By VitalPost Editorial · July 7, 2026
Emergency medicine physicians earn a national annual mean of $317,480 and a median of $335,550 (BLS OEWS, May 2025). See how pay varies by state and what drives the differences.
Emergency medicine is one of the most intense specialties in medicine, and compensation reflects both the acuity of the work and the around-the-clock staffing that emergency departments require. According to the U.S. Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) program (May 2025), emergency medicine physicians in the United States earn an annual mean wage of $317,480 and an annual median wage of $335,550. In plain terms, half of the emergency medicine physicians captured in the survey earn more than $335,550 and half earn less.
Those two national numbers are a useful anchor, but they hide a wide range. Where you practice can move your earning power substantially, shaped by local demand, cost of living, competition among employers, and the mix of hospitals and staffing groups operating in a given market. The table below breaks down emergency medicine physician wages by state using the same BLS OEWS (May 2025) dataset.
| Rank | State | Annual mean wage |
|---|---|---|
| 1 | North Dakota | $424,750 |
| 2 | Rhode Island | $411,330 |
| 3 | Iowa | $401,640 |
| 4 | Missouri | $400,590 |
| 5 | Maryland | $387,020 |
| 6 | West Virginia | $381,470 |
| 7 | Vermont | $379,960 |
| 8 | Michigan | $377,660 |
| 9 | Minnesota | $375,630 |
| 10 | Massachusetts | $370,880 |
| 11 | Connecticut | $364,450 |
| 12 | Indiana | $360,570 |
| 13 | New Mexico | $360,410 |
| 14 | Nebraska | $353,880 |
| 15 | Washington | $348,790 |
| 16 | Ohio | $344,190 |
| 17 | Alaska | $341,520 |
| 18 | North Carolina | $340,980 |
| 19 | South Dakota | $335,490 |
| 20 | Florida | $301,220 |
| 21 | Oklahoma | $300,600 |
| 22 | Mississippi | $300,550 |
| 23 | District of Columbia | $292,750 |
| 24 | South Carolina | $285,730 |
| 25 | Texas | $262,170 |
| 26 | New Jersey | $262,080 |
| 27 | Georgia | $259,490 |
| 28 | New York | $257,790 |
| 29 | Idaho | $242,480 |
| 30 | Kentucky | $214,570 |
| 31 | Utah | $178,200 |
Figures are U.S. Bureau of Labor Statistics OEWS annual mean wages, May 2025 (31 states/territories with published data; BLS suppresses some states, which are omitted rather than estimated).
State-to-state wage gaps are rarely random. A handful of forces show up again and again.
Cost of living and wage normalization. High-cost coastal metros often post strong nominal salaries, but those dollars buy less housing, childcare, and everyday goods. Conversely, some lower-cost states post headline numbers that look modest yet stretch much further in real terms. When you compare offers across states, adjust for local cost of living rather than reacting to the raw figure alone.
Supply, demand, and rural premiums. Emergency departments must be staffed 24/7/365, so a shortage of physicians willing to work in a given area pushes pay up. Rural and remote hospitals, critical-access facilities, and communities that struggle to recruit frequently offer premiums, sign-on bonuses, and loan-repayment incentives that a wage survey alone will not show. Densely served urban markets with training programs and a deep applicant pool can be more competitive and, sometimes, lower-paying per shift.
Employment setting and employer type. How a state's emergency medicine workforce is organized matters. Markets dominated by large hospital systems, academic medical centers, contract-management groups, or independent democratic groups can produce very different pay structures. Academic roles may trade some cash compensation for teaching, research time, and benefits. Staffing and locum-tenens arrangements can pay a high hourly rate but shift more risk and instability onto the physician.
Payer mix and patient volume. States and regions differ in insurance coverage, reimbursement, and how busy their departments run. Higher-acuity, higher-volume departments in growing regions can support stronger compensation, while areas with thin volumes or heavy uncompensated care may constrain it.
Treat the BLS figures as a well-sourced baseline, not a personal quote.
Mean vs. median. The mean (average) is pulled by the highest and lowest earners, while the median (midpoint) better reflects a typical physician. When the two diverge, the median is usually the safer reference point for "what someone like me tends to make." Look at both to understand the shape of the distribution in your market.
All settings are blended. Each state figure combines hospitals, outpatient and freestanding emergency centers, academic institutions, and other employers, across metro and non-metro areas and every experience level. A single number therefore averages a first-year attending and a 20-year veteran, a rural critical-access shift and a high-volume urban trauma center. Your specific setting, subspecialty, shift load, and seniority can move you well above or below the state figure.
Individual offers vary widely. Base salary is only part of the picture. Productivity models (such as RVU-based pay), shift differentials for nights, weekends, and holidays, sign-on and retention bonuses, malpractice coverage, retirement contributions, and paid time off all change the true value of an offer. Two positions with the same headline salary can differ meaningfully once the full package is counted.
Self-employed and partnership physicians are undercounted. OEWS primarily captures wage and salary workers. Many emergency physicians work as independent contractors, own equity in a democratic group, or are partners whose income flows through profit distributions rather than a W-2 wage. Those earnings are not fully reflected here, which is one reason real-world compensation in some markets runs higher than a wage survey suggests. Emergency medicine also carries structural realities worth weighing alongside pay: circadian disruption from rotating shifts, burnout risk, and shifting dynamics around contract-management and group ownership.
When you negotiate, pair these state benchmarks with specialty compensation surveys, local recruiter intelligence, and colleagues' real numbers. The BLS data tells you the neighborhood; your own diligence tells you the house.
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