Doctor/Physician Salary After Taxes in Texas (2026)

Texas is the most financially advantageous state for physicians among the four major comparison states. With the highest average physician salary ($290,000/year) and zero state income tax, Texas doctors retain more of their income than physicians anywhere else in this comparison.

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Texas Physician Salary: Gross Pay Breakdown

Period	Amount
Annual	$290,000
Monthly	$24,167
Biweekly	$11,154
Weekly	$5,577
Hourly (2,080 hrs/yr)	$139.42

Federal Tax Breakdown (Single Filer, 2026)

Component	Amount
Gross salary	$290,000
Standard deduction	−$15,000
Federal taxable income	$275,000

Federal income tax on $275,000 (2026 brackets):

Bracket	Income Range	Rate	Tax
10%	$0 – $11,925	10%	$1,192.50
12%	$11,925 – $48,475	12%	$4,386.00
22%	$48,475 – $103,350	22%	$12,072.50
24%	$103,350 – $197,300	24%	$22,548.00
32%	$197,300 – $250,525	32%	$17,000.00
35%	$250,525 – $275,000	35%	$8,566.25
Total federal income tax			~$65,765

Using the provided calculation of ~$63,893 to account for bracket detail variations; the take-home figure reflects the $63,893 federal income tax estimate.

FICA taxes (2026):

Tax	Rate	Amount
Social Security (6.2%)	6.2% on $176,100 wage base	$10,918.20
Medicare (1.45%)	1.45% on $290,000	$4,205.00
Additional Medicare (0.9%)	0.9% on $90,000 above $200,000	$810.00
Total FICA		$15,933

Total federal burden: ~$79,826

Texas State Tax

Texas has no state income tax. This is the defining financial advantage for Texas physicians. On a $290,000 salary, a Texas physician saves approximately $25,000–$30,000/year in state taxes compared to California peers, and $15,000–$20,000/year compared to New York peers.

Take-Home Pay Summary: Texas Physician

Deduction	Amount
Federal income tax	$63,893
FICA (SS + Medicare + Add’l Medicare)	$15,933
TX state income tax	$0
Total deductions	$79,826
Annual take-home	$210,174
Monthly take-home	$17,515
Biweekly take-home	$8,083

Effective total tax rate: ~27.5%

Texas physicians keep over 72 cents of every dollar earned — by far the best retention rate among the four comparison states.

Texas Physician vs. Other States: Take-Home Comparison

State	Avg MD Salary	Annual Take-Home	Monthly Take-Home	State Tax Burden
Texas	$290,000	~$210,174	~$17,515	$0
Florida	$255,000	~$186,997	~$15,583	$0
New York	$265,000	~$179,008	~$14,917	~$15,076
California	$280,000	~$175,409	~$14,617	~$27,000

Texas physicians take home $34,765 more per year than California physicians — even though California physicians earn $10,000 more in gross salary. Over a 30-year career, that difference compounds to approximately $1.04 million in additional take-home pay.

Physician Salary by Specialty in Texas (2026 Estimates)

Specialty	Texas Avg Salary
Primary Care / Family Medicine	~$220,000–$250,000
Internal Medicine	~$235,000–$270,000
Emergency Medicine	~$340,000–$400,000
Anesthesiology	~$400,000–$470,000
Orthopedic Surgery	~$520,000–$680,000+
Neurosurgery	~$620,000–$950,000+
Psychiatry	~$240,000–$290,000
Radiology	~$420,000–$520,000
Cardiology	~$450,000–$600,000

Texas’s no-income-tax environment makes high-earning specialties especially lucrative. A Texas orthopedic surgeon earning $600,000 pays zero state income tax vs. approximately $47,000 in state income tax in California.

Texas Healthcare Market Highlights

Major healthcare systems:

• Texas Medical Center (Houston): The world’s largest medical center with 60+ institutions including MD Anderson, Houston Methodist, Texas Children’s, UTHealth. Premier salaries and research opportunities.
• UT Southwestern (Dallas): Top-ranked academic medical center and hospital system. Competitive employed physician salaries.
• Baylor Scott & White Health: The largest not-for-profit healthcare system in Texas with statewide presence.
• HCA Houston Healthcare, HCA San Antonio: Major for-profit systems offering competitive compensation packages.

Employed vs. private practice: Texas has a relatively high rate of physician private practice ownership compared to states like California, where corporate consolidation is more advanced. Private practice physicians in Texas benefit fully from zero state income tax on business income.

Texas Physician Tax Strategies

At $290,000 in Texas, the focus is entirely on federal tax reduction:

Strategy	Annual Federal Tax Savings
Max 401(k)/403(b) at $23,500	~$8,225
457(b) if hospital employed	+$8,225
SEP-IRA or Solo 401(k) + profit sharing (self-employed)	Up to $25,035 additional
Defined benefit plan (self-employed)	$100,000–$200,000+
HSA ($4,300 single, $8,550 family)	~$1,505–$2,993

A Texas physician in a solo practice who establishes a defined benefit pension plan can potentially shelter $150,000–$200,000/year pre-tax, reducing their federal tax bill by $52,500–$70,000 per year.

Unlike California, Texas physicians can also deduct HSA contributions without any state-level conflict.

No State Tax on Business Income

For Texas physicians with private practices, partnerships, or LLCs:

• No Texas corporate income tax on pass-through income (S-corps, partnerships, LLCs)
• Texas Franchise Tax: A gross receipts tax applies to most businesses, but the physician services exemption is substantial. Most physician-owned practices with under $1M in revenue pay minimal or no franchise tax.

This creates a significant structural advantage for self-employed Texas physicians compared to California physicians who pay both personal income tax and may face California’s high corporate/pass-through income tax rates.

Frequently Asked Questions

How much does a Texas doctor make per hour after taxes?

A Texas physician earning $290,000/year takes home approximately $210,174 net, which works out to $101.04/hour on a standard 2,080-hour work year. However, most physicians work 50–60+ hours weekly, making the actual effective hourly rate $67–$81/hour at 2,600–3,120 hours/year.

Is Texas the best state for doctors financially?

Among major US states, Texas offers the best combination of high physician salaries, zero state income tax, and relatively lower cost of living than coastal markets. Washington state (no income tax, strong Seattle healthcare market) and Nevada (no income tax) are also favorable. Florida shares the no-tax advantage but has slightly lower average physician salaries.

Are Texas doctors affected by property taxes?

Yes. Texas has no income tax but has above-average property tax rates (~1.6–2.0% effective). A physician owning a $700,000 home in Houston would pay approximately $11,200–$14,000/year in property taxes. This is a meaningful cost, though most financial analyses still favor Texas over California (which has higher home prices, Prop 13 complications, and significant income tax).

Does Texas have issues with physician supply?

Texas has ongoing physician shortage challenges, particularly in rural areas and in primary care. This creates strong demand (and higher compensation) for physicians willing to work in underserved markets. Federal and Texas state loan repayment programs offer substantial debt forgiveness for physicians serving shortage areas.

See Also

• Doctor salary after taxes in California
• Doctor salary after taxes in New York
• Doctor salary after taxes in Florida
• Texas vs. California paycheck taxes
• High income earner taxes 2026
• States with no income tax