Cardiac Anesthesia: Salary, Training & Job Outlook
Key Takeaways
- Cardiac anesthesiologists command the highest compensation among anesthesia subspecialties — averaging $590,000–$609,000+ annually (AllStar Healthcare/Marit Health, 2026)
- The subspecialty premium over general anesthesiology ranges from 10–25%, with top earners exceeding $700,000
- Training requires a one-year ACGME-accredited Adult Cardiothoracic Anesthesiology (ACTA) fellowship after a four-year anesthesiology residency
- Demand for cardiac anesthesiologists is outpacing the supply of fellowship-trained providers, creating exceptional job security
- Locum tenens cardiac anesthesiologists earn $450–$475/hr — a 15–25% premium over general anesthesia locum rates
If you’re researching cardiac anesthesiologist salary, you’re looking at the single highest-paying subspecialty within anesthesiology — and one of the most lucrative paths in all of medicine. Cardiac anesthesiologists provide perioperative care for patients undergoing open-heart surgery, structural heart procedures, heart and lung transplants, and other complex cardiothoracic operations. The clinical complexity, high-acuity patient populations, and specialized skill set command a significant salary premium over general anesthesiology.
This comprehensive guide breaks down everything you need to know about cardiac anesthesia compensation, the fellowship training pathway, board certification, and the job market outlook for 2026 and beyond. Whether you’re an anesthesiology resident considering subspecialty fellowship or an established anesthesiologist exploring a career pivot, this data will help you make an informed decision. For a broader look at anesthesiologist compensation across all settings, see our complete anesthesiologist salary guide.
📊 Salary Data Sources & Freshness This guide cites data from multiple sources: the U.S. Bureau of Labor Statistics (BLS, May 2024 — latest government data), ZipRecruiter (2026 advertised salaries), Glassdoor, AMN Healthcare, SalaryDr, and other industry reports. Government salary surveys have a 12–18 month reporting lag. Current advertised salaries on job boards typically reflect real-time market conditions and may be higher. Anesthesia provider compensation has risen steadily over the past five years.
Cardiac Anesthesiologist Salary: 2026 Compensation Data
Cardiac anesthesiologists consistently earn more than their general anesthesiology colleagues. Multiple sources confirm a substantial premium for this high-demand subspecialty.
| Compensation Metric | Cardiac Anesthesiologist | General Anesthesiologist |
|---|---|---|
| Average Total Compensation | $590,000–$609,000 (AllStar Healthcare/Marit Health, 2026) | $569,729 avg (SalaryDr, 2026) |
| Median Total Compensation | ~$600,000 (Marit Health, 2026) | $535,000 (SalaryDr, 2026) |
| Reported Range | $550,000–$850,000+ (MedicalRecruiting, 2026) | $393,215 advertised avg (ZipRecruiter, 2026) |
| AMN Healthcare Listings | Up to $650,000–$700,000/yr (AMN, 2026) | Starting ~$377,000+ (AMN, 2025) |
| BLS Mean Base (All Anesthesiologists) | — | $336,640 (BLS, May 2024) |
| Locum Tenens Hourly | $450–$475/hr (Locums.one, 2026) | $300–$450/hr |
| Locum Annual Gross | $700,000–$950,000+ | $600,000–$900,000+ |
| Subspecialty Premium | +10–25% over general | Baseline |
(Sources: AllStar Healthcare Solutions 2026, Marit Health 2026, MedicalRecruiting 2026, AMN Healthcare 2026, Locums.one 2026, BLS May 2024, SalaryDr 2026)
Note that the BLS does not break out cardiac anesthesiologists as a separate category — the BLS mean of $336,640 (May 2024) reflects base pay across all anesthesiologists and does not include production bonuses, call pay, cardiac stipends, or other components of total compensation. Real-world total compensation for cardiac anesthesiologists is substantially higher.
What Drives the Cardiac Anesthesiologist Salary Premium?
Several factors explain why cardiac anesthesiologists command the highest pay in the specialty:
- Clinical complexity: Managing patients on cardiopulmonary bypass, intra-aortic balloon pumps, ventricular assist devices, and extracorporeal membrane oxygenation (ECMO) requires advanced training
- High-acuity case mix: Cardiac surgical patients are among the sickest in the hospital, demanding intense intraoperative vigilance and expert hemodynamic management
- Advanced imaging skills: Proficiency in transesophageal echocardiography (TEE) is essential and represents a distinct, marketable expertise
- Limited provider pool: Fewer fellowship-trained cardiac anesthesiologists exist relative to demand, creating favorable market conditions
- Call burden: Cardiac anesthesiologists often take heavier call responsibilities, with dedicated cardiac call stipends adding $50,000–$100,000+ to base compensation
- Revenue generation: Cardiac surgical cases generate significant hospital revenue, supporting higher anesthesia compensation
Cardiac Anesthesiologist Salary by Practice Setting
Compensation varies meaningfully depending on where you practice:
| Practice Setting | Estimated Total Compensation |
|---|---|
| Private practice / Large group | $600,000–$850,000+ |
| Hospital-employed (non-academic) | $550,000–$700,000 |
| Academic medical center | $450,000–$600,000 |
| Locum tenens | $700,000–$950,000+ gross |
Academic positions typically offer lower cash compensation but include research funding, teaching opportunities, sabbatical time, and prestige that many cardiac anesthesiologists value highly. Community hospital and private practice settings offer the highest total compensation packages.
