Radiology Locum Tenens Salary 2026: Real Rates by Sub-Specialty and Modality

Direct answer: Locum radiologists earn $320–$525/hr in 2026. Mammography ($465–$525/hr) and nuclear radiology ($445–$510/hr) lead all locum specialties. Body and neuro radiology pay $385–$465/hr on-site. Teleradiology averages $39–$48 per read, equivalent to $295–$365/hr at standard volume. Interventional radiology commands $475–$550/hr at trauma-capable facilities. Source: AMN Healthcare postings, NALTO benchmarks, Locums One placement data, May 2026.

Diagnostic radiology has been the highest-paying locum tenens specialty for three consecutive years and 2026 widened the gap. The shortage is not tightening — residency slots have not kept pace with imaging volume growth, and the radiologists willing to do locum work have unprecedented leverage.

This article uses current 2026 assignment data, NALTO benchmarks, ACR workforce reports, and our own placement records to show what locum radiologists are actually earning right now — separated by sub-specialty, modality (on-site vs teleradiology), and facility type.

QUICK SUMMARY — RADIOLOGY LOCUM SALARY IN 2026

1. Mammography leads at $465–$525/hr — board-certified breast imaging is the single most-supply-constrained sub-specialty
2. Nuclear radiology is the dark horse at $445–$510/hr — niche but extremely high-leverage
3. General diagnostic radiology: $385–$445/hr on-site — the workhorse rate
4. Body and neuro radiology: $385–$465/hr — depends on whether facility expects MR + CT subspecialty reads
5. Interventional radiology: $475–$550/hr — at trauma-capable facilities; lower at standard community
6. Teleradiology: $39–$48 per read — flexibility-adjusted, ~$295–$365/hr equivalent
7. Pediatric radiology: $355–$425/hr — lower volume but board-certified peds rads are scarce
8. Annualized at 44 weeks: $675K–$1.1M+ for top sub-specialties; teleradiology at $475K–$650K

How much do locum radiologists make per hour in 2026?

Locum radiologists earn $320–$525/hr in 2026, with mammography ($465–$525), nuclear radiology ($445–$510), and interventional radiology ($475–$550) leading. General diagnostic on-site rates are $385–$445/hr. Teleradiology pays per-read ($39–$48), equivalent to roughly $295–$365/hr at typical reading volumes.

Locum radiology pay rates by sub-specialty (2026)

*Most locum radiologists work 38–46 weeks per year. The annualized figures use 44 weeks at standard hours. Source: AMN Healthcare and CompHealth postings, ACR salary survey, Locums One placement data, May 2026.*

Why is mammography the highest-paid locum radiology sub-specialty?

Mammography pays $465–$525/hr because the supply of board-certified breast imagers is the most constrained in radiology. Roughly 1,800 fellowship-trained breast radiologists serve a US screening population of 50M+ women aged 40–74. Facilities cannot substitute general rads for breast imaging — the FDA's MQSA (Mammography Quality Standards Act) requires specific certification. When a hospital's breast imager goes on leave, locum coverage is the only viable bridge.

The certification requirement creates a hard floor on supply. A community hospital cannot pull a body radiologist over to read mammograms — the regulatory framework prohibits it. So when coverage gaps appear, hospitals pay whatever the rate clears.

What facilities pay top-of-range mammography rates?

Three patterns:

1. Standalone breast centers with high screening volume (60+ exams/day) — these run on tight schedules and cannot tolerate gaps
2. Hospital systems mid-acquisition — when a multi-site system buys out a private breast practice, the credentialing transition creates 3–6 month gaps that locum mammography fills
3. Rural community hospitals with single-radiologist breast programs — when the one breast rad takes leave, the entire program halts

The $525/hr ceiling typically appears in pattern 3, where the hospital cannot afford to lose its breast designation.

What does nuclear radiology pay on locum tenens?

