Cardiac Anesthesia Locum Tenens in 2026: Pay Rates, Demand & What You Need to Know

If you're a cardiac anesthesiologist weighing locum tenens work — or you're already doing it and wondering if your rate is competitive — here's what the 2026 market actually looks like.

Cardiac anesthesia is one of the highest-paid locums subspecialties in medicine right now, and the supply-demand imbalance is only getting wider. Here's why.

What Cardiac Anesthesiologists Earn on Locums in 2026

Cardiac anesthesia locums rates currently range from $450 to $475 per hour, depending on the facility, case complexity, call requirements, and geography.

For context, general anesthesiology locums rates in 2026 sit between $300 and $407/hr. The cardiac premium — typically 15–25% above general — reflects the procedural complexity, TEE requirements, and the shrinking pool of fellowship-trained cardiac anesthesiologists willing to take assignments.

On a typical 10-hour OR day, that's $4,500–$4,750 per day before any call differentials.

How That Compares to Permanent

The SCA's most recent salary survey (covering 2020–2024) shows the permanent cardiac anesthesiology median salary climbed from $425,000 to $525,000 — but satisfaction dropped from 57% to 47% over the same period. The nominal 5.1% annual growth barely keeps pace with inflation, coming out to 0.1% real growth.

A cardiac anesthesiologist working locums at $450/hr for 45 weeks (4 days/week, 10-hour days) earns roughly $810,000 gross — significantly above the permanent median (see our 2026 locum tenens salary guide for cross-specialty comparisons), with full schedule control.

1099 vs W-2

Most cardiac anesthesia locums work as 1099 independent contractors. This adds approximately 6% in net compensation over W-2 arrangements after accounting for self-employment tax, because you gain access to deductions (home office, travel, licensing, CME, retirement contributions) that W-2 employees can't take.

If you're new to 1099 locums taxes, our complete tax guide breaks down S-Corp elections, quarterly estimated payments, and multi-state filing.

One thing worth asking any agency: do they connect you with tax professionals who specialize in 1099 physician income? Locums One provides free tax professional connections for every physician — saving you from learning the S-Corp and quarterly tax game through expensive mistakes.

Why Demand Is Surging

Three forces are converging to make cardiac anesthesia one of the tightest locums markets in 2026.

1. The Workforce Is Aging Out

56.9% of all anesthesiologists are 55 or older. Among cardiac anesthesiologists specifically, the numbers are worse — this is a subspecialty that requires years of post-fellowship experience to build competence, so the average practitioner skews older.

The HRSA projects a shortage of 6,300–8,450 anesthesiologists by 2036–2037. And 40.6% of current anesthesiologists say they plan to leave their roles within two years — the highest exit intent of any medical specialty.

2. Cardiac Surgery Volume Is Growing

The US performs over 900,000 cardiac surgeries per year (iData Research), and that number is projected to grow at roughly 4% annually, reaching 1.3 million procedures by 2029.

The biggest driver is structural heart. TAVR procedures alone now exceed 200,000 worldwide annually, with more than half performed in the US. Edwards Lifesciences reported 8.9% year-over-year growth in TAVR sales. The expansion of TAVR to low-risk patients has dramatically increased volume at community hospitals that previously didn't do these cases — and those programs need cardiac anesthesiologists.

The structural heart devices market is projected to grow from $13.8B (2025) to $21.5B (2030) at a 9.24% CAGR. Every one of those cases needs a cardiac anesthesiologist in the room.

3. The CT Surgery Shortage Creates Downstream Demand

The STS (Society of Thoracic Surgeons) projects that cardiothoracic surgery will have the largest projected physician shortfall of any specialty by 2035. Around 900 CT surgeons are expected to retire while demand increases 20%, resulting in a 31% shortfall.

But here's what matters for cardiac anesthesiologists: every hospital trying to recruit or retain a CT surgeon also needs cardiac anesthesia coverage. When a community hospital finally lands a cardiac surgeon, the first call is to a staffing agency to find a cardiac anesthesiologist.

What You Need to Qualify

The Non-Negotiables

• Board certification in Anesthesiology (ABA)
• ACTA fellowship — completion of an ACGME-accredited Adult Cardiothoracic Anesthesiology fellowship (1 year; 74 accredited programs in the US)
• Advanced PTEeXAM certification (TEE board certification through the National Board of Echocardiography)
• Active, unrestricted medical license in the assignment state
• DEA registration

TEE Certification: Basic vs Advanced

This is where many physicians get tripped up. There are two levels:

Basic PTEeXAM — requires 150 perioperative TEE exams (50 personally performed) plus passing the exam. Sufficient for monitoring, but not for making surgical decisions based on TEE findings.

