Answer: On a $350,000 surgeon salary in NYC, your take-home is approximately $7,635 per paycheck ($198,500 annually) after federal, NY State, NYC local taxes, and FICA. The combined effective rate is approximately 43%.
NYC Surgeon Salary by Specialty (2026)
| Specialty | Typical Range | Median Estimate | Approx. Net/Year |
|---|---|---|---|
| General Surgery (Attending) | $250K–$380K | ~$300K | ~$170K |
| Orthopedic Surgery | $380K–$650K | ~$500K | ~$272K |
| Cardiac / Thoracic Surgery | $400K–$700K | ~$550K | ~$297K |
| Neurosurgery | $450K–$800K+ | ~$600K | ~$322K |
| Plastic Surgery | $300K–$600K | ~$400K | ~$224K |
| Surgical Resident (PGY-1–7) | $72K–$90K | ~$80K | ~$55K |
Tax Breakdown: $350,000 Surgeon Salary in NYC
| Tax / Deduction | Per Bi-Weekly Check | Annual Amount | % of Salary |
|---|---|---|---|
| Gross Pay | $13,461.54 | $350,000 | 100% |
| Federal Income Tax | −$3,657.69 | −$95,100 | 27.2% |
| NY State Income Tax | −$1,092.31 | −$28,400 | 8.1% |
| NYC Local Tax | −$527.69 | −$13,720 | 3.9% |
| FICA (SS + Medicare) | −$358.08 | −$9,310 | 2.7% |
| Net Take-Home | $7,825.77 | $203,470 | 58.1% |
Note: At $350K, Social Security tax (6.2%) only applies to wages up to $176,100, so the effective FICA rate is lower than at mid-level incomes. The combined federal + NY State + NYC marginal rate on income above $250K is approximately 48–50%.
Attending vs. Resident: The Salary Cliff
Surgical Resident Pay in NYC
Surgical residents at NYC academic medical centers — Columbia, NYU, Mount Sinai, Cornell/Weill, SUNY Downstate, Montefiore — earn between $72,000 and $90,000 per year under house staff union contracts (1199SEIU represents many NYC house officers). After taxes, that's approximately $48,000–$60,000 take-home annually. In a city where a modest one-bedroom apartment costs $2,200–$3,200/month, residents frequently rely on moonlighting income, spouse income, or below-market hospital housing stipends to make ends meet.
Surgical residencies run 5–7 years (general surgery is 5; ortho, neuro, and plastics require additional fellowship years). The investment is enormous — and the payoff only arrives at the attending level. Many NYC surgical residents accumulate $250,000–$400,000 in medical school debt while earning resident salaries, making early career financial planning critical.
First Attending Year: The Transformation
The jump from chief resident ($85,000–$90,000) to attending ($250,000–$500,000+) is one of the most dramatic income shifts in any profession. A newly minted general surgery attending at a major NYC hospital jumps to $260,000–$320,000 immediately. After 5–7 years of post-residency practice and reputation building, experienced attending surgeons in high-demand specialties routinely earn $400,000–$700,000.
Academic vs. Private Practice Surgeons in NYC
Academic surgeons at institutions like NYU Langone, Columbia/NewYork-Presbyterian, and Mount Sinai typically earn $280,000–$450,000, depending on specialty and RVU productivity. These positions offer research time, resident teaching, and institutional prestige, but base salaries are generally lower than private practice equivalents.
Private practice surgeons in NYC — particularly orthopedic surgeons affiliated with ambulatory surgery centers (ASCs) in Manhattan and the outer boroughs — can earn $500,000–$800,000+ when combining surgical fees, facility ownership distributions, and ancillary revenue. The trade-off is full business risk, malpractice costs ($50,000–$150,000/year for high-risk surgical specialties), and administrative overhead.
Tax Planning for NYC Surgeons
At $350,000+, tax planning becomes critically important. The combined federal + state + city marginal rate for NYC surgeons in the top brackets is approximately 49–51%. Key strategies include:
- Defined Benefit / Cash Balance Plans: Self-employed or private practice surgeons can contribute $100,000–$300,000+ per year to a cash balance pension plan, creating large pre-tax deductions that dramatically reduce taxable income.
- S-Corp or Partnership structures: Private practice surgeons often structure their businesses to minimize self-employment tax exposure. Reasonable salary + distributions can reduce FICA on practice income above the salary component.
- Backdoor Roth IRA: Surgeons above the Roth contribution income limits can use the backdoor Roth strategy ($7,000/year) to build tax-free retirement assets despite high income.
- 529 Plans: NY State allows a $10,000/year deduction per taxpayer for 529 contributions, reducing state taxable income.
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Use the Free Calculator →Frequently Asked Questions: NYC Surgeon Salary
How much does a surgeon make in NYC after taxes?
A surgeon earning $350,000 takes home approximately $198,500–$203,000 per year after all taxes, or about $7,635–$7,825 per bi-weekly paycheck. At this income level, the effective tax rate is approximately 42–44%, with a marginal rate on income above $250K approaching 50%.
What is the highest-paying surgical specialty in NYC?
Neurosurgery, cardiac/thoracic surgery, and orthopedic surgery are consistently the highest-paid surgical specialties in NYC, with experienced attending salaries of $450,000–$800,000+. Private practice orthopedic surgeons with ambulatory surgery center ownership can exceed $1 million in total compensation in the NYC metro area.
How much do surgical residents earn in NYC?
Surgical residents in NYC earn $72,000–$90,000 annually. After taxes, that's approximately $48,000–$60,000 take-home — a challenging income for one of the world's most expensive cities, particularly given typical medical school debt loads.