Physicians earn a national median of $214,370 per year — but where you practice can be worth more than a pay raise. California's 13.3% top income tax rate vs. Texas's 0% means a physician there pays $28,000+ more in state taxes every year. Here are the best and worst states for physician take-home pay in 2026.
Physician Take-Home Pay by State — Top & Bottom 10
| State | Median Wage | Take-Home / Year | State Tax Rate |
|---|---|---|---|
| Alaska | $239,810 | $166,900 | 0% |
| Washington | $229,840 | $163,600 | 0% |
| Wyoming | $211,890 | $150,200 | 0% |
| Texas | $215,870 | $152,900 | 0% |
| Florida | $208,980 | $147,900 | 0% |
| Nevada | $211,350 | $149,700 | 0% |
| Massachusetts | $248,350 | $164,300 | 5.0% |
| — — | — — | — — | — — |
| Minnesota | $221,360 | $133,200 | 9.85% |
| Hawaii | $220,360 | $135,800 | 11.0% |
| New Jersey | $241,320 | $148,000 | 10.75% |
| Oregon | $222,470 | $134,700 | 9.9% |
| California | $224,800 | $134,900 | 13.3% |
Alaska: The Hidden Top State for Physicians
Alaska pays the highest physician wages in the country ($239,810 median) and has no state income tax. A physician there takes home roughly $166,900 per year — around $32,000 more than a California physician despite a lower headline salary differential. The trade-off is geographic isolation and cost of living in remote areas.
The California Problem: High Pay, High Taxes
California attracts physicians with a $224,800 median wage, but the state's top marginal rate of 13.3% (applied to income above $1 million, with 9.3–12.3% on income well below that) takes a substantial bite. A California physician earning the state median pays roughly $22,000–$28,000 in California state income tax alone.
Beyond Taxes: Physician Loan Repayment Programs
Many states and federal programs offer loan repayment for physicians working in underserved areas. These tax-advantaged benefits can be worth $50,000–$100,000+ over a career — and don't show up in median wage data. When evaluating states, factor in National Health Service Corps awards, state-specific HPSA incentives, and VA/military loan forgiveness programs.
See the full physician salary ranking for all 50 states — including monthly take-home and effective tax rates.
Physician Salary by State →