How Cardiac Anesthesiologist Salary Compares to Other Subspecialties
Cardiac anesthesiology leads the pack when it comes to subspecialty compensation. Here’s how the major anesthesia subspecialties compare:
| Subspecialty | Estimated Avg Total Comp (2026) | Premium vs. General |
|---|---|---|
| Cardiac Anesthesiology | $590,000–$609,000 | +10–25% |
| Pain Management | $450,000–$550,000 | Variable |
| Pediatric Anesthesiology | $450,000–$550,000 | +5–15% |
| Critical Care Anesthesiology | $400,000–$500,000 | +0–10% |
| Obstetric Anesthesiology | $400,000–$500,000 | +0–10% |
| Regional Anesthesia | $400,000–$500,000 | +0–10% |
| General Anesthesiology | $535,000 median total comp | Baseline |
(Sources: SalaryDr 2026, MedicalRecruiting 2026, AllStar Healthcare Solutions 2026, Medscape 2025)
The cardiac premium is driven by both the additional training investment and the acute market shortage of fellowship-trained providers. As cardiac surgical volumes continue growing — fueled by an aging population and expanding structural heart programs — this premium shows no signs of narrowing.
Cardiac Anesthesia Fellowship Training: Requirements & Timeline
The Path to Becoming a Cardiac Anesthesiologist
Becoming a cardiac anesthesiologist requires completing one of the longest training pipelines in medicine:
| Training Stage | Duration | Details |
|---|---|---|
| Undergraduate (Pre-med) | 4 years | Bachelor’s degree with science prerequisites |
| Medical school (MD/DO) | 4 years | Allopathic or osteopathic medical degree |
| Anesthesiology residency | 4 years | ACGME-accredited program (includes CA-1, CA-2, CA-3 clinical years + intern year) |
| ACTA Fellowship | 1 year | ACGME-accredited Adult Cardiothoracic Anesthesiology fellowship |
| Total training | 13 years | Post-high school to independent practice |
For a comprehensive overview of anesthesiology fellowship options beyond cardiac, see our anesthesiologist fellowship guide.
ACTA Fellowship: What to Expect
The Adult Cardiothoracic Anesthesiology (ACTA) fellowship is a one-year ACGME-accredited program that provides advanced training in:
- Cardiac surgical anesthesia: Coronary artery bypass grafting (CABG), valve repair/replacement, aortic surgery, heart transplantation
- Thoracic surgical anesthesia: Lung resection, esophageal surgery, mediastinal procedures
- Transesophageal echocardiography (TEE): Intraoperative imaging and hemodynamic assessment
- Mechanical circulatory support: Ventricular assist devices (VADs), ECMO, intra-aortic balloon pumps
- Structural heart procedures: Transcatheter aortic valve replacement (TAVR), MitraClip, and other catheter-based interventions
- Post-operative critical care: Cardiothoracic ICU management
Fellowship programs are listed on the Society of Cardiovascular Anesthesiologists (SCA) website, and recruitment is conducted through the SF Match process. Most programs offer one to three positions per year.
Board Certification
After completing an ACTA fellowship, cardiac anesthesiologists are eligible for the Adult Cardiac Anesthesiology Exam administered by the American Board of Anesthesiology (ABA). Board certification in the subspecialty is increasingly expected by top employers and academic institutions. Requirements include:
- Active, unrestricted medical license
- ABA primary certification in anesthesiology
- Completion of an ACGME-accredited ACTA fellowship
- Passing the subspecialty examination
Fellowship Salary During Training
ACTA fellows earn resident-level salaries during their training year:
| Fellowship Year | Approximate Salary |
|---|---|
| ACTA Fellow (PGY-5/6) | $85,000–$100,000 |
While the fellowship year represents a short-term income reduction compared to entering practice as a general anesthesiologist, the long-term return on this one-year investment is substantial — typically adding $50,000–$150,000+ per year to lifetime compensation.
