Internal Medicine (Primary Care) Salary
Internal medicine primary care is the highest volume attending market in the country, which means the comp range is wide and almost entirely driven by how a contract converts visits into wRVUs. The base is rarely where the money is. The bonus formula is.
Median total cash compensation for a mid-career attending. Source: Medscape 2024 (publicly cited). Treat figures as medians, not targets. Real compensation varies widely by geography, employment model, and experience.
Live anonymous cohort, Internal Medicine (Primary Care)
We display a live Internal Medicine (Primary Care) cohort once at least 10 attendings have submitted in the last 24 months. Until then, the published benchmark and regional table below are your reference. Be one of the first to seed it.
Submit your comp anonymouslyInternal Medicine (Primary Care) pay by region
Directional regional medians, anchored to the Medscape 2024 national figure and US Census region adjustments. The South and Midwest pay more in absolute dollars because physician supply is lower and demand is higher; the Northeast runs lower with a higher cost of living.
| Region | Median total comp | Notes |
|---|---|---|
| National median | $260,000 | Doximity 2024 / Medscape 2024 nationwide median. |
| South | $286,000 | Highest absolute compensation. Houston, Jacksonville, Charlotte, Atlanta lead. |
| Midwest | $280,800 | Indianapolis and St. Louis often top Doximity median tables. |
| West | $265,200 | Wide spread. California pays well but is offset by cost of living. |
| Northeast | $252,200 | Lower in absolute terms (high supply of physicians) and higher cost of living. |
Regional figures are modeled adjustments to the national median, not separately surveyed values. Use them for direction, not as an offer benchmark.
What drives Internal Medicine (Primary Care) compensation
- The wRVU conversion rate, typically the largest swing factor. A few dollars per wRVU compounds into five figures a year at a full panel.
- Capture quality. G2211, prolonged services, transitional care, and annual wellness visits separate a median earner from a top-quartile one at the same patient volume.
- Panel size and the threshold above which production pays. A low threshold with a fair rate beats a high base with a punitive threshold.
- Employed versus value-based or direct primary care models, which trade fee-for-service ceiling for predictability.
Model your own number, not the median
Internal Medicine (Primary Care) reports a median of about 5,000 wRVUs a year. Your take-home is that volume times your contract rate, above your threshold. Plug your real visit mix into the calculator and see the bonus your specific offer produces, then negotiate against it.
Negotiation levers at offer time
- •Anchor on the wRVU rate, not the base. Model both at your real expected volume before you counter.
- •Ask for the threshold in writing and confirm whether it resets annually or ratchets up.
- •Confirm who keeps ancillary and care-management revenue (CCM, RPM, AWV), since that is often negotiable and rarely volunteered.
Internal Medicine (Primary Care) at a glance
Direct path to attending. Lowest fellowship cost. Bonus rates often $40-55/wRVU. Typical setting: outpatient clinic, mostly employed.
Frequently asked questions
Is internal medicine primary care compensation mostly base salary or bonus?
For most employed primary care contracts the base is a floor and the productivity bonus is where realized income separates. The wRVU conversion rate and the production threshold matter more to take-home than the headline base.
How much does region change internal medicine pay?
Counterintuitively, the South and Midwest tend to pay more in absolute dollars than the Northeast because physician supply is lower and demand is higher. The regional table on this page shows the directional spread.
What is the fastest way to raise internal medicine income without more hours?
Closing the documentation gap. Eligible add-on codes such as G2211, advance care planning, and annual wellness visits are widely under-captured, and recovering them raises wRVUs at the same visit volume.
Filter every specialty by region with the live cohort tool.
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The codes that actually drive this specialty's wRVUs.
30-year cumulative earnings with regional cost adjustment.
Educational reference, not financial, billing, or legal advice. Published medians are publicly cited from Medscape 2024. The live cohort is self-reported and anonymized; individual rows are never exposed and a cohort is shown only at a minimum size. Verify any number against your own contract and market before acting on it.