Published May 18, 2026 • Updated regularly with current MGMA and CMS data
Key Findings: Family Medicine Salary 2026
Family medicine compensation varies significantly by state, employer type, and career stage. On average, FM physicians earn:
- Year 1: $165,000–$185,000 nationally
- Year 3: $185,000–$210,000
- Year 5+: $200,000–$240,000
However, these ranges mask substantial regional variation. Rural and underserved areas offer higher base salaries (up to $250,000 Y1) plus loan repayment and incentives. High-cost metros (SF, Boston, NYC) offer lower salaries but higher benefits packages.
State-by-State Comparison
Below is a representative sample. Your earnings depend on practice type (safety-net vs. hospital) and patient demographics.
| State |
Year 1 Range |
Year 3 Avg |
Loan Repayment |
| Arizona | $170–$190k | $195k | NRSA, state programs |
| California | $160–$200k | $210k | PSLF eligible, minimal state |
| Texas | $175–$210k | $205k | NRSA, private employer |
| New Mexico | $190–$220k | $230k | State Loan Repay (up to $100k) |
| Colorado | $165–$195k | $200k | NRSA, rural programs |
| Wyoming | $200–$240k | $250k | State + employer (up to $150k) |
| Montana | $210–$235k | $245k | NRSA + Rural Health Professions |
| Massachusetts | $155–$180k | $190k | PSLF, loan forgiveness limited |
Compensation Components Beyond Base Salary
Sign-On Bonuses
- Rural/underserved: $25k–$75k
- Urban FQHCs: $5k–$20k
- Hospital systems: $10k–$40k
Loan Repayment
- Federal PSLF: Up to $250k after 120 payments (~10 years) at qualifying employers
- State programs: New Mexico ($100k), Wyoming ($150k), rural incentives in most states
- Employer direct: Safety-net and FQHCs typically offer $10k–$50k annually for 2–5 years
Call Compensation & Shift Differentials
After-hours availability varies widely:
- FQHC/safety-net: Minimal call, $5–$15/hour on-call differential
- Hospital-employed: Higher call load, $50–$150/call shift
- Rural: Often salaried with built-in call expectations
CME Allowance & Professional Development
- Standard: $2,000–$5,000 annually
- Academic/research-focused: $10,000+
Employer Type Breakdown
Safety-Net Organizations & FQHCs
- Salary: $170k–$220k (mission-driven, often lower cost-of-living regions)
- Loan repayment: Strong (PSLF eligible)
- Best for: Social mission focus, underserved populations, potential PSLF benefit
Hospital Systems
- Salary: $165k–$210k (competitive, variable by market)
- Loan repayment: Modest (not PSLF eligible for private nonprofits)
- Best for: Stability, benefits, career advancement paths
Veterans Affairs (VA)
- Salary: ~$190k (federal pay scale, predictable)
- Benefits: Excellent (federal pension, 40-hour weeks, 30 days PTO)
- Loan repayment: Limited (not PSLF eligible, but paid federal employment)
Indian Health Services (IHS)
- Salary: $200k–$240k (rural, higher compensation for underserved work)
- Loan repayment: Strong IHS repayment programs
- Best for: Rural commitment, loan relief, mission-driven practice
💡 Pro Tip: Compare total compensation, not just base salary. A $160k PSLF-eligible role with $50k annual loan repayment and low COL can exceed a $200k non-PSLF role after 10 years.
Cost of Living Adjustments
A $200k salary in San Francisco ≠ $200k in rural Montana. Adjust for local COL:
- High COL (SF, Boston, NYC): Multiply salary × 0.6–0.7 for real buying power
- Moderate COL (Phoenix, Denver, Austin): Multiply by 0.85–0.95
- Low COL (rural MT, NM, WY): Multiply by 1.0–1.15 (money goes further)
How to Use This Data
- Identify comparable employers in your target region using salary data
- Factor in loan repayment: PSLF-eligible roles are worth $150k–$250k more over 10 years
- Adjust for COL using your target city's index
- Use Attending Compass to model competing offers side-by-side with your priorities
Compare Offers Across All Factors
Salary is only part of the equation. Use our interactive tool to rank employers on compensation, EMR, loan repayment, call burden, and mission fit.
Try the Scoring Tool →
Data Sources
This guide references:
- MGMA Physician Compensation and Production Survey (2025)
- US Bureau of Labor Statistics (Occupational Employment Survey)
- AAFP Resident Survey data
- State-specific loan repayment program websites
- Employer 990 filings and public salary disclosures
Key Takeaways
- FM salary ranges $165k–$245k Y1 depending on state and employer type
- Rural and underserved areas offer highest salaries + loan repayment
- PSLF eligibility can add $150k–$250k value over 10 years
- Sign-on bonuses and relocation aid can provide $25k–$75k upfront
- Always compare total compensation, not just base salary