General Surgeon Salary in Texas 2026,
$222,820 Median | BLS Data by City

A median $222,820 a year, or $107.13 an hour, per BLS OEWS May 2025 — 46.2% below the national median of $414,010, with no state income tax deducted. The band runs $72,820 at the 10th percentile to $646,370 at the 90th, and the gap between the $83,570 quarter-point and the $494,800 seventy-fifth percentile is where the real story is: two different populations in one estimate.

Dallas-Fort Worth-Arlington at $494,800, then Austin-Round Rock-San Marcos $271,390, San Antonio-New Braunfels $251,170, McAllen-Edinburg-Mission $80,210 and Houston-Pasadena-The Woodlands $80,140. A six-fold spread across one state's metros is composition rather than geography — the top row is a private and hospital-employed surgical market, the bottom two are academic training concentration and a heavily public-payer border market.

Payer mix. McAllen-Edinburg-Mission at $80,210 sits in a region with among the highest uninsured rates in the country and a large Medicaid-covered population, so surgical practice revenue per case is structurally constrained. Much of the surgical workforce there is employed in safety-net and public settings on salaries that reflect that constraint. It is not a reflection of surgical need — the Rio Grande Valley's need is high — but of the funding available behind it, which is the state's central surgical access problem.

SOC 29-1249 is a residual category capturing surgical specialties that BLS does not publish separately, so general surgery sits alongside other surgical work in a single estimate. That pooling contributes to the extreme band from $72,820 to $646,370, because specialties with different economics are mixed. Use the $222,820 median as a rough general surgery benchmark and treat the $646,370 ninetieth percentile as describing the highest-value surgical work within the code rather than general surgery specifically.

Not at all — no state personal income tax and no local income tax anywhere in Texas. At the $494,800 seventy-fifth percentile that is a six-figure annual difference against the highest-taxing states. Texas physicians also frequently cite the state's statutory caps on non-economic damages in medical liability claims as a reason for relocating here. The offsets are property tax, among the higher effective rates in the country, and the state franchise tax on practice entities above a revenue threshold.

Houston-Pasadena-The Woodlands at $80,140 and McAllen-Edinburg-Mission at $80,210 arrive at the same place by entirely different routes. Houston's estimate is dominated by the training and academic employment that the world's largest medical complex generates — residents, fellows and faculty on academic scales, counted as surgeons because they are. McAllen's reflects a border market where uninsured and Medicaid-covered patients dominate and surgical practice revenue is constrained by what those payers reimburse. One is a composition effect, the other an economic one. That two such different mechanisms produce the same number is the best possible illustration of why a metro median must be interpreted rather than read.

It sits in the empty space between two populations. With $83,570 at the 25th percentile and $494,800 at the 75th, there is very little employment near the median itself, so it describes neither trainees nor established surgeons well. The occupational code is residual, pooling surgical specialties with different economics. The wage measure excludes call pay, partnership distributions and facility income, all significant in surgery. And with about 1,710 people counted at a location quotient of 0.75, much of Texas's independent surgical practice is outside this estimate entirely.

Practice structure first — the move from salaried academic or safety-net employment into private or hospital-employed clinical practice is most of the distance from the $83,570 quarter-point to the $494,800 seventy-fifth percentile. Market second, and it matters unusually much in Texas because payer mix varies so sharply: the Dallas-Fort Worth metroplex against the Rio Grande Valley is a payer story before it is anything else. Trauma call third, since Department of State Health Services designation determines where acute surgical volume and its associated pay sit. Subspecialty and case complexity fourth.