Orthopedic Surgeon Salary in Texas 2026,
$200,780 Median | BLS Data by City

The published Texas median is $200,780 a year, or $96.53 an hour, per BLS OEWS May 2025 — 44.0% below the national median of $358,550, with no state income tax deducted. But the sample is about 490 surgeons and the band runs from $75,580 at the 10th percentile to $758,150 at the 90th, with the 75th at $639,500. The median is not a reliable description of Texas orthopaedic practice; the upper percentiles are far more informative.

Because of what the survey counts. OEWS measures wages paid to employees on payrolls, and Texas orthopaedics is unusually heavily organised through physician-owned practices and ambulatory surgical centres, where income comes as practice profit rather than wages. What remains on payrolls is weighted toward residents, fellows, academic faculty and salaried health-system appointments. A location quotient of 0.38 on about 490 surgeons in the second most populous state confirms the point: most Texas orthopaedic surgeons are not in this estimate at all.

Dallas-Fort Worth-Arlington at $666,930, against Houston-Pasadena-The Woodlands at $83,160 — an eight-fold difference between two comparably sized metros. Dallas-Fort Worth's figure reflects a private and hospital-employed surgical market; Houston's reflects academic and training employment in the state's largest medical complex. Neither is a typical local salary, and only these two metros carry a published row at all.

Not at all — no state personal income tax and no local income tax. For this specialty the structural point is more valuable than the headline: Texas orthopaedics is heavily physician-owned, and the state does not tax distributed practice or facility profit as personal income either, which is a real advantage over states that tax pass-through income at high marginal rates. The offsets are property tax, among the higher effective burdens in the country, and the state franchise tax, which reaches practice and ambulatory surgical centre entities above its revenue threshold.

That the upper band is the informative part. The $639,500 seventy-fifth percentile and $758,150 ninetieth are both far above the national median of $358,550, and they describe the private practice and subspecialty tier that dominates Texas orthopaedics. The $200,780 median describes payroll-employed orthopaedics, which in this state is a minority of the specialty. Combine the upper band with no state income tax and the state's statutory caps on non-economic damages in medical liability claims, and Texas is a substantially more attractive market than the headline figure implies.

Because the alternative is silence about a real state market, and because the shape of the data is itself informative even where the median is not. A location quotient of 0.38 in the second most populous state tells a reader something true and useful: that Texas orthopaedics is organised outside conventional employment to an unusual degree. The extreme spread between the $155,250 quarter-point and the $639,500 seventy-fifth percentile says the same thing from another direction. Read honestly, with its limits stated, this record explains the structure of the specialty in Texas better than a tidier number from a larger sample would.

It is unrepresentative, and this page says so plainly rather than presenting it as a Texas orthopaedic salary. The sample is small, only two metros carry a published row, and the eight-fold gap between them makes clear that composition rather than geography drives the metro estimates. Most importantly, wage surveys do not capture physician-owned practice income or ambulatory surgical centre distributions, which is where a large share of Texas orthopaedic earnings actually sits. Treat the median as the payroll-employed figure it is.

Practice structure first, and by an enormous margin — moving from salaried employment into an independent or partnership practice is the difference between the $155,250 quarter-point and the $639,500 seventy-fifth percentile in this data. Facility ownership second: Texas's ambulatory surgical centre sector has absorbed much of the state's orthopaedic procedure volume, and equity in a centre is a distinct income stream that no wage figure shows. Subspecialty volume third, with joint replacement, spine and sports medicine carrying the highest case values. And market fourth, with the Dallas-Fort Worth metroplex the state's strongest private orthopaedic market.