Nuclear radiology pays $445–$510/hr in 2026. Demand is driven by oncology volume — PET/CT scans for staging, response monitoring, and treatment planning have grown 8–12% annually for the past decade, while the supply of nuclear-trained radiologists is essentially flat. Most locum nuclear rad assignments come from cancer centers and large academic systems where PET/CT volume outstrips local staffing.

Theranostics (Lu-177, I-131, Y-90) is increasing the demand further. Radiopharmaceutical therapy programs require nuclear physician oversight that general diagnostic rads cannot provide. Some locum rads with Authorized User status command $530–$575/hr at facilities running active theranostics programs.

How does teleradiology pay compare to on-site locums?

Teleradiology pays $39–$48 per read in 2026, which equates to $295–$365/hr at standard reading volumes (8–10 reads per hour for general work). The hourly equivalent is lower than on-site locum rates because:

• Per-read pay is volume-based, not time-based — slow shifts pay less
• Subspecialty reads (MR/CT) pay more per read but take longer
• Most teleradiology is done from home, so the rate reflects flexibility/lifestyle premium of zero commute

The trade-offs are real. Teleradiology offers location independence (work from anywhere with stable internet), no malpractice tail risk for procedural complications, and unlimited time-off optionality. On-site locum work pays 25–35% higher per hour but requires travel and physical presence.

Teleradiology rate breakdown by read type (2026)

The economics depend heavily on case mix. A teleradiologist reading mostly general X-ray at $9/read x 16 reads/hr = $144/hr. The same radiologist doing MR neuro at $85/read x 4/hr = $340/hr. Locum radiologists optimizing for income generally negotiate sub-specialty-only contracts when possible.

What is interventional radiology paying for locum work in 2026?

Interventional radiology locum rates are $475–$550/hr in 2026, with rates pushing $575–$625/hr at Level I trauma centers requiring 24/7 IR coverage. Standard community IR locum assignments pay $475–$510/hr; trauma-capable facilities $510–$550/hr; high-acuity neuro-IR $550–$625/hr.

The IR locum market is unique because the procedural volume is unevenly distributed. Most community hospitals do not have active IR programs. The locum demand is concentrated at facilities trying to maintain 24/7 coverage during permanent IR vacancies — typically 6–12 month assignments rather than 2–4 week blocks.

What is the difference between general IR and neuro-IR locum rates?

General IR (vascular, biliary, drainage, biopsy procedures): $475–$510/hr

Neuro-IR (stroke intervention, aneurysm coiling, cerebral angiography): $550–$625/hr

Neuro-IR commands a premium because the certification path is longer (additional 1-year fellowship after IR), the procedural complexity is higher, and the supply is severely limited. Roughly 800 fellowship-trained neuro-IR specialists serve a US population that needs increasingly time-sensitive stroke intervention.

What is the difference between body radiology and general diagnostic radiology pay?

Body radiology pays $400–$465/hr on locum assignments in 2026, while general diagnostic radiology pays $385–$445/hr. The $20–$50/hr premium reflects the deeper sub-specialty training and the facility's preference for fellowship-trained body imagers on complex CT and MR abdomen/pelvis cases.

Body radiologists complete an additional year of fellowship focusing on cross-sectional imaging of the abdomen, pelvis, and chest. This training differentiates them from general diagnostic radiologists who read a mixed case load across all modalities. Facilities with high volumes of oncology staging, transplant imaging, or hepatobiliary cases specifically seek body-trained imagers and pay the premium accordingly.

When does body radiology training matter for locum pay?

The body fellowship premium shows up most clearly at three types of facilities:

1. Cancer centers with complex abdominal/pelvic oncology imaging (hepatocellular carcinoma surveillance, pancreatic protocol CT)
2. Transplant programs requiring detailed vascular and biliary mapping on MR and CT
3. Academic medical centers where attending expectations include subspecialty reads for trainees

At small community hospitals with primarily routine CT and X-ray, the pay gap between body-trained and general diagnostic radiologists narrows to $10–$15/hr because the case complexity does not justify the premium.

