Healthcare Recruiting
Gastroenterologist Compensation 2026: General GI, Hepatology, Advanced Endoscopy, Pay Tables, Endoscopy Volume
Gastroenterology in 2026 is one of the highest-earning medical (non-surgical) specialties. The combination of high-volume procedural workflow (colonoscopy + EGD), strong professional fees, and ASC ownership opportunities makes it a top-quartile compensation field across all settings.
This guide covers what gastroenterologists are actually earning across all major subspecialty paths in 2026, with detailed scope-volume benchmarks and partnership economics.
National compensation by subspecialty: 2026
| Subspecialty | Median (W-2) | 25th | 75th |
|---|---|---|---|
| General gastroenterology (employed) | $565,000 | $485,000 | $675,000 |
| General GI (private group, post-partnership) | $745,000 | $625,000 | $895,000 |
| Hepatology (transplant-focused) | $475,000 | $415,000 | $555,000 |
| Advanced endoscopy / ERCP / EUS | $725,000 | $615,000 | $865,000 |
| Pediatric GI | $385,000 | $335,000 | $455,000 |
| Inflammatory bowel disease (IBD specialist) | $525,000 | $455,000 | $615,000 |
Scope volume and RVU math
The economics of GI revolve around scope volume:
- Colonoscopy (screening): 25-35 min total time, 4.5 wRVU
- EGD: 15-25 min, 2.0 wRVU
- ERCP (advanced): 60-90 min, 8-12 wRVU
- EUS (advanced): 45-75 min, 5-8 wRVU
A typical productive general GI does 15-25 scopes per scope-day, working 2-3 scope days/week (60-80 scopes/week, ~3,500 scopes/year). At 4.0 average wRVU per scope, that's 14,000+ wRVU annually from procedures alone, before clinic visits.
RVU targets by setting
- General GI employed: 11,500-14,000 wRVU target, $58-$72/wRVU
- Advanced endoscopy: 11,000-13,500 wRVU, $72-$92/wRVU (procedure-rich)
- Hepatology: 7,500-9,500 wRVU (less procedural), $58-$72/wRVU
- Pediatric GI: 7,500-9,500 wRVU, $52-$65/wRVU
ASC ownership: the big-comp lever
Most successful private GI practices own their endoscopy ASC. Standard structure:
| ASC structure | Buy-in | Annual distribution per partner |
|---|---|---|
| 2-room GI ASC, 4 partners | $150K-$300K | $185K-$345K |
| 4-room GI ASC, 6-8 partners | $250K-$450K | $245K-$425K |
| Mixed-specialty ASC w/ GI dominance | $200K-$400K | $165K-$295K |
Endoscopy ASCs are particularly profitable because most procedures are high-volume, well-reimbursed, and short-duration. A screening colonoscopy generates a $450-$750 facility fee on Medicare, more on commercial. A high-throughput GI ASC processing 25-35 scopes/day across 2 rooms generates $5M-$8M/year in facility fees.
Partnership track economics
Standard private GI group partnership:
- Year 1: W-2 employee, $475K-$575K base
- Year 2: Performance review
- Year 2-3 buy-in: $150K-$400K equity buy-in to professional corp + ASC
- Post-buy-in (year 3+): 1099 K-1, total comp $725K-$1.05M for general GI, $895K-$1.4M for advanced endoscopy
The crossover between employed and private GI typically happens at year 3-4 post-partnership. Employed roles pay better in years 1-2, private partnership pays significantly better in year 4+.
Top-paying states: 2026
- South Dakota: General GI $675K, rural premium
- Iowa / Nebraska: $665K general GI
- Mississippi: $655K general GI, $865K advanced endoscopy
- Alabama: $645K general GI
- Oklahoma: $635K general GI
Coastal states pay below median: California $495K, New York $525K, Massachusetts $515K. Florida and Texas are roughly at median.
Locum tenens rates
- General GI: $2,400-$3,200/day, $300-$400/hour
- Hepatology: $2,200-$2,900/day
- Advanced endoscopy: $3,000-$4,200/day
- Pediatric GI: $2,200-$2,900/day
What we see at Ava Health
For GI candidates we work with, the partnership track decision is the single biggest career inflection point. The 5-year NPV math typically favors private partnership by $400K-$800K for high-volume scope readers. The trade-off is year 1-2 cash flow, a $250K buy-in spread over 24 months means $125K/year of "shadow earnings" during ramp.
The fastest-moving GI placements: general GI in growing Sun Belt metros (Tampa, Charlotte, Nashville, Phoenix, Austin) where private groups are actively recruiting partnership-track candidates. We've placed 8 GI physicians into Florida groups in the last 18 months at total first-year comp $475K-$565K and post-partnership trajectories $850K+.
For physicians considering hepatology fellowship: the comp delta is negative ($475K hepatology vs $565K general GI median) but the lifestyle is significantly better, hepatology is mostly clinic-based with limited night/weekend call. Career-trajectory-wise, hepatology positions you for transplant center academic roles which can later transition to senior administrative positions ($600K+ for medical directors).
Related: Gastroenterologist Salary 2026, Physician Contract Negotiation Levers, General Surgeon Compensation 2026.
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