Anesthesiologist Hourly Pay (2026): How Much Do Anesthesiologists Make Per Hour?

Anesthesiologist hourly pay varies dramatically by practice structure, subspecialty fellowship, state, and call burden. The national median sits at $196.69/hour, but anesthesia hourly rates reach $328.20+ in top markets like Bellevue, WA and exceed $400/hour for private-practice partners and locum rates in shortage markets.

This guide breaks down the five biggest drivers of anesthesiologist hourly pay differences across 1661+ U.S. metropolitan areas. Whether you're a CA-3 resident selecting fellowship, a working anesthesiologist evaluating private-practice partnership, or an ASC administrator benchmarking competitive wages, the framework below is the central reference.

1. Practice Structure: Academic / Private Practice / Hospital-Employed / Locum

Practice structure drives the largest single variation in anesthesia hourly pay:

• Private practice partnership (top tier) — equity partners at mature anesthesia groups earn $500,000–$900,000+ annually. Effective hourly $240–$430+. Major PE-backed groups: USAP, NorthStar Anesthesia, MEDNAX / Pediatrix, NAPA, American Anesthesiology, Anesthesia Care Associates.
• Hospital-employed — competitive with private-practice non-partner. W-2 salary plus shift differential plus call structure.
• Academic medical center — 20–40% below private-practice partnership but with research time, teaching engagement, PSLF eligibility for university appointments.
• ASC anesthesia — no-call schedules with strong hourly. Rapidly growing segment.
• Locum tenens — $250–$420/hour normal, $450–$650/hour crisis. Travel / housing / malpractice covered.
• 1099 contractor — office-based / outpatient pain / ASC contracts at $300–$550/hour. No benefits. S-corp tax optimization.
• VA / military anesthesiology — federal employment with strong pension, PSLF, no income tax in some states. Below private practice but competitive with academic.

2. Subspecialty Fellowship

Fellowship subspecialization drives premium pay:

• Pain medicine fellowship (ACGME) — interventional pain medicine fellows command top of anesthesia distribution. Strong cash-pay procedural revenue at private pain clinics.
• Cardiothoracic anesthesia — premium at cardiac surgery programs (Cleveland Clinic, Texas Heart Institute, Mass General, Stanford, UCSF, Methodist DeBakey).
• Pediatric anesthesia — premium at children's hospitals (CHOP, Boston Children's, Texas Children's, Children's LA, Lurie Chicago, Cincinnati Children's, Seattle Children's, St. Jude, Nationwide Children's, Phoenix Children's).
• Obstetric anesthesia — premium at high-volume L&D centers.
• Neuroanesthesia — premium at neurosurgery-heavy academic centers.
• Regional anesthesia / acute pain — premium at orthopedic surgery centers.
• Transplant anesthesia — premium at transplant centers.
• Critical care medicine (ICU) — premium for anesthesiologists serving as intensivists.

3. State and Metro

Location drives anesthesia hourly rate variation:

• Texas — strong private practice partnership market (USAP Texas, NorthStar Texas). No state income tax. Top real take-home for anesthesia partners.
• Florida — strong private practice + USAP / NAPA presence. No state income tax. Strong retiree-driven surgical volume.
• California — strong nominal hourly but high state income tax (13.3% top) erodes take-home for partners.
• Northeast (NY, MA, NJ, CT) — strong academic medical centers but high state taxes.
• Mountain West / rural (Wyoming, Montana, Idaho, Alaska, Nevada) — rural critical-access locum opportunities at premium rates.
• State malpractice environment — Texas, Florida, Indiana, Mississippi have favorable malpractice caps lowering anesthesiologist premium burden.

4. Experience and Career Stage

Anesthesia career stage drives meaningful pay progression:

• New graduate / first attending year ($300,000–$450,000) — equivalent hourly $145–$215.
• Partnership track (years 1–3) — typically employed at partner-track salary before equity buy-in.
• Equity partner (years 4+) — $500,000–$900,000+ at mature private practices.
• Senior partner / managing partner — additional administrative supplements.
• ABA (American Board of Anesthesiology) board certification — required for credentialing at virtually all hospitals.
• ABA Critical Care, Pain Medicine, Pediatric subspecialty board — subspecialty board certification adds 5–15% pay premium.

5. Locum, 1099, and Crisis-Rate Strategy

Non-employed structures consistently outperform staff hourly:

• Locum tenens — $250–$420/hour normal. Major agencies: CompHealth, Weatherby Healthcare, Staff Care, AMN, Barton Associates, Locumtenens.com.
• Crisis-rate locum — rural critical-access hospital shortages drive $450–$650/hour crisis rates.
• 1099 contractor — office-based anesthesia, outpatient pain management, ASC contracts at $300–$550/hour. S-corp structure.
• Float pool / locally-employed contract — hospital-internal float coverage at premium hourly.
• Crisis-strike rates — during anesthesia provider strikes or staffing crises, rates reach $600–$900/hour.

2026 Anesthesiologist Hourly Pay Outlook

Anesthesiologist pay has grown at a compound annual rate of 4.50% nationally over the past five years — driven by sustained anesthesia provider shortage, post-pandemic surgical volume recovery and growth, expanding ASC anesthesia (rapidly growing outpatient surgical volume), aggressive PE-backed private practice consolidation (USAP, NorthStar, NAPA, MEDNAX, American Anesthesiology), growing pain medicine and interventional pain demand, ongoing No Surprises Act / OON billing dynamics affecting practice economics, and structural retirement of senior anesthesiologists. States with rapid PE consolidation (Texas, Florida, Arizona, North Carolina, Tennessee, California) and no-state-income-tax states (Texas, Florida, Tennessee) are seeing the fastest state-level take-home growth. The BLS projects anesthesiologist employment growth at 1% through 2033, with very strong upward pay pressure especially for fellowship-trained subspecialists.