June 25, 2026 · Alex, MD
What call pay, locums rates, and admin stipends actually pay in 2025, and how to get numbers you can defend
Getting the numbers is easy now. Getting numbers you can say out loud in a negotiation is the real work. Here is the method, and all the data.
Three numbers quietly run a physician’s working life. What a night of call pays. What a director title is worth when you take one on. What an hour of your time goes for when you moonlight. We negotiate all three and benchmark none of them, because the data feels locked away and asking feels like complaining. The data is not as locked as you think. But the easy version, where you ask AI and paste whatever it says, is a trap. A confident-looking number you cannot back is worse than no number, because you will say it in the room and someone who does this every day will know in a second that you cannot.
The method that makes a number trustworthy
I started in Claude to find the sources and frame the question. Then I handed the same brief to two deep research agents, Codex and Gemini, and let each one spend its own time sweeping the web, citing every number with a source and a date, with no inventing allowed. Three independent reads of the same question.
Then came the part no single tool does for you. I put the three side by side and reconciled them. Where all three agreed, I had something solid. Where they split, I had found the number to verify by hand. And one of them had quietly handed me total salaries dressed up as director stipends, a mistake the other two did not make, which is the whole reason you never trust one pass.
Everything I found, with its confidence
This is the full pull, cleaned. Read the last column as carefully as the dollars.
On-call pay (daily stipend, when separately paid)
| Specialty | Figure | Source (year) | Confidence |
|---|---|---|---|
| Anesthesiology | ~$1,656/day (regional medians $1,000 to $1,600) | Marit Health (2025); Residency Advisor (2026) | High |
| Orthopedic Surgery | ~$1,132/day non-trauma; ~$2,320/day trauma | Marit Health (2025); MD Ranger (2023) | High / Medium |
| Hospital Medicine | ~$861/day (or $400 to $600 per 12h differential) | Marit Health (2025) | High |
| Psychiatry | ~$1,034/day, among those who get paid | Marit Health (2025) | Medium |
| Emergency Medicine | No separate call pay (shift-based) | all sources | High |
Context: trauma centers pay a 22 to 32 percent premium. The share of surgery centers funding anesthesia stipends jumped from 28 percent in 2024 to 44 percent in 2025, per VMG Health. The authoritative source is the SullivanCotter On-Call Survey, paywalled, next edition November 2026.
Locum tenens (hourly, to the physician, 2026)
| Specialty | Range | Confidence |
|---|---|---|
| Anesthesiology | $300 to $450/hr (~$2,500 to $3,500/day) | High |
| Orthopedic Surgery | $300 to $500/hr ($450 callback; up to $600 high-trauma) | High |
| Emergency Medicine | $250 to $320/hr ($375 to $425 rural) | High |
| Hospital Medicine | $190 to $235/hr day; $215 to $285/hr nocturnist | High |
| Psychiatry | $200 to $350/hr ($180 to $240 outpatient floor) | High |
Context: the agency keeps 35 to 45 percent of what the hospital pays (lean independents about 18 percent), so the bill rate is well above your take-home. Geography is the biggest swing: coastal metro low, rural high.
Medical-director / admin stipend
| Item | Figure | Confidence |
|---|---|---|
| General admin hourly (all roles) | $150/hr median | Medium |
| Surgical directorship hourly | ~$200/hr median | Medium |
| Annual stipend, anesthesia | $25k to $75k/yr | Medium |
| Annual stipend, emergency medicine | $40k to $120k/yr ($70k flat example) | Medium |
| Annual stipend, hospital medicine | $37.5k to $40k/yr | Medium |
| Specialty-specific (ortho, psych) | No clean public figure | Low |
The authoritative source is the SullivanCotter Physician Executive Survey, paywalled, next edition August 2026. A free proxy is the CMS hospital cost report.
The part that actually matters
Read the last column. Not the dollars. The confidence.
The locum rows are High, because that market is competitive and public and three independent tools landed in the same place. The call-pay numbers come from one good 2025 survey, averaged across only the doctors who get paid at all, solid but hiding everyone who gets nothing. The stipend rows are Medium and Low, with a few thrown out entirely. Same table, three very different levels of trust. That column is the AI telling you where it is guessing.
So you do not paste the number. Anchor on the High-confidence ones. Treat the Medium ones as a question, not an answer. Throw out the Low ones. Verify before any figure leaves your mouth. And when the number is locked away, the real call-pay survey sits behind a paywall until November, you do not guess. You ask the one question that gets you a real number anyway, because the hospital cannot see it for free either: “I want this to sit cleanly within fair market value, so which survey and which percentile are we working from?”
How I ran it, exactly (so you can too)
Three steps, maybe an evening.
- Frame it and find the sources. Tell one AI what you are negotiating and ask which benchmarks actually carry weight in your specialty. For call pay and stipends that is SullivanCotter, MGMA, MD Ranger. For locums it is the agency rate guides.
- Run it through two deep research agents, separately. I used Codex and Gemini. Same brief to each, independently, so two different tools sweep the web and you can see where they agree.
- Reconcile, and verify the gaps by hand. Agreement across tools is your confidence. Disagreement is your to-do list.
The brief I gave each tool, which you can reuse:
Act as a physician-compensation research analyst. Find current US benchmarks for [call pay / a director stipend / locum rate] in [specialty], [region]. Rules: every number needs a source, a year, a unit, and a percentile if stated. Prefer 2025 and 2026 data, flag anything older as stale. If the authoritative figure is paywalled, say so and give the closest free proxy. If no real public number exists, say “no public figure found” and do not estimate. Tag each number High, Medium, or Low confidence. Show where three or more sources agree.
What to trust, and what I threw out
- Cite freely: Marit Health, MD Ranger, VMG Health, SullivanCotter, CompHealth, real job postings.
- Use only to triangulate: Locums.one, Premium Locums, Residency Advisor, Salary.com, ZipRecruiter.
- What I threw out: the six-figure “stipend” numbers from salary aggregators were total medical-director salaries, not stipends. A couple of confident regulatory claims traced to a single low-quality source, so they did not make the cut. Stale 2012 figures, gone.
The takeaway
You cannot negotiate a number you have never looked up, and you cannot defend a number you cannot source. An evening of this and you walk in knowing the shape of the deal and exactly which numbers are yours to stand on. That is half the work done. Next, the other half: what you actually say once you are in the room.