Call Pay in Medicine: Who Gets Paid, How Much, and Why It Varies

Research

Key Takeaways

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Most physicians don’t get paid for taking call. Only 19% of physicians report receiving additional compensation for on-call duties.
Surgical and procedural specialties are far more likely to offer paid call. For example, 43% of orthopedic surgery and 39% of neurosurgery roles include it, versus nearly 0% in rheumatology or allergy.
Rates range widely across specialties. Neurosurgeons average $2,045/day, radiologists $1,845/day, while endocrinologists average just $363/day and infectious disease $533/day.
Heavier call burden doesn’t always mean higher pay. Nephrology and infectious disease physicians face frequent call with little to no extra compensation.
Practice setting matters. Private groups (25%) are slightly more likely to pay for call than hospitals (24%) or academic settings (21%). Government-employed doctors are least likely (~10%).
Regional differences exist. Call pay is most common in the West & Pacific (34%) and Rocky Mountain (33%) regions, and least common in the Northeast (~16–18%).
In-hospital call pays more than at-home call. On-site overnight typically commands much higher stipends than carrying a pager from home.
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Introduction

In our last post about unreasonable call demands, we highlighted how frequently physicians take call and how heavy those schedules can be. This follow-up dives into the dollars and cents of call - who gets paid, how much, and why compensation varies so widely.

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Using data from Marit’s community-powered physician salaries, we’ve analyzed thousands of verified physician salary reports to uncover patterns in call pay across specialties, practice settings, and regions. The findings reveal striking disparities: only a minority of physicians receive any call pay, and the going rates can swing from just a few hundred dollars to well over $2,000 per on-call day depending on your specialty and situation. Let’s dive in.

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Call Pay by Specialty

Across all physicians, only 19% report receiving extra pay for call, but the differences by specialty are dramatic. Orthopedic surgery (43%), neurosurgery (39%), urology (37%), and anesthesiology (32%) are among the most likely to receive stipends, while fields like rheumatology, allergy, and nephrology almost never do.

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Among those who are compensated, the amounts vary just as widely. Neurosurgeons average $2,045 per day on call, radiologists $1,845, and pathologists $1,700 – all specialties where coverage is scarce and hospitals are highly motivated to ensure it. By contrast, endocrinologists ($363), family medicine physicians ($455), and infectious disease physicians ($533) earn far less. Despite frequent and sometimes heavy call, these fields generate more modest direct revenue, so hospitals often treat call duty as an expected responsibility rather than something to compensate separately.

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The disconnect between call burden and call pay is especially stark. Nephrologists and infectious disease physicians often have some of the heaviest call schedules but little to no stipend. Meanwhile, fields with lighter call, like radiology, can command high stipends when coverage is needed.

Call Pay by Practice Setting and Region

Employer type also shapes call pay. Physicians in private medical groups are most likely to be paid (25%), followed closely by hospitals and health systems (24%). Academic centers (21%) lag slightly, while government employers pay stipends least often (~10%). Average amounts of call pay per day are surprisingly consistent across settings, typically $1,000–$1,300/day when call pay is offered.

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Surprisingly, there are meaningful differences in % of salaries that reported getting paid for call across regions. The Northeast region, which is known to have the lowest physician pay, was also the lowest, with only 16% - 18% of physicians reporting being paid for call. This was followed by the Midwest (~20% - 23%) and the South (20% - 28%). Rocky Mountain and the West region reported the highest % salaries with paid call (~34%), which is almost twice as much as the Northeast. The average pay for call is approximately the same across all regions, ranging from $1,050 in the Southeast to $1,280 in the Rocky Mountain region.

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At-Home vs. In-Hospital Call

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The biggest gap in call pay isn’t between different specialties or practice settings – it’s between the different call types. Unsurprisingly, in-hospital call pays substantially more than at-home call.

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For example, anesthesiologists’ at-home call might pay a few hundred dollars, but in-hospital call typically pays $1,000+ per shift, pushing their overall average to $1,600/day. OB/GYN, surgery, and neurosurgery follow similar patterns. In contrast, family medicine or psychiatry, where call is almost always taken at home, see little or no separate pay.

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This distinction matters in negotiations. If your role requires frequent overnight hospital call, you have a strong case for a stipend. At-home call may not justify as much pay, but you can still negotiate limits on frequency, post-call time off.

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Making Call Work for You

The key to fair call compensation is anchoring negotiations in real data and distinguishing between in-hospital and at-home call.

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Use specialty benchmarks to set expectations. Neurosurgeons earning ~$2,000 per call day and orthopedic surgeons around $1,100 are clear signals that surgical call is marketable. By contrast, in specialties where call is rarely paid, like endocrinology or infectious disease, data can still be used to push back against extreme burdens (e.g., every-other-night coverage).
Differentiate by call type. In-hospital call consistently commands higher stipends because it extends the workday and restricts rest. If your role requires overnight presence, reference benchmarks showing that in-hospital rates are often double at-home rates. For at-home call, where pay is less common, data can still support negotiating frequency caps, recovery time, or modest stipends.

Not all call is created equal. But physicians who can bring hard data to the table are in the strongest position to ensure call duties are compensated fairly.

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About Our Data & Methodology

Marit's data is different - it is:

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Unique - since it captures the compensation data along with all the details that matter - bonuses, shifts, schedule, benefits, and more ‍
Comprehensive - Across all specialties and Professions (Physicians & APPs), Employer Types (large and small, including Self-employed, Academic & Non Academic), Job Types (Full Time, Part Time, PRNs and Locums) and Employment Types (W-2, 1099, K-1)‍
Current - Unlike other benchmarks that only update their data once a year, all salaries reflect the clinician’s current compensation, and all averages are updated in real-time as new salaries are added

All data in this report comes from anonymized salary contributions on Marit, as of Sept 5, 2025. Only verified salary reports approved by our moderation team are included.