Advanced PTEeXAM — requires a 12-month cardiac anesthesia fellowship, 300 comprehensive TEE exams (150 personally performed), 40 hours of CME in echocardiography, and passing the advanced exam. This is what most facilities require for cardiac locums assignments, because you'll be directing surgical decisions based on intraoperative TEE.

Between 2010 and 2020, TEE certification among cardiac anesthesiologists rose from 69% to 90%, and fellowship training from 63% to 82%. The bar is rising — facilities are less willing to accept non-fellowship-trained anesthesiologists for cardiac cases, even with experience.

Case Mix You Should Expect

Core cases on most assignments:

• CABG (still the highest-volume cardiac surgery)
• Valve repair/replacement (aortic, mitral)
• Combined CABG + valve
• Aortic surgery (ascending, arch, descending)
• Thoracic cases (lung resection, esophageal)
• Vascular surgery

Growing procedural areas:

• TAVR and structural heart (MitraClip, WATCHMAN)
• Hybrid cases (combined cath lab + OR)

Usually NOT included in locums assignments:

• Heart transplants
• LVAD implantation
• ECMO management

These high-acuity cases are typically handled by the permanent team. If a facility is asking a locums provider to cover transplants or LVADs, that's a different conversation about rate and support.

Academic vs Community: Where the Assignments Are

Community Cardiac Programs (Most Locums Positions)

The majority of cardiac anesthesia locums positions are at community hospitals with open-heart programs that need coverage. These are typically:

• Open staffing model (74.2% of cardiac programs nationally)
• Small cardiac anesthesia teams (sometimes 2–3 attendings)
• Case mix focused on CABG, valve, vascular, thoracic
• You may be the sole cardiac anesthesiologist on some days
• Higher autonomy, less bureaucracy

When one member of a 3-person cardiac anesthesia group goes on leave, retires, or quits — that program needs a locum immediately or they shut down their OR.

Academic Medical Centers (Less Common for Locums)

• Closed staffing model (37.4%)
• Fellows and residents present
• More complex cases (transplants, LVADs, congenital)
• You'll work alongside trainees
• Teaching expectations may apply

Academic positions are less common in locums because these programs usually have enough depth to absorb temporary gaps. But when they do need locums coverage, the rates tend to be competitive because the credentialing is more involved.

Licensing and Credentialing

Multi-State Licensing

The Interstate Medical Licensure Compact (IMLC) now covers 42 states plus DC and Guam, which dramatically accelerates multi-state licensing from months to days or weeks.

Notable non-compact states: California and New York — both high-demand cardiac markets that still require traditional applications (60–90+ days).

If you're building a locums career in cardiac anesthesia, accumulate 5–10 state licenses in high-demand regions. The IMLC makes this far more practical than it was even a few years ago.

Credentialing Timeline

Standard hospital credentialing runs 60–120 days for full privileges. Temporary/emergency privileges can be granted in as little as 2 weeks if your license and DEA are already in place.

Cardiac anesthesia adds complexity because facilities must grant specific privilege delineation for:

• Cardiac anesthesia cases
• Intraoperative TEE (diagnostic use)
• Specific procedure types (CABG, valve, TAVR)

Some facilities request case logs to verify your cardiac case volume, and others want letters from prior cardiac programs attesting to competency. Keep a "credentialing-ready" file updated at all times: CV, case logs, references, board certifications, malpractice history, and TEE certification documentation. At Locums One, our average credentialing time is 21 days — including the additional privilege delineation for cardiac cases and TEE — compared to the industry average of 60–90 days.

What Assignments Look Like Day-to-Day

Typical schedule: Monday–Friday, 7:00 AM to 4:00–5:00 PM, roughly 5 cases per day.

Assignment length: Weeks to months. Cardiac assignments tend to run longer than general anesthesia locums because of the credentialing investment. Both sides want continuity.

Call: This varies widely. Some assignments are call-free (weekday OR only). Others include weeknight call (5 PM–7 AM) and 24-hour weekend call. The SCA salary survey found that increased call frequency independently correlates with decreased compensation satisfaction — so if a facility wants heavy call coverage, your rate should reflect that.