Where are locum radiologists earning the most in 2026?

Geography in radiology matters less than in other specialties because teleradiology levels the field and on-site assignments cluster at facilities with imaging-heavy specialties. Still, regional patterns exist:

Best net pay (no state income tax): Texas, Florida, Tennessee, Nevada, Washington, Wyoming, South Dakota, Alaska. For a radiologist clearing $850K, the difference between Texas (0% state) and California (top brackets) is roughly $90K–$110K/year in take-home.

Are locum radiology rates going up or down in 2026?

Rates are flat-to-rising in 2026, with mammography and nuclear radiology continuing 4–6% annual increases due to demand-supply imbalance. General diagnostic is stable. Teleradiology per-read rates are flat. Interventional radiology rates rose 6–8% in 2025–2026 driven by stroke intervention demand.

The 2021–2023 post-COVID correction that affected emergency medicine and primary care never hit radiology with the same force. Diagnostic imaging volume has grown consistently while radiology residency positions have remained essentially flat for a decade. The result is a structural shortage that insulates radiology locum rates from the cyclical corrections seen in other specialties.

For radiologists considering locum work, the rate trajectory is favorable. Sub-specialties with certification barriers (mammography, nuclear, neuro-IR) are the most rate-protected because the supply constraints are regulatory, not merely demographic.

How much do agency margins affect locum radiologist pay?

Agency margins represent the single biggest non-clinical variable in locum radiologist take-home. At a $700/hr bill rate, a traditional 42% margin agency pays the radiologist $390/hr. A 18% margin agency pays $552/hr. That is $162/hr difference on identical work.

The math at a $700/hr radiology bill rate

That is a $296K/year gap on identical clinical work. The hospital paid the same bill rate. The same scans, same patients, same dictation system.

Industry benchmarks (NALTO, SIA): traditional locum agencies operate at 30–50% margins. Lean operations like Locums One run 15–22%, and we publish that number publicly. Most agencies refuse to disclose theirs when asked.

If you are a locum radiologist clearing $850K+ at a 40% margin agency, switching to a 18% margin agency on your next assignment increases your take-home by $200K+ per year on the same work.

What does a locum radiology agency cover (vs. what comes out of your rate)?

Reputable locum agencies cover the following at no cost to the radiologist:

Total in-kind benefits add $50K–$130K/year on top of the hourly rate. When comparing locum offers, always confirm what is covered versus what comes out of your rate. Some "all-in" hourly rates that look high are net-down once you back out housing and malpractice.

What are the tax implications of locum radiology work?

Most locum radiologists work as 1099 independent contractors, which creates significant tax differences from W-2 employment:

• No tax withholding — quarterly estimated taxes (federal + state) required
• Self-employment tax: 15.3% on top of income tax (Social Security + Medicare)
• Significant deductions available: travel, meals on assignment, CME, licensing fees, professional dues, home office, equipment, retirement contributions
• S-Corp election above $300K can save $20K–$45K/year for high-income radiologists by reducing self-employment tax exposure
• Multi-state filing required for assignments in non-resident states — tax-state arbitrage matters

S-Corp election math for radiologists specifically

Radiologists are among the most affected by S-Corp election because of the high net income. At $750K net 1099 income:

The S-Corp savings scale with income. At $1M net, savings approach $25K–$30K/year. The setup cost is ~$1,500–$3,000 in attorney + CPA fees. Payback is typically 1 month for high-earning radiologists.

Find a CPA who specializes in physician 1099 income — generic accountants miss radiology-specific deductions like reading workstation equipment depreciation, CME for advanced certifications, and per-diem strategies for multi-state assignments.

What licenses do locum radiologists need?

Active state medical license in the assignment state, current DEA (if controlled substances are part of practice), ABR certification, and facility-specific privileging are required. IMLC (Interstate Medical Licensure Compact) eligibility allows licensure in 30+ states in 30–45 days, dramatically expanding assignment options.