Cardiac Anesthesia Job Outlook: 2026 and Beyond
A Subspecialty in High Demand
The job outlook for cardiac anesthesiologists is exceptionally strong. Several converging trends are driving sustained demand:
Growing cardiac surgical volume: The American Heart Association reports that cardiovascular disease remains the leading cause of death in the United States. An aging population means more patients requiring coronary artery bypass, valve replacement, and other cardiac procedures. The rapid expansion of structural heart programs — particularly TAVR and transcatheter mitral valve interventions — is creating entirely new procedural volume that requires anesthesia teams with cardiac expertise.
Supply-demand imbalance: A 2025 study published in the Journal of Cardiothoracic and Vascular Anesthesia found that demand for cardiothoracic anesthesiology services has grown rapidly, and the pace of growth has exceeded our ability to train an adequate number of providers. The limited number of ACTA fellowship positions means the pipeline of newly trained cardiac anesthesiologists cannot keep pace with demand.
Locum tenens demand surge: According to Locums.one (2026), anesthesiology locums demand surged 55% year-over-year in 2025, the highest of any medical specialty. Cardiac anesthesia is the tightest segment of this market, with locum rates reaching $450–$475/hr — a 15–25% premium over general anesthesia locum assignments.
BLS projections: The Bureau of Labor Statistics projects 3.2% employment growth for anesthesiologists overall between 2024 and 2034, adding approximately 1,400 new positions nationally. While modest in percentage terms, this steady growth combined with retirements ensures consistent demand. Cardiac anesthesiologists — as the most specialized and sought-after segment — face even more favorable conditions.
Where Are the Jobs?
Cardiac anesthesiologists are in demand at:
- Major academic medical centers: Teaching hospitals with cardiothoracic surgery programs, transplant services, and structural heart programs
- High-volume community hospitals: Facilities performing 300+ cardiac cases annually
- Hybrid OR programs: Hospitals investing in structural heart and hybrid surgical-interventional programs
- Locum tenens agencies: Short-term and travel assignments across the country, especially at facilities struggling to recruit permanent cardiac anesthesia coverage
For current openings, browse anesthesiologist jobs on AnesthesiaJobs.com.
The Role of CRNAs and CAAs in Cardiac Anesthesia
Cardiac anesthesia is delivered by a collaborative team. While fellowship-trained cardiac anesthesiologists lead the care team, CRNAs and CAAs play vital roles in cardiac anesthesia programs across the country.
CRNAs in Cardiac Anesthesia
Certified Registered Nurse Anesthetists with cardiac experience are highly valued. CRNAs working in cardiac settings typically earn a premium above general practice — with the BLS reporting a median CRNA salary of $223,210 (BLS, May 2024) and advertised averages reaching $260,000 (ZipRecruiter, 2026). CRNAs with dedicated cardiac experience can command compensation at the higher end of these ranges and beyond, particularly in care-team models at high-volume centers.
CAAs in Cardiac Anesthesia
Certified Anesthesiologist Assistants (CAAs) also contribute significantly to cardiac anesthesia teams. CAAs with cardiac specialization earn a notable premium — $264,000–$328,000 at institutions like Emory (Emory, 2026) — compared to the national CAA average of $247,000–$253,000 (Becker’s/Marit Health, 2026). The cardiac premium reflects the advanced skills and high-stakes environment these providers operate in.
All three roles — anesthesiologists, CRNAs, and CAAs — are essential to meeting the growing demand for cardiac anesthesia services. The collaborative care-team model allows programs to maximize surgical volume while maintaining the highest standards of patient safety.
Cardiac Anesthesiologist Salary Negotiation Tips
Whether you’re a new fellowship graduate or an experienced cardiac anesthesiologist exploring opportunities, these strategies can help you maximize your compensation:
1. Know Your Market Value
Use multiple data sources to benchmark your worth. Cardiac anesthesiologists with fellowship training and board certification should target total compensation well above the general anesthesiologist median of $535,000 (SalaryDr, 2026). The cardiac subspecialty premium means your baseline negotiating position starts at $550,000+ in most markets.
2. Negotiate the Full Package
Total compensation for cardiac anesthesiologists includes more than base salary:
| Component | Typical Range |
|---|---|
| Base salary | $400,000–$550,000 |
| Cardiac call stipend | $50,000–$100,000+ |
| Production bonus | $50,000–$150,000+ |
| Sign-on bonus | $25,000–$75,000 |
| Relocation | $10,000–$25,000 |
| CME/professional development | $5,000–$10,000 |
| Loan repayment assistance | $50,000–$200,000 (select employers) |
3. Leverage the Supply Shortage
The well-documented shortage of fellowship-trained cardiac anesthesiologists gives you significant negotiating power. Programs that have lost a cardiac anesthesiologist often face urgent coverage gaps, making them willing to offer premium packages to attract replacements quickly.
