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OB/GYN Salary by State 2026: Subspecialty Pay, Call Burden, and Top Markets

AH
Ava Health Team
··8 min read

OB/GYN remains one of the most demanding medical specialties, with one of the most variable compensation structures, driven primarily by call volume. Median OB/GYN salary reached $362,000 in 2026, with subspecialty fellowships commanding 15-30% premiums.

OB/GYN Subspecialty Benchmarks (2026)

SubspecialtyMedian BaseTop QuartileTypical Sign-On
General OB/GYN$362,000$445,000$40,000-$80,000
Maternal-Fetal Medicine (MFM)$425,000$520,000$60,000-$125,000
Gynecologic Oncology$495,000$605,000$75,000-$150,000
Reproductive Endocrinology (REI)$445,000$575,000$50,000-$125,000
Urogynecology / FPMRS$415,000$505,000$50,000-$100,000
Gynecology-Only (no OB)$310,000$385,000$25,000-$60,000
Pediatric & Adolescent Gynecology$340,000$415,000$30,000-$75,000

Top 10 Highest-Paying States for OB/GYN (2026)

RankStateMedian Base
1Wisconsin$425,000+
2Indiana$412,000+
3Nebraska$405,000+
4Oklahoma$395,000+
5Kentucky$392,000+
6Iowa$388,000+
7Missouri$385,000+
8South Dakota$382,000+
9North Dakota$378,000+
10Mississippi$375,000+

Call Structure: The Biggest Pay Lever

OB/GYN call is the most-negotiated item in 2026 contracts. Typical structures:

  • 1:3 call (every 3rd night): Premium +$40K-$75K vs 1:6. Brutal but common at small community hospitals.
  • 1:5 or 1:6 call: Standard at mid-size hospitals. Sustainable long-term.
  • 1:7 or 1:8 call: Large academic centers or big private groups.
  • Laborist/nocturnist model: No call; scheduled shifts. $400K-$475K base for experienced OBs. Growing model.
  • GYN-only practice: No OB call. Lower base but much higher quality of life.

Private Group vs Hospital-Employed

ModelTypical Comp
Hospital-employed$360K-$420K base + wRVU bonus
Private group (associate → partner)Year 1-2: $340K-$400K, partner: $450K-$625K
Academic OB/GYN$310K-$380K + teaching time
Laborist-only (hospital)$400K-$475K
Subspecialty academic (MFM/GynOnc)$400K-$510K

Sign-On + Loan Repayment

  • General OB/GYN (urban): $40K-$80K sign-on + $20K relocation
  • General OB/GYN (rural): $75K-$150K sign-on + HRSA loan repayment up to $200K
  • Subspecialty: $50K-$125K sign-on depending on fellowship

What OB/GYNs Negotiate in 2026

  1. Call frequency (the #1 lever)
  2. Malpractice with tail coverage (OB/GYN malpractice is in the top 3 specialties for premium)
  3. Patient cap per clinic day
  4. Delivery volume expectations
  5. Access to OR block time
  6. RVU bonus threshold and rate
  7. CME stipend + board recertification
  8. Parental leave (notably important, OB/GYN has highest % female physicians)
  9. Productivity thresholds during maternity leave

Ava Health places OB/GYNs across practice models nationwide. Contact us for current openings.

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