Choosing the right state to practice surgery can influence career satisfaction, earning potential, and work–life balance. Whether you’re an early-career surgery specialist building a patient base or an experienced provider looking to relocate, location matters.

The list below features the top 10 states that offer the most favorable conditions for surgeons—blending salary potential, growth opportunities (clinical, stewardship, and public-health roles), and supportive health care and public-health infrastructure.

1. Wisconsin – Among the highest-paying states for surgeons, with an annual mean income of $449,560, paired with a low estimated cost of living of $43,601 and a top national ranking as the #1 state to practice medicine.

2. Utah – One of the top-earning states for surgeons, with an annual mean salary of $515,130, a moderate cost of living of $49,737, and very low reported physician burnout levels.

3. Ohio – Offers strong surgeon compensation at $448,480, a relatively low cost of living at $42,400, and ranks among the top 5 states for overall physician practice environment.

4. Minnesota – Provides surgeons with an annual mean salary of $424,030, a cost of living of $45,864, and ranks as one of the best states to practice medicine.

5. Iowa – A high-value state for surgeons, with an annual mean salary of $404,100, a low cost of living of $43,454, and one of the lowest malpractice lawsuit rates in the nation.

6. North Carolina – Offers surgeons an annual mean income of $426,470, a cost of living of $46,875, and includes Charlotte, the highest-paying metro area for physicians nationwide.

7. North Dakota – Provides favorable real-income potential with a salary floor of $239,200 or greater, a low cost of living at $41,148, and some of the lowest malpractice payouts in the country.

8. South Dakota – A top state for physician take-home income due to no state income tax, a surgeon salary floor of $239,200 or greater, and a low cost of living of $41,081, along with very low malpractice payouts.

9. Idaho – Offers surgeons an annual mean salary of $387,320 and a moderate cost of living at $48,216.

10. New Hampshire – Provides surgeons with an annual mean salary of $379,550, a cost of living of $51,552, and one of the lowest malpractices claim frequencies nationwide.

Sources: Becker’s ASC Review, Malpractice Search, Physicians Thrive