4. Consider Geographic Arbitrage
Cardiac anesthesiologist salary varies by region. Markets in the South and Midwest often offer higher compensation relative to cost of living compared to coastal metropolitan areas. For state-level salary data, see our anesthesiologist salary in Texas guide as an example of a high-value market.
5. Explore Locum Tenens Strategically
Locum cardiac anesthesia assignments at $450–$475/hr can generate $700,000–$950,000+ in annual gross income. Even short locum stints between permanent positions can provide substantial supplemental income and exposure to different practice environments.
Is a Cardiac Anesthesia Fellowship Worth It?
The one-year opportunity cost of fellowship training is the most common hesitation for residents considering the ACTA path. Here’s the financial case:
| Factor | Without Fellowship (General) | With ACTA Fellowship (Cardiac) |
|---|---|---|
| Year 1 income | ~$377,000+ (AMN, 2025) | ~$90,000 (fellowship salary) |
| Year 2 income | ~$400,000+ | $550,000–$700,000 (first attending year) |
| 5-year cumulative earnings | ~$2,200,000 | ~$2,740,000 |
| 10-year cumulative earnings | ~$5,000,000 | ~$6,000,000+ |
| Career ceiling | $535,000 median total comp | $700,000–$850,000+ |
The math is compelling. After a single year of reduced fellowship income, cardiac anesthesiologists typically surpass the cumulative earnings of their general colleagues within two to three years — and the gap widens every year after that. Over a 25–30 year career, the financial advantage of the cardiac subspecialty can exceed $3–5 million in additional lifetime earnings.
Beyond compensation, the fellowship opens doors to:
- Academic leadership: Division chief, fellowship director, department chair positions
- Research opportunities: TEE innovation, hemodynamic monitoring advances, cardiac pharmacology
- Professional distinction: Board certification and SCA membership signal expertise to employers and patients
- Practice flexibility: Cardiac anesthesiologists can always do general cases, but general anesthesiologists cannot easily take cardiac assignments
Related Reading
- How Much Do Anesthesiologists Make? 2026 Salary Breakdown
- Anesthesiologist Salary in Texas: 2026 Guide
- Anesthesiologist Fellowship Guide
- Anesthesiologist Job Market & Outlook
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Frequently Asked Questions
How much do cardiac anesthesiologists make?
Cardiac anesthesiologists earn average total compensation of $590,000–$609,000 annually (AllStar Healthcare/Marit Health, 2026), with reported ranges from $550,000 to $850,000+ depending on practice setting and geographic location (MedicalRecruiting, 2026). This represents a 10–25% premium over general anesthesiologists, who earn a median total compensation of $535,000 (SalaryDr, 2026). Locum tenens cardiac anesthesiologists can gross $700,000–$950,000+ per year at rates of $450–$475/hr.
How long does it take to become a cardiac anesthesiologist?
The full training pathway takes approximately 13 years after high school: four years of college, four years of medical school, four years of anesthesiology residency, and one year of an ACGME-accredited Adult Cardiothoracic Anesthesiology (ACTA) fellowship. Board certification through the American Board of Anesthesiology is available after completing fellowship training.
Is a cardiac anesthesia fellowship worth the investment?
Yes — the financial return on a one-year cardiac anesthesia fellowship is among the strongest in medicine. While fellows earn approximately $85,000–$100,000 during their training year, cardiac anesthesiologists typically earn $550,000–$700,000+ in their first year of independent practice. Most cardiac anesthesiologists surpass the cumulative earnings of their general anesthesiology peers within two to three years of completing fellowship, with the gap widening significantly over time.
What is the job outlook for cardiac anesthesiologists?
The job outlook is excellent. A 2025 study in the Journal of Cardiothoracic and Vascular Anesthesia found that demand for cardiothoracic anesthesiology services is growing faster than the training pipeline can supply. Locums demand for anesthesiology surged 55% year-over-year in 2025, with cardiac anesthesia being the tightest segment. The aging population and expansion of structural heart programs continue to drive growing demand.
Do cardiac anesthesiologists earn more than general anesthesiologists?
Yes. Cardiac anesthesiologists command a consistent 10–25% premium over general anesthesiologists. While general anesthesiologists earn a median total compensation of $535,000 (SalaryDr, 2026), cardiac anesthesiologists average $590,000–$609,000+ (AllStar Healthcare/Marit Health, 2026), with top earners exceeding $700,000 in private practice and high-volume community settings. The premium reflects the additional fellowship training, specialized skill set, and limited supply of qualified providers.
Practicing anesthesiologist with experience across MD-only, medical supervision of CRNAs, and medical direction of CAAs. Founded AnesthesiaJobs.com to help anesthesia professionals find the best job for their personal and professional life.
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