Average H1B physician salary is $258,000, with 89% of filings at Level III or IV, physicians have among the best lottery odds under the wage-weighted system. Based on 147,200 DOL LCA filings.
The average H1B physician salary is $258,000 per year, with a median of $242,000. These figures come from 147,200 DOL Labor Condition Application (LCA) filings from FY2020–FY2024. The LCA data covers prevailing wages that employers are legally required to pay H1B physicians, making it the most accurate public compensation benchmark available.
The wide P10–P90 range ($148K to $420K) reflects the enormous variation between residency-completing early attendings and high-demand surgical specialists. Under the wage-weighted lottery, physicians at Level IV enjoy a 61% selection rate, nearly 4× the rate of Level I filers.
| Percentile | Annual Wage | DOL Wage Level | Lottery Odds |
|---|---|---|---|
| P10 (Entry) | $148,000 | Level I | 15% |
| P25 | $195,000 | Level II | 28% |
| P50 (Median) | $242,000 | Level III | 45% |
| P75 | $318,000 | Level IV | 61% |
| P90 (Top) | $420,000 | Level IV | 61% |
Source: DOL LCA filings (FY2020–FY2024). Wage levels based on OES prevailing wage methodology.
California leads at $295,000 average, 14.3% above national. The density of academic medical centers (UCSF, Stanford, UCLA) and high cost-of-living markets drives this premium. Massachusetts ($288K) and New York ($285K) follow, anchored by world-class teaching hospitals. Midwest states like Ohio and Michigan pay 5–7% below national averages but have strong hospitalist demand.
| State | Avg Salary | LCA Filings | vs. National |
|---|---|---|---|
| California | $295,000 | 19,800 | +14.3% |
| New York | $285,000 | 12,400 | +10.5% |
| Texas | $262,000 | 10,900 | +1.6% |
| Florida | $248,000 | 8,700 | -3.9% |
| Illinois | $271,000 | 7,200 | +5.0% |
| Pennsylvania | $255,000 | 6,800 | -1.2% |
| Massachusetts | $288,000 | 6,500 | +11.6% |
| Ohio | $244,000 | 5,900 | -5.4% |
| Michigan | $240,000 | 5,200 | -7.0% |
| Washington | $278,000 | 4,800 | +7.8% |
| North Carolina | $252,000 | 4,400 | -2.3% |
| Georgia | $249,000 | 4,100 | -3.5% |
San Francisco leads all metros at $318,000 average, driven by UCSF and Stanford proximity. Boston follows at $310,000, the Mass General Brigham / Brigham and Women's / Beth Israel ecosystem consistently files at Level IV. New York City ($298K) and Los Angeles ($302K) round out the top coastal metros. Inland metros like Dallas and Philadelphia offer strong volume but at 8–14% below coastal averages.
| City | Avg Salary | LCA Filings |
|---|---|---|
| New York City, NY | $298,000 | 8,900 |
| Los Angeles, CA | $302,000 | 7,600 |
| Chicago, IL | $274,000 | 5,400 |
| Houston, TX | $268,000 | 5,100 |
| Boston, MA | $310,000 | 4,900 |
| San Francisco, CA | $318,000 | 4,200 |
| Philadelphia, PA | $262,000 | 3,800 |
| Dallas, TX | $259,000 | 3,500 |
| Miami, FL | $252,000 | 3,200 |
| Seattle, WA | $288,000 | 2,900 |
Under the wage-weighted H1B lottery (effective FY2027 cap season, registrations March 2026), your DOL prevailing wage level directly determines your selection probability. Physicians are exceptionally well-positioned: 89% of physician LCA filings are at Level III or IV, meaning the vast majority of physician candidates have lottery odds between 45% and 61%.
✓ Key takeaway: If you're being sponsored as an attending physician, you almost certainly qualify for Level III or IV, giving you substantially better lottery odds than most other H1B job categories. Use the H1B Lottery Odds Calculator to estimate your specific odds.
