and private group roles can yield higher earnings than hospital-employed positions, though they require self-funding benefits.

A first-year attending emergency room (ER) doctor typically makes between $300,000 and $450,000 per year, depending heavily on location, shift counts, and practice structure.

Average Pay and Hourly Rates

• National Average: Overall emergency medicine compensation averages roughly $421,000 per year according to the Weatherby Healthcare Emergency Medicine Salary Report. First-year doctors often start slightly below the mid-career average, but can match it quickly depending on hours worked.
• Hourly Pay: Most ER doctors are paid an hourly rate ranging from $200 to $300+ per hour, with independent contractor (1099) roles in rural or underserved areas often paying higher hourly rates than employee (W2) positions.

Key Factors Impacting First-Year Pay

• Geography: Rural areas and regions with high demand (such as parts of the South, Midwest, or Pacific Northwest) usually offer higher hourly rates to attract physicians. Major metropolitan areas with high residency density often have lower starting offers due to higher supply.
• Practice Setting: Private community hospitals and independent groups generally pay more than academic medical centers, which trade higher pay for research and teaching opportunities.
• Shift Mix: Working nights, weekends, and holidays often includes shift differentials that boost total take-home pay.
• Compensation Model: Some positions offer a flat salary, while others rely on an hourly wage plus Relative Value Units (RVUs) tied to patient volume and documentation productivity.