At Locums One, cardiac anesthesia assignments include:

• Malpractice insurance — occurrence-based, $1M/$3M through ProAssurance
• Travel — flights or mileage reimbursement
• Housing — agency-arranged furnished housing or a housing stipend
• Rental car — provided or reimbursed
• Licensing and credentialing costs — covered by the agency for that specific assignment
• DEA registration — typically reimbursed
• Weekly direct deposit — paid weekly, not biweekly or monthly

What's usually NOT included: board certification renewal, CME beyond what the agency sponsors, and personal travel insurance.

Market Outlook: 2026 and Beyond

The locum tenens market overall is projected to grow from $10.2B (2025) to $14.6B (2030) at a 7.6% CAGR. Anesthesiology is leading the growth — demand surged 55% year-over-year, the highest of any specialty.

For cardiac anesthesia specifically, every trend points to sustained or increasing demand:

• Surgical volume growing at 4% annually, with structural heart growing at 9%+
• Workforce aging out — 56.9% of anesthesiologists are 55+
• Exit intent at historic highs — 40.6% plan to leave within 2 years
• Fellowship pipeline can't keep pace — 95.6% fill rate is healthy but cannot offset retirement + volume growth
• CT surgery shortage creates downstream anesthesia demand at every facility

The structural imbalance favors locums providers. Hospitals are paying rates they never paid before, and the physicians who have fellowship training, TEE certification, and multi-state licenses are in a position to choose where, when, and how much they work. Before accepting any offer, review our locum contract negotiation guide to ensure you're getting fair rate protections and cancellation terms. CRNAs in cardiac settings also have strong demand — see our CRNA locum salary guide for the CRNA side of anesthesia staffing.

Frequently Asked Questions

How much do cardiac anesthesiologists make on locums?

Cardiac anesthesiologists earn $450–$475 per hour on locum tenens assignments in 2026, above general anesthesiology locums rates ($375–$425/hr). On a 10-hour OR day, that's $4,750 before any call differentials.

Do you need a fellowship to do cardiac anesthesia locums?

Yes. Most facilities require completion of an ACGME-accredited Adult Cardiothoracic Anesthesiology (ACTA) fellowship and Advanced PTEeXAM certification (TEE board certification). Between 2010 and 2020, fellowship training among cardiac anesthesiologists rose from 63% to 82%, and facilities are increasingly unwilling to credential non-fellowship-trained providers for cardiac cases.

What is the demand outlook for cardiac anesthesia locums?

Demand is strong and growing. Anesthesiology locums demand surged 55% year-over-year in 2025, the highest of any specialty. Cardiac anesthesia is the tightest segment due to rising cardiac surgery volumes (4% annual growth), an aging workforce (56.9% of anesthesiologists are 55+), and the structural heart/TAVR procedure explosion (9.24% CAGR).

How long does credentialing take for cardiac anesthesia locums?

Standard hospital credentialing takes 60–120 days for full privileges. Temporary privileges can be granted in as little as 2 weeks. Cardiac anesthesia adds time because facilities must grant specific privilege delineation for cardiac cases, TEE, and individual procedure types. Keeping a current "credentialing-ready" file significantly speeds the process.

Is cardiac anesthesia locums better than permanent employment?

It depends on your priorities. A cardiac anesthesiologist working locums at $450/hr for 45 weeks earns roughly $810,000 gross — significantly above the $525,000 permanent median. Locums offers schedule control, geographic flexibility, and no administrative burden. The trade-off is managing your own benefits, taxes, and retirement as a 1099 independent contractor. Our tax guide covers how to structure this.

What types of cases do cardiac anesthesia locums cover?

Most assignments involve CABG, valve repair/replacement, combined procedures, aortic surgery, and thoracic cases. TAVR and structural heart cases (MitraClip, WATCHMAN) are increasingly common. High-acuity cases like heart transplants, LVAD implantation, and ECMO management are typically reserved for the permanent team.

Which states pay the most for cardiac anesthesia locums?

Rates vary more by facility need than by state. That said, hospitals in states with acute cardiac anesthesia shortages — particularly rural programs and states outside the IMLC compact (California, New York) — tend to offer the highest rates because recruitment is harder and credentialing takes longer.

Do cardiac anesthesia locums assignments include malpractice insurance?

Yes. Locums One provides occurrence-based malpractice insurance ($1M/$3M) through ProAssurance on every cardiac anesthesia assignment, along with travel, housing, rental car, and licensing/credentialing costs. Always confirm the policy type — occurrence-based is preferred over claims-made because it doesn't require tail coverage when the assignment ends.

For the full anesthesiology specialty overview, visit our anesthesiology specialty page.