At an average of $543,000 per year, orthopedic surgeons lead the physician pay scale in 2025 — but pay fell 3% year over year, signaling the specialty’s longheld lead may be beginning to recede. A key factor is Medicare’s 2.83% physician fee schedule cut for 2025, which lowered the conversion factor from $33.29 to $32.35. “It’s definitely not sustainable to continue to see Medicare force pay cuts on physicians.”Expense pressures are adding to the squeeze. Senators have urged Congress to act to avert physician pay cuts, but the outcome remains uncertain. Without relief, orthopedic surgeons may continue to see their long-standing compensation advantage narrow, even as the specialty remains among the most highly compensated.