Cardiothoracic surgeon salary: regional and seniority differences in take-home pay

What a cardiothoracic surgeon salary covers

Cardiothoracic surgery — heart and lung surgery — is a small, highly specialised branch of medicine in the UK. Almost all posts sit in NHS tertiary cardiac and thoracic centres, usually in or near major cities, with a limited number of posts in independent hospitals. Training is long, entry is competitive, and the pay structure follows the national medical and dental consultant framework rather than a specialty-specific scale.

There is an important limitation to any headline figure. The ONS Annual Survey of Hours and Earnings does not publish a distinct line for cardiothoracic surgeons. The closest published benchmark is the medical practitioners group (SOC 2211), and analysis based on that ONS ASHE data puts median full-time gross pay for a senior hospital consultant at roughly £128,400 a year, with the 25th percentile near £109,475 and the 75th percentile near £158,000. That is a reasonable proxy for a senior NHS consultant, not a precise cardiothoracic surgeon salary.

Gross pay: what shapes the number

NHS consultant pay scales

Consultant basic pay in England is set nationally. NHS Employers' Pay and Conditions Circular (M&D) 1/2026 sets out revised national salaries, fees and allowances for medical and dental consultants, applying in full from 1 April 2026, with the National Clinical Impact Award changes effective from 1 April 2025. The circular is the authoritative source for scale points, so check it rather than relying on third-party summaries.

Extra programmed activities and on-call

Most consultant contracts are built on 10 programmed activities (PAs). Cardiothoracic surgeons frequently work beyond that, with extra PAs for additional theatre lists or specialist sessions, and out-of-hours cover. On-call availability supplements are usually a percentage of basic pay and depend on the frequency and intensity of the rota, so the busiest tertiary units attract the higher categories.

Awards and additional sessions

Clinical Excellence Awards have been replaced by the National Clinical Impact Awards, which are pensionable and awarded nationally. Waiting-list initiative sessions and other additional activity payments can also lift gross pay well above basic.

Private practice

Some cardiothoracic surgeons do private work, though it is rarely as dominant an income stream as it can be in other surgical specialties. Private income is not NHS pensionable and is normally reported through self-assessment.

Take-home pay after Income Tax and National Insurance

Gross salary is not what reaches your bank account. For a UK taxpayer with the standard Personal Allowance of £12,570, Income Tax is 20% on roughly £12,570–£50,270 and 40% on £50,270–£100,000, with 45% above £125,140. Employee National Insurance is 8% between about £12,570 and £50,270, then 2% above that.

Consultants sit in a difficult zone. Between £100,000 and £125,140 the Personal Allowance tapers away, giving an effective marginal rate of around 62% once Income Tax and National Insurance are combined. Above that band, 45% plus 2% National Insurance applies.

Illustrative take-home estimates for surgeons, before pension and student loan, look like this:

• £105,000 gross gives roughly £70,500 net a year, about £5,870 a month
• £130,000 gross gives roughly £80,700 net a year, about £6,700 a month
• £190,000 gross (senior consultant with private practice) gives roughly £112,500 net a year, about £9,370 a month

These are illustrative only. Your tax code, pension arrangement, benefits in kind and student loan plan all change the answer. Use the take-home calculator for your own figures.

Regional differences

Location matters in three ways.

First, London weighting. Consultant posts in inner and outer London attract a High Cost Area Supplement on top of basic pay, which has no direct equivalent elsewhere in England.

Second, devolution. Consultant pay in Scotland, Wales and Northern Ireland is negotiated separately from England's circular, so scale points and the timing of uplifts can differ.

Third, where the work is. Cardiac surgery is concentrated in a limited number of tertiary centres in cities such as London, Birmingham, Manchester, Newcastle, Liverpool, Southampton, Glasgow and Edinburgh. That narrows where you can build a career and makes local housing and commuting costs part of the real-world comparison.

Scotland and Income Tax

If your main home is in Scotland, HMRC applies Scottish Income Tax rates to your earnings, even if you work elsewhere in the UK. For 2026/27 those rates are 19% (starter), 20% (basic), 21% (intermediate), 42% (higher), 45% (advanced) and 48% (top), applied above the same £12,570 Personal Allowance. National Insurance is unchanged UK-wide. For a consultant on a six-figure salary, the Scottish higher, advanced and top rates usually mean more Income Tax than the equivalent post in England.

Pension, annual allowance and student loan

The NHS Pension Scheme is a career average (CARE) scheme: you build 1/54 of pensionable pay each year. Employee contributions are tiered by pay, from roughly 5.1% at lower salaries to about 12.5% above £75,633, with an employer contribution of around 23.7%. Contributions come out before Income Tax, which softens the impact — and for anyone caught by the Personal Allowance taper, added pension saving can be unusually tax-efficient.

The pensions annual allowance is £60,000, tapered for the highest earners (threshold income above £200,000 or adjusted income above £260,000) down to as little as £10,000. Senior surgeons with private income often run into this limit.

Medical degrees are long, so student loans are common. Plan 2 repayments are 9% above £27,295; Plan 5 is 9% above £25,000; postgraduate loans are 6% above £21,000. These are taken from net pay after tax and National Insurance, so a £130,000 salary can lose several hundred pounds a month to a student loan alone.

Putting the figure in context

For comparison, the UK median full-time gross annual pay is around £39,039, and a full-time worker on the National Living Wage takes home roughly £1,780 a month. A consultant cardiothoracic surgeon earns several times the median — but in the £100,000–£125,140 band the tax system claws back a disproportionate share of every extra pound.

Use the salary data pages for benchmark comparisons, browse salary articles for other roles and grades, or check topics for related guides on tax, pensions and student loans.