Pediatrician Salary in Texas 2026,
$173,360 Median | BLS Data by City

A median $173,360 a year, or $83.34 an hour, per BLS OEWS May 2025 — 17.5% below the national median of $210,040, with no state income tax deducted. The middle half falls between $108,010 and $232,990 and the full band runs $77,570 to $366,790. The wide lower tail reflects training and part-time appointments in the same occupation code.

Dallas-Fort Worth-Arlington at $242,160, ahead of San Antonio-New Braunfels $212,640, El Paso $176,710, Austin-Round Rock-San Marcos $175,680 and Brownsville-Harlingen $168,640. The seventy-thousand-dollar gap between Dallas-Fort Worth and Brownsville-Harlingen tracks payer mix rather than cost of living — the border and Valley markets carry the highest uninsured and Medicaid-covered child populations.

Payer mix, principally. Texas has among the highest rates of uninsured children of any state, and a large share of insured paediatric care is covered by Medicaid and the Children's Health Insurance Programme, both of which reimburse below commercial rates. General paediatrics is more exposed to that than most specialties because its patient population is entirely children. The result is a 17.5% shortfall despite genuine and growing clinical demand.

Not at all. Texas levies no state personal income tax and no local income tax, so the whole of a $173,360 median or a $232,990 seventy-fifth percentile is subject only to federal tax. Against that, Texas property tax is among the higher effective rates in the country, and a practice organised as a professional entity may fall within the state franchise tax above the revenue threshold.

The border, the Rio Grande Valley and the rural markets, and the metro table shows why: Brownsville-Harlingen at $168,640 and El Paso at $176,710 sit at the bottom of the published range while serving populations with the greatest paediatric need. That combination of high need and constrained practice revenue is the state's central paediatric workforce problem, and it is why recruitment incentives outside the published wage data are common in those markets.

Because a paediatric practice cannot diversify its payer base the way an adult practice can. An internist sees commercially insured working-age adults, Medicare patients and Medicaid patients in some mixture; a pediatrician sees children, and in Texas a large share of children are covered by Medicaid, the Children's Health Insurance Programme, or nothing at all. Practice revenue per visit follows directly, and physician compensation follows revenue. That is the clearest explanation for a 17.5% gap to the national median in a state with a huge and growing child population — the demand is real, the funding behind it is not commensurate, and the metro table maps it precisely.

The lower quarter of the band is training and part-time practice rather than established general paediatrics, so the median is the right reference and any average would mislead. The occupation code covers general paediatrics; paediatric subspecialists are counted in other rows in some cases, which complicates the upper band. The wage measure excludes partnership distributions and productivity arrangements. And with about 2,740 pediatricians the sample is moderate for a large state.

Payer mix first, which in practice means market: Dallas-Fort Worth-Arlington at $242,160 against Brownsville-Harlingen at $168,640 is more than seventy thousand dollars and is largely a commercial-versus-public insurance difference. Subspecialty second — paediatric subspecialty practice and hospital-based roles are what the $232,990 seventy-fifth percentile and $366,790 ninetieth describe. Practice ownership third, though it brings the franchise tax into the calculation. Full-time status fourth, given how much of the lower band is part-time and training.