- The average neurosurgeon salary in the US reaches $721,201 (₹6.4 Crore) annually, making it one of medicine’s highest-paid specialties.
- Private practice neurosurgeons earn the highest compensation, averaging $800,000 (₹7.1 Crore) per year, compared to other practice settings.
- Spine surgery and vascular neurosurgery represent the highest-paid neurosurgery subspecialisations in the US.
What if your passion for saving lives could also secure one of medicine’s most rewarding careers in the USA? The journey to becoming a neurosurgeon demands years of dedication, yet the financial and professional rewards make it one of healthcare’s most sought-after specialisations. Every day, these specialists perform life-changing procedures that restore hope to patients and families facing the most challenging neurological conditions.
In this blog, we’ll break down how much neurosurgeons earn at various career stages and what factors influence their pay.
Who Are Neurosurgeons?
Neurosurgeons stand at the intersection of medicine’s most challenging specialty, where precision meets life-saving intervention. These highly trained medical professionals specialise in diagnosing and treating conditions affecting the brain, spinal cord, and peripheral nervous system through both surgical and non-surgical methods.
The path to neurosurgery requires completing four years of medical school, followed by one of medicine’s longest residency programmes spanning seven years of intensive training. Neurosurgeons treat conditions ranging from brain tumours and aneurysms to spinal disorders and traumatic injuries.
Neurosurgeon Salaries in the USA
Understanding compensation structures helps medical professionals make informed career decisions. Neurosurgeon salaries in the United States vary significantly based on data sources, practice type, geographic location, and experience level, making it one of the highest-compensated medical specialties.
Average Annual Earnings
Neurosurgeon salaries typically range from $394,000 to $936,000 annually (₹3.4 Crore to ₹8.2 Crore), with the average standing at approximately $721,201 per year (₹6.4 Crore). This translates to an average hourly rate of $347 (₹30,809).
Salary by Practice Type
The setting where neurosurgeons practise significantly impacts their earning potential and work-life balance. According to data from NERVES (Neurosurgery Executives’ Resource Value and Education Society), compensation varies substantially across practice settings.
| Practice Type | Average Annual Salary (USD) | Average Annual Salary (INR) |
|---|---|---|
| Private Practice | $800,000 | ₹7.1 Crore |
| Hospital Employment | $721,201 | ₹6.4 Crore |
| Academic/Teaching | $647,000 | ₹5.7 Crore |
Private practice offers the highest financial rewards but requires business management skills and often involves longer working hours. Hospital employment provides stability, structured schedules, and comprehensive benefits packages. Academic positions offer opportunities for research, teaching, and contributing to medical advancement.
Top 5 Highest-Paying States for Neurosurgeons in the USA
Geographic location creates substantial salary variations for neurosurgeons across the United States. According to MGMA, these are the median salaries for neurosurgeons by state:
| Rank | State | Average Neurosurgeon Salary (USD) | Average Salary in INR (Crore) |
|---|---|---|---|
| 1 | South Carolina | $1,439,660 | ₹4.6 Cr |
| 2 | Virginia | $1,178,753 | ₹4.6 Cr |
| 3 | Minnesota | $1,144,000 | ₹4.1 Cr |
| 4 | Florida | $1,127,357 | ₹3.7 Cr |
| 5 | California | $1,117,888 | ₹3.7 Cr |
Top Factors Affecting Neurosurgeon Salary in the USA
Many different elements contribute to the significant salary variations in a neurosurgeon’s career. Below are some of the most common factors that influence their earnings.
1. Experience Level
Experience remains one of the most significant determinants of neurosurgeon compensation, with earnings increasing substantially throughout a career.
Neurosurgery Residents
Residents work under supervision while developing surgical skills and clinical judgment, with compensation reflecting their trainee status despite demanding 80+ hour work weeks.
- Average Salary: $60,000–$80,000/year (₹53.2-71L)
Early Career Neurosurgeons (1-5 years post-residency)
Surgeons begin independent practice, building their patient panels, professional reputation, and surgical volume.
