Neurosurgeons stand at the very top of the medical pay scale. Known for their complex operations on the brain, spine, and nervous system, they undergo some of the longest and most intensive training in medicine. By 2025, neurosurgeons remain among the highest-earning physicians in the United States, but their salaries vary significantly depending on experience, subspecialty, and where they practice.
This article breaks down what neurosurgeons really earn in 2025. We’ll look at national averages, how pay changes with years of experience, which states offer the highest compensation, and which subspecialties command the biggest paychecks. We’ll also explore how neurosurgeon salaries compare to other specialties and highlight factors—such as malpractice costs and practice setting—that can influence income. Whether you’re a medical student, a resident considering neurosurgery, or simply curious about physician pay, this guide provides a clear, data-driven picture.
Average Neurosurgeon Salary in 2025
According to the most recent data from the Bureau of Labor Statistics (BLS), Medscape’s 2025 Physician Compensation Report, and Doximity, the **average neurosurgeon in the United States earns between $780,000 and $950,000 annually. At the very top end, highly experienced or specialized neurosurgeons—particularly those in private practice or high-demand regions—can earn over $1.2 million per year.
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Median salary (U.S.): ~$880,000
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Top 10%: $1,200,000+
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Bottom 10% (newer attendings): ~$450,000
These numbers make neurosurgery one of the best-compensated medical careers, consistently ranking alongside orthopedic surgery and interventional cardiology. However, the figures don’t tell the whole story: years of training, malpractice premiums, and intense workloads all factor into the financial reality of this specialty.
Do neurosurgeons earn more in private practice or hospitals?
Private practice neurosurgeons generally earn more due to higher procedure volumes and fewer institutional salary caps, while hospital-employed neurosurgeons may have more stable but slightly lower incomes.
How much does a neurosurgeon make in 2025?
In 2025, U.S. neurosurgeons earn $780,000–$950,000 on average, with top earners exceeding $1.2 million annually.
Which neurosurgery subspecialty pays the most?
Spine and complex cranial neurosurgeons often earn the highest salaries, while academic roles typically pay less.