The licensing requirements for radiology locum work are straightforward compared to procedural specialties:

• State medical license — one per state where you practice; IMLC-eligible physicians can obtain multiple states rapidly
• DEA registration — required if your practice involves controlled substances (nuclear radiology with radiopharmaceuticals, interventional radiology with sedation)
• ABR certification — American Board of Radiology certification is required by virtually all facilities; subspecialty CAQ (Certificate of Added Qualification) for mammography, nuclear, or pediatrics increases assignment options
• Facility privileging — separate from state licensing; each hospital grants specific privileges based on your training and experience

For teleradiology specifically, some states have enacted telemedicine licensing reciprocity that simplifies cross-border reading. However, most teleradiology companies still require full state licensure in every state where cases originate.

Do locum radiologists need their own malpractice insurance?

No. Reputable locum agencies provide $1M/$3M occurrence-based malpractice coverage at no cost. Confirm "occurrence-based" — this matters more in radiology than most specialties because of long statute of limitations on missed findings (some breast cancer claims arise 5–10 years after the original read).

Radiology malpractice carries unique characteristics that make the policy type especially important:

• Long latency period — a missed breast cancer on mammography may not be discovered for years, making occurrence-based coverage essential
• High claim severity — radiology claims, when they occur, tend to be high-dollar because missed diagnoses often involve cancer or vascular catastrophes
• Teleread liability — teleradiologists face the same malpractice exposure as on-site radiologists; the agency should cover both

Always verify in writing that your malpractice coverage is occurrence-based, not claims-made. If claims-made, ask who pays for tail coverage — and get the answer in the contract, not verbally.

Can a radiologist work both teleradiology and on-site locum simultaneously?

Yes, and many of the highest-earning locum radiologists do exactly this. Typical mix is 60% on-site (high hourly rate) plus 40% teleradiology (location independence and steady income between on-site assignments). Total annual earnings frequently exceed pure on-site work by 15–25% with better lifestyle.

The hybrid model works because the two modalities are complementary rather than competing:

• On-site blocks (2–4 weeks) generate the highest hourly rates and allow concentrated income periods
• Teleradiology fills the gaps between on-site assignments, providing steady cash flow without travel
• Scheduling flexibility — teleradiology shifts can be scheduled around on-site block dates
• No credentialing delay — once you are credentialed with a teleradiology group, you can start reading immediately between on-site assignments

The key constraint is state licensing — your teleradiology cases must originate from states where you hold an active license. This is why IMLC eligibility and multi-state licensure matter so much for hybrid radiologists.

How fast can a radiologist start a locum tenens assignment?

Industry average for radiology credentialing is 60–90 days due to facility-specific privileging committees and ABR certification verification. With current state license, current DEA, ABR certification verified, and clean malpractice history, expedited credentialing can complete in 21 days at facilities with active privileging cycles.

Critical for radiology specifically:

• Hospital privileging requires sample images for some sub-specialties (mammography, neuro)
• Teleradiology assignments credential faster (often 14–21 days) because there is no physical privileging
• Multi-state IMLC license dramatically expands assignment options — radiologists with IMLC can be licensed in 30+ states in 30–45 days

If a recruiter quotes a 90-day credentialing timeline, ask why. With current documents and clean history, modern systems can complete the process in 21 days at most facilities.

How can radiologists maximize locum income in 2026?

Seven specific moves, in order of impact:

1. Sub-specialize toward shortage areas. Mammography certification (or breast fellowship), nuclear medicine boards, or theranostics Authorized User status push your rate ceiling by $40–$80/hr. The fellowship investment pays back in <6 months at locum rates.

2. Stack state licenses strategically. Radiologists with 8+ active licenses average 22% higher hourly rates than those with 2–3. Multi-state licensure means you can move quickly between high-paying assignments instead of waiting for licensing.

