| Factor | Impact |
|---|
| Experience | 10+ years → top quartile |
| Location | NYC > upstate; Manhattan/Westchester premium |
| Academic Affiliation | Prestigious centers (NYU, Columbia, Cornell) → higher base + research funding |
| Practice Model | Private practice > hospital-employed (but higher overhead/risk) |
| Subspecialty | Cerebrovascular, pediatric, complex spine, functional → premium |
| Volume/Complexity | High-RVU cases (cranial, vascular) > routine spine |
| Incentives | Quality, productivity, academic bonuses |
Important Caveats
- Figures are gross, pre-tax, pre-overhead (private practice overhead 40–60%).
- Malpractice premiums in NY: $80k–$200k+ for neurosurgery.
- Japanese text in source removed (translation artifact).
- Consult MGMA, AMGA, or specialty society surveys for current negotiations.
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