- Average Salary: $350,000–450,000/year (₹3-3.9 Cr)
Senior Neurosurgeons (15+ years)
Maximum efficiency, extensive referral networks, partnership stakes in practices, and premium rates for expertise in complex cases drive top-tier compensation.
- Average Salary: $700,000–$900,000+/year (₹6.2-7.9+ Cr)
2. Subspecialisation
Neurosurgery encompasses various subspecialties, each commanding different salary ranges based on case complexity, demand, and required expertise.
| Subspecialty | Average Annual Salary (USD) | Average Annual Salary (INR) |
|---|---|---|
| Pediatric Neurosurgery | $500,000–$620,000 | ₹4.4-5.5 Cr |
| Neurocritical Care | $340,000–$450,000 | ₹3.0-3.9 Cr |
| Functional Neurosurgery | $580,000–$700,000 | ₹5.1-6.2 Cr |
| Neuro-Oncology | $620,000–$750,000 | ₹5.5-6.6 Cr |
| Vascular Neurosurgery | $650,000–$800,000 | ₹5.7-7.1 Cr |
| Spine Surgery | $700,000–$850,000 | ₹6.2-7.5 Cr |
| Skull Base Surgery | $600,000–$720,000 | ₹5.3-6.4 Cr |
Best Medical Schools for Neurosurgery Programmes in USA
Selecting the right medical school and residency programme shapes your entire career trajectory. These institutions offer world-class training, research opportunities, and connections that open doors throughout your professional life.
| University | Medical School Name | QS World University Ranking 2026 |
|---|---|---|
| Harvard University | Harvard Medical School | #4 |
| Stanford University | Stanford University School of Medicine | #6 |
| University of Pennsylvania | Perelman School of Medicine | #11 |
| Johns Hopkins University | Johns Hopkins University School of Medicine | #14 |
| University of California, Los Angeles (UCLA) | David Geffen School of Medicine | #16 |
Conclusion
Neurosurgery represents one of medicine’s most demanding yet rewarding career paths in the USA, with average salaries of approximately $721,201 (₹6.4 Crore) annually. The financial rewards match the dedication required, with private practice offering the highest compensation, followed by hospital employment and academic positions that balance research with patient care.
Your earning potential grows exponentially with experience. What begins as a resident’s journey transforms into a senior surgeon’s premium compensation, especially when you specialise in high-demand areas like spine or vascular neurosurgery.
The path starts with gaining admission to prestigious medical schools and completing an intensive residency program that shapes world-class surgeons.
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FAQs
Do neurosurgeons need to complete a fellowship after residency?
In the United States and similar systems, neurosurgeons are not required to complete a fellowship to practice.
Can neurosurgeons in the US work part-time or in locum tenens positions?
Yes, neurosurgeons in the US can work part-time and are in high demand in locum tenens.
Can international medical graduates become neurosurgeons in the USA?
Yes, international medical graduates can match into US neurosurgery residencies after passing USMLE exams and obtaining ECFMG certification.
What are the typical working hours for neurosurgeons in the USA?
Neurosurgeons typically work 60-80 hours weekly, including emergency on-call duties and weekend coverage responsibilities.
How much do neurosurgeons pay for malpractice insurance annually?
Neurosurgeons pay malpractice insurance premiums up to $100,000 (₹88 lakh) annually.
What is the average neurosurgeon salary in the USA in 2026?
The average neurosurgeon salary in the USA is approximately $721,201 (₹6.4 crore) per year, with an hourly rate of $347.
What is the highest-paying neurosurgery subspeciality in the USA?
Spine surgery offers the highest compensation, ranging from $700,000 to $850,000 (₹6.2-7.5 crore) annually.
How long is neurosurgery residency training in the USA?
Neurosurgery residency requires seven years of intensive training following four years of medical school
Which US state pays neurosurgeons the highest salary?
South Carolina offers the highest median neurosurgeon salary at $1,439,660 (₹12.7 crore) annually, followed by Virginia and Minnesota.
How much do neurosurgeons earn in private practice versus hospital employment?
Private practice neurosurgeons earn approximately $800,000 (₹7.1 Cr) annually, whilst hospital-employed neurosurgeons earn around $721,201 (₹6.4 Cr) per year.
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