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Dermatologist Salary 2026: Cash-Pay, Mohs, and Partnership Economics

AH
Ava Health Team
··8 min read

Dermatology has been structurally transformed by private equity consolidation and the rise of cash-pay aesthetic practices. Median dermatologist base salary reached $475,000 in 2026, but the real wealth creation is in partnership tracks, cosmetic practice ownership, and Mohs surgery volume.

Subspecialty Benchmarks (2026)

Subspecialty / ModelMedian BaseTop Quartile
General Dermatology (hospital-employed)$430,000$525,000
General Derm (PE-backed private)$455,000$575,000
Mohs Surgeon (fellowship-trained)$585,000$750,000
Pediatric Dermatology$385,000$485,000
Dermatopathology$465,000$575,000
Cosmetic / Aesthetic-heavy Derm$625,000$950,000+
Academic Dermatology$325,000$415,000

Private Equity in Dermatology

By 2026, roughly 25-30% of US dermatology practices are PE-backed (up from 5% in 2015). Implications for recruiters and candidates:

  • Signing bonuses are aggressive — $100K-$200K common at PE-owned mega-groups
  • Base salaries competitive but partnership equity is typically unavailable
  • "Partner" titles at PE practices usually don't include real ownership
  • Productivity expectations are higher (45-55 patients per day typical)
  • Some dermatologists prefer independent/physician-owned practices for autonomy and true partnership

Cosmetic / Aesthetic Practice Economics

Dermatologists with meaningful cosmetic volume can out-earn most specialties:

  • Injectables (Botox, filler): Margin 65-80% of gross. High-volume injectors generate $500K-$1M+ from injectables alone.
  • Laser + RF: Equipment capex $50K-$250K; 3-year payback typical at volume
  • Body contouring (CoolSculpting, EmSculpt): Premium cash-pay, 55-70% margin
  • Cosmetic practice owner: $800K-$1.6M+ after 5-7 years

Mohs Surgery Economics

Mohs-trained dermatologists command a significant premium:

  • Fellowship in ACMS-accredited program required for top pay
  • Standard day: 6-10 Mohs cases, revenue $4K-$10K/case
  • Mohs surgeons in private practice average $585K-$750K+
  • Dedicated Mohs lab (in-office) adds 10-15% to effective revenue through CPT 88305 pathology

Top 10 Highest-Paying States for Dermatology

RankStateMedian Base
1Wisconsin$525,000+
2Indiana$510,000+
3Oklahoma$505,000+
4Nebraska$500,000+
5Missouri$495,000+
6Iowa$490,000+
7Kentucky$485,000+
8Florida$480,000+
9Ohio$478,000+
10Texas$475,000+

What Dermatologists Negotiate in 2026

  1. Daily patient load (40-50 is sustainable, 60+ leads to burnout)
  2. Cosmetic product/laser capex ownership and revenue share
  3. Mohs case volume allocation (if fellowship-trained)
  4. Partnership terms (true ownership vs PE "partner")
  5. Non-compete geographic/time limits
  6. Malpractice tail coverage
  7. CME + dermatology board recertification
  8. Teaching/residency involvement

Ava Health places dermatologists across employment models nationwide. Contact us for current openings.

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