Best US States for Surgeons
All 50 states + DC ranked by Surgeon salary. State tax structure noted for take-home math.
| # | State | Estimated salary | Cost mult. | State tax |
|---|---|---|---|---|
| 1 | District of Columbia | $336,000 | 1.20× | ~5% effective |
| 2 | California | $330,400 | 1.18× | ~5% effective |
| 3 | Hawaii | $322,000 | 1.15× | ~5% effective |
| 4 | New York | $322,000 | 1.15× | ~5% effective |
| 5 | Alaska | $316,400 | 1.13× | No state tax |
| 6 | New Jersey | $316,400 | 1.13× | ~5% effective |
| 7 | Massachusetts | $313,600 | 1.12× | ~5% effective |
| 8 | Connecticut | $308,000 | 1.10× | ~5% effective |
| 9 | Washington | $308,000 | 1.10× | No state tax |
| 10 | Maryland | $302,400 | 1.08× | ~5% effective |
| # | State | Salary | After state tax (rough) |
|---|---|---|---|
| 1 | District of Columbia | $336,000 | $246,456 |
| 2 | California | $330,400 | $242,348 |
| 3 | Hawaii | $322,000 | $236,187 |
| 4 | New York | $322,000 | $236,187 |
| 5 | Alaska | $316,400 | $247,899 |
| 6 | New Jersey | $316,400 | $232,079 |
| 7 | Massachusetts | $313,600 | $230,026 |
| 8 | Connecticut | $308,000 | $225,918 |
| 9 | Washington | $308,000 | $241,318 |
| 10 | Maryland | $302,400 | $221,810 |
| 11 | Colorado | $294,000 | $215,649 |
| 12 | New Hampshire | $294,000 | $230,349 |
| 13 | Oregon | $294,000 | $215,649 |
| 14 | Rhode Island | $288,400 | $211,541 |
| 15 | Virginia | $288,400 | $211,541 |
| 16 | Nevada | $285,600 | $223,768 |
| 17 | Arizona | $280,000 | $205,380 |
| 18 | Delaware | $280,000 | $205,380 |
| 19 | Florida | $280,000 | $219,380 |
| 20 | Illinois | $280,000 | $205,380 |
| 21 | Minnesota | $280,000 | $205,380 |
| 22 | Vermont | $277,200 | $203,326 |
| 23 | Maine | $271,600 | $199,219 |
| 24 | Pennsylvania | $271,600 | $199,219 |
| 25 | Texas | $271,600 | $212,799 |
| 26 | Utah | $271,600 | $199,219 |
| 27 | Georgia | $263,200 | $193,057 |
| 28 | North Carolina | $263,200 | $193,057 |
| 29 | Idaho | $260,400 | $191,003 |
| 30 | Michigan | $260,400 | $191,003 |
| 31 | Montana | $260,400 | $191,003 |
| 32 | Wisconsin | $260,400 | $191,003 |
| 33 | Wyoming | $260,400 | $204,023 |
| 34 | New Mexico | $257,600 | $188,950 |
| 35 | North Dakota | $257,600 | $188,950 |
| 36 | South Carolina | $257,600 | $188,950 |
| 37 | Tennessee | $257,600 | $201,830 |
| 38 | Indiana | $254,800 | $186,896 |
| 39 | Kansas | $254,800 | $186,896 |
| 40 | Nebraska | $254,800 | $186,896 |
| 41 | Ohio | $254,800 | $186,896 |
| 42 | South Dakota | $254,800 | $199,636 |
| 43 | Iowa | $252,000 | $184,842 |
| 44 | Louisiana | $252,000 | $184,842 |
| 45 | Missouri | $252,000 | $184,842 |
| 46 | Alabama | $246,400 | $180,734 |
| 47 | Kentucky | $246,400 | $180,734 |
| 48 | Oklahoma | $246,400 | $180,734 |
| 49 | Arkansas | $240,800 | $176,627 |
| 50 | West Virginia | $240,800 | $176,627 |
| 51 | Mississippi | $235,200 | $172,519 |
Salary range across states
For Surgeons, the estimated median salary ranges from $235,200 in Mississippi to $336,000 in District of Columbia — a 43% range. State-by-state variation reflects local cost of living, employer density, and labor market dynamics.
No-state-tax states
Nine US states have no state income tax: Alaska, Washington, New Hampshire, Nevada, Florida, Texas, Wyoming, Tennessee, South Dakota. For high earners, this can mean $5,000-15,000+ extra per year in take-home pay vs neighboring states with similar gross salaries. New Hampshire taxes interest/dividends only (phasing out).
But: many no-state-tax states make up revenue with higher property tax (Texas) or sales tax (Tennessee). And cost of living varies — Texas urban metros (Austin, Houston) have grown expensive while Florida coastal areas command premium real estate prices.
Cost of living matters more than nominal salary
California pays the most for Surgeons on a nominal basis — but housing in coastal California (SF, LA, San Diego) eats 35-50% of net income for median earners. A Surgeon earning $330,400 in California often has less spendable income than one earning $271,600 in Texas.
Use our cost-of-living comparison tool to see specific city pairs. For state-level take-home, use our state-specific Paycheck Calculator.