Everything you think you know about where doctors make the most money is wrong. The prestigious East Coast medical centers? They’re actually the worst-paying cities in the US.
The data are in, and the highest-paying city for doctors isn’t New York or LA. Let’s count down the top 10, and I guarantee number one is going to surprise you.
10 | Charlotte, NC – $448,400
Coming in at number 10 is Charlotte, North Carolina, where physicians average $448,000 per year. This Southeast powerhouse is the only city from the region to crack the top 10.
Charlotte’s transformation from banking capital to healthcare hub, anchored by Atrium Health and Novant, is driving physician salaries up while maintaining a reasonable cost of living.
9 | San Francisco, CA – $449,830
At number 9, we have San Francisco, California, with an average of $450,000. But unfortunately, your salary won’t go as far due to California’s state income tax, which can climb to 13.3%, and of course extreme housing costs.
8 | Minneapolis, MN – $452,598
Number 8 takes us to the Upper Midwest with Minneapolis, Minnesota, at $453,000. The Twin Cities benefit from multiple competing health systems, such as HealthPartners, Allina, and M Health Fairview, which all compete for talent. This competition drives salaries up while maintaining that Midwest cost of living advantage most doctors overlook.
7 | Riverside, CA – $455,986
The seventh spot goes to Riverside, California, in the Inland Empire, where doctors earn an average of $456,000.
Here’s why: Riverside has only 120 physicians per 100,000 people compared to California’s average of 194. That physician shortage directly translates to premium pay, without the traffic and housing nightmares of LA or San Francisco.
6 | Phoenix, AZ – $459,082
Coming in at number 6 is Phoenix, Arizona, with physicians averaging $459,000 per year. As one of America’s fastest-growing metros, Phoenix combines explosive population growth with an influx of retirees who need specialists and carry good insurance.
Add in Arizona’s lower tax rate, which maxes out at 4.5% versus California’s 13.3%, and you’ll understand why doctors are flocking to the desert.
5 | Sacramento, CA – $460,671
Number 5 brings us to California’s capital, Sacramento, at $461,000. The state capital advantage is real, as government employee healthcare plans and competition between Kaiser and Sutter Health push compensation higher. Sacramento is quietly outperforming both San Diego and San Francisco in physician pay.
4 | San Jose, CA – $469,878
At number 4, we have San Jose, California, the heart of Silicon Valley, with an average of $470,000 a year. Interestingly, it’s the only top 10 city where compensation declined this year. The tech downturn is affecting even physician salaries, but venture capitalists and tech executives, as patients, still keep the numbers strong.
3 | Los Angeles, CA – $470,198
The third-highest-paying city is Los Angeles, California, where doctors earn an average of $470,000. LA’s massive population creates massive demand across all specialties. The entertainment industry provides a unique patient base with premium insurance, while UCLA, USC, and Cedars-Sinai compete for top talent.
2 | St. Louis, MO – $484,883
Number 2 might be the biggest surprise. It’s St. Louis, Missouri, at $485,000. This Midwest giant beats every single California city on our list. How?
Competition between Washington University’s Barnes-Jewish Hospital and Saint Louis University creates a bidding war for physicians. Combine that with Missouri’s cost of living, where you can buy a mansion for the price of a California condo, and you’ve found the ultimate arbitrage opportunity.
1 | Rochester, MN – $495,532
And here we are at number 1. Without further ado, the highest-paying city for doctors in the US is Rochester, Minnesota, where physicians average $496,000 per year.
This small city in southeastern Minnesota is home to the Mayo Clinic, and that creates a unique economic dynamic.
But why number 1? It comes down to two main forces. First, a location premium. Rochester is a small, cold market, which makes recruiting harder and pushes compensation up. Second, an excellence premium. Mayo competes for the best physicians in the country, and elite systems pay to win. Add a steady inflow of complex cases, a specialty mix that leans procedural, which pays more than non-procedural, and strong payer contracts, and you get the highest paying city for doctors. It also grew 8.7% this year, the fastest among the top-10 metros.
To put this in perspective, on average, a doctor in Rochester earns $137,000 more per year than a doctor in Durham, North Carolina, home to Duke University Medic al Center. Over a 30-year career, that’s over $4 million in additional earnings, not even accounting for inflation and investments.
The pattern is clear: it’s not about prestige or coastal living. It’s about supply, demand, and cost of living.
Four of the highest-paying cities are in California, but pay is only one factor to consider. In fact, California is listed as one of the worst states for doctors. Find out why in this guide, where we reveal the best and worst states for doctors in America.
