While orthopedic surgeons are among the highest-paid physician specialists in 2025, their wages suffered a 3% decline between 2024 and 2025.
Additionally, according to the U.S. Bureau of Labor Statistics’ inflation calculator, the average salary for orthopedic surgeons in 2015, $421,000, has the same buying power as $572,253 in 2025. In 2025, orthopedic surgeons are earning an average salary of $543,000, falling slightly below 2015 earnings, based on current inflation rates.
Becker’s connected with five orthopedic and spine specialists to discuss whether current compensation trends are keeping pace with inflation and other economic factors.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Do you feel that orthopedic and spine surgeons are fairly compensated in comparison to rising rates of inflation?
Adam Bruggeman, MD. Orthopedic Surgeon at Texas Spine Center (San Antonio): Compensation is well behind the actual cost of care. It’s not just spine surgeons or orthopedic surgeons, it’s our colleagues in every aspect of medicine, including every physician specialty, physical therapy, social work, counseling, and our nurse practitioners and physician assistants.
In 2000, the Medicare conversion factor was $36.6173. Today, it is $32.4365. Inflation is nearly 100% in that timeline. If you even assume that the 2000 fee schedule was appropriate, doctors should have a conversion factor over $70.
Ultimately, the answer to the question lies in the percentage of doctors who have chosen employment over independent practice. Over 70% of U.S. physicians are now employed. This wasn’t by chance, and it likely wasn’t the choice most would make, all things being equal. Over half of those who became employed have done so in the last decade. Physicians have hung on as long as they can in independent practice, but without a counterbalance to the dramatic declines in compensation, the very fabric of our healthcare system has been torn apart. Meanwhile insurers and hospitals, who are the most common employers of physicians, are seeing large returns over the last decade. Physicians, regulators and legislators must work together to find solutions that allow the independent practice of medicine to thrive. Consolidation has hurt all of us.
Brian Gantwerker, MD. President of the Craniospinal Center of Los Angeles: It takes about over a dozen and a half years to make a spine surgeon. A lot of time, money, people giving up weekends and nights, goes into that training, and it takes a long time to get the privilege of operating on someone. It would make more sense to be fairly compensated for it. Basically to be compensated on a scale that is comparable to the amount of training and skill level. For one, there has never been a cost of living adjustment for Medicare reimbursements. Not ever in the history of Medicare. There has never been an inflation adjustment for Medicare. There has never been an inflationary adjustment and the costs keep going up and up and up. So one of two things happen: Physicians join a large system and become employed, or they stop taking certain insurances. It would behoove regulators and policy makers that physicians should be compensated more fairly. When you get into the conversation of what would be fair compensation, people who make the policies don’t want to have that discussion. The conversation always falls apart. When you say, let’s talk about compensation, the line always goes dead. Or an ad hominem attack happens. Until people are interested in discussing what physicians should make, we will never solve this problem and physicians will never be compensated fairly. I have had patients say, ‘I saw the summary of benefits from Medicare and its highway robbery. You did a three-and-a-half hour surgery on my back and they paid you $800?’ Until people in government are serious about talking about what physicians should make based on skill level and cost of doing business, it wont get better.
Thomas Loftus, MD. Neurosurgeon and Founder at Austin (Texas) Neurological Institute: Compensation has been steadily falling for decades with continuing Medicare cuts and bundling of procedure codes. We have seen steadily decreasing reimbursements for many years in relation to “normal” inflation, but the recent significant inflation rate increases have only accelerated the decline in adjusted income for all specialties including spine surgeons.
Abilio Reis, MD. Spine surgeon at OrthoVirginia (North Chesterfield): Absolutely not.
Lali Sekhon, MD. Neurosurgeon at Reno (Nev.) Orthopedic Center: The risk reward ratio for orthopedic surgeons and spine surgeons is getting worse and worse. Most of us did it for altruistic reasons, but regardless, there is an opportunity cost to the work we do and for some surgeries, it is very high risk. There is little sympathy from the general public. Ultimately, when access becomes an issue, the question of why will be asked. When the only physicians you can see are hospital employed and there is a six month wait to see an APP and then you see the surgeon on the day of surgery. When all that happens, don’t say we didn’t warn you. So yes, inflation is already eroding the margins private practice physicians have, an erosion that has occurred for over 10 years with reduced reimbursement, let alone inflation. There will be a time when the brightest and the best may not become physicians.