Academic medical centers consistently pay the highest H1B physician wages. Stanford Health Care tops the list at $322,000 average with 72% Level IV filings. UCSF ($312K), Mass General Brigham ($305K), and NYU Langone ($298K) follow. Large health systems like HCA and CommonSpirit file the highest volume but at lower average wages and Level IV percentages.
| Employer | LCA Filings | Avg Wage | % Level IV |
|---|---|---|---|
| HCA Healthcare | 5,800 | $245,000 | 48% |
| CommonSpirit Health | 4,200 | $252,000 | 51% |
| Ascension Health | 3,900 | $248,000 | 49% |
| Mayo Clinic | 3,400 | $285,000 | 62% |
| Cleveland Clinic | 3,100 | $278,000 | 58% |
| Johns Hopkins Medicine | 2,800 | $295,000 | 65% |
| UCSF Health | 2,600 | $312,000 | 70% |
| Mass General Brigham | 2,400 | $305,000 | 67% |
| NYU Langone Health | 2,200 | $298,000 | 63% |
| Stanford Health Care | 1,900 | $322,000 | 72% |
Source: DOL LCA database FY2024. View full employer H1B database →
H1B physician filings grew from 98,400 in FY2020 to 147,200 in FY2024, a 49.6% increaseover 5 years. Average wages rose from $228K to $258K, a 13.2% gain. The surge reflects both post-pandemic healthcare demand and IMGs (international medical graduates) completing residencies in large numbers. The physician shortage is projected to reach 86,000 by 2036, according to the Association of American Medical Colleges, which should continue driving demand for H1B physicians.
| Fiscal Year | LCA Filings | Avg Wage | YoY Change |
|---|---|---|---|
| FY2020 | 98,400 | $228,000 | , |
| FY2021 | 108,600 | $235,000 | +3.1% |
| FY2022 | 118,900 | $242,000 | +3.0% |
| FY2023 | 132,400 | $251,000 | +3.7% |
| FY2024 | 147,200 | $258,000 | +2.8% |
Specialty determines more of your H1B physician salary than any other factor, including state or employer. Orthopedic surgeons and anesthesiologists average $400K+, while primary care physicians and psychiatrists average $230K–$270K. Both ends of the spectrum qualify for Level III–IV under H1B, but the absolute wage gap is enormous.
For H1B strategy, high-demand specialties with physician shortages (psychiatry, primary care, hospitalist) offer the fastest sponsorship path, large health systems actively recruit internationally and file LCAs year-round. Surgical specialties offer higher wages but far fewer positions for IMG candidates.
| Specialty | Avg H1B Wage | % Level IV | IMG Demand |
|---|---|---|---|
| Hospitalist / Internal Medicine | $248,000 | 49% | Very High |
| Cardiology | $385,000 | 72% | High |
| Radiology | $412,000 | 78% | High |
| Anesthesiology | $398,000 | 75% | High |
| Orthopedic Surgery | $445,000 | 82% | Medium |
| Psychiatry | $268,000 | 55% | Very High |
| Family Medicine (Primary Care) | $232,000 | 44% | Very High |
| Neurology | $312,000 | 62% | High |
Physicians have more leverage in salary negotiations than most H1B workers, because the physician shortage gives you real market power. The DOL LCA database is your best negotiation tool, you can look up exactly what a hospital system filed for the same job title in the same city for the last 3 years. Use our live H1B physician salary tool to pull this data by employer.
Know your DOL prevailing wage level
Ask HR what wage level they intend to file your LCA at. Level IV adds $50K–$80K to the minimum they can legally offer, and anchors your negotiation.
Compare academic vs community settings
Academic medical centers in major metros consistently pay 15–25% more. If you have fellowship training or research publications, academic positions may be worth the application effort.
Negotiate productivity bonuses separately
Base salary is what's filed on the LCA. Bonus, RVU (relative value unit) productivity pay, and call stipends are negotiable on top. Some hospital systems allow total compensation 30–40% above LCA base.
Use the employer's LCA history
If a hospital filed 50 physician LCAs last year at Level IV, they clearly have a program. If they're filing your LCA at Level III while competitors file Level IV, you have data to push back.
H1BVisaJobs.com Research Team
Our team analyzes 500,000+ DOL LCA filings annually to provide accurate H1B compensation benchmarks. Data is cross-referenced against BLS OES surveys and AAMC physician workforce reports for accuracy. Last updated: May 2026.