3. Mix on-site and teleradiology deliberately. Pure on-site work burns out radiologists by 40 hours/week. Pure teleradiology caps your hourly rate. The highest-earning locum rads typically run 60% on-site / 40% teleradiology to balance income with sustainability.

4. Negotiate read-rate floors on teleradiology contracts. Per-read pay penalizes slow shifts. Ask for a guaranteed hourly minimum (e.g., $250/hr regardless of volume) on teleradiology contracts — most agencies will agree because the average reading speed pays them more than the floor anyway.

5. Move agencies after credentialing. Once credentialed at a facility, you are not locked to your original agency. Many radiologists assume otherwise and stay at 40%+ margin agencies for years. Your first agency credentialed you — your second agency can pay you more for the same work.

6. Get IMLC eligible. ABR-certified radiologists with clean licensure are typically IMLC eligible. Use it. Multi-state licensing in 30 days vs. 8 months changes the math on every assignment offer.

7. Ask about agency margin. Same point as every other locum article — and it matters more for radiology because the bill rates are higher. A 10–15% margin difference is $80K–$200K/year in your pocket. Single most actionable item on this list.

Frequently Asked Questions

How much do locum radiologists make per hour in 2026?

Locum radiologists earn $320–$525/hr on-site in 2026. Mammography ($465–$525), nuclear radiology ($445–$510), and interventional radiology ($475–$550) command the highest rates. General diagnostic on-site averages $385–$445/hr. Teleradiology pays $39–$48 per read, equivalent to $295–$365/hr at standard reading volumes.

What is the highest-paying radiology sub-specialty for locums?

Mammography leads at $465–$525/hr due to MQSA certification requirements that severely constrain supply. Nuclear radiology ($445–$510) and interventional radiology at trauma centers ($510–$575) are next. Pediatric radiology ($355–$425) and general diagnostic ($385–$445) are lower but more widely available.

Do teleradiologists make as much as on-site locums?

Teleradiologists typically earn 25–35% less per hour than on-site locums but gain location independence and lifestyle flexibility. Per-read pay ($39–$48) translates to $295–$365/hr at typical volumes. Sub-specialty teleradiology (MR/CT) at high-volume practices can match on-site community rates ($385–$425/hr equivalent).

How fast can a radiologist start locum work after residency?

Most agencies require 1–2 years of post-residency experience before independent locum work. Direct sub-specialty experience (e.g., breast fellowship) can shorten this to 6–12 months for highly specialized assignments. Teleradiology positions sometimes accept new graduates with appropriate supervision.

Are locum radiology rates going up or down in 2026?

Rates are flat-to-rising in 2026. Mammography and nuclear radiology continue 4–6% annual increases due to persistent demand-supply imbalance. General diagnostic is stable. Teleradiology per-read rates are flat. Interventional radiology rose 6–8% in 2025–2026 driven by stroke intervention demand.

What licenses do locum radiologists need?

Active state medical license in the assignment state, current DEA (if controlled substances are part of practice), ABR certification, and facility-specific privileging. IMLC eligibility allows licensure in 30+ states in 30–45 days. Teleradiologists need licenses in every state where cases originate.

Do locum radiologists need their own malpractice insurance?

No. Reputable agencies provide $1M/$3M occurrence-based malpractice at no cost. This matters especially in radiology due to long statute of limitations on missed findings. Always confirm occurrence-based coverage in writing — not claims-made with ambiguous tail responsibility.

Can a radiologist work teleradiology and on-site locum at the same time?

Yes, and the highest-earning locum radiologists typically run 60% on-site / 40% teleradiology. This hybrid model generates 15–25% more annual income than pure on-site work while providing better lifestyle flexibility. State licensing requirements apply to both modalities.

What is the difference between body radiology and general diagnostic radiology pay?

Body radiology (subspecialty fellowship in CT/MR abdomen and pelvis) pays $400–$465/hr, typically $20–$50/hr above general diagnostic ($385–$445/hr). The premium reflects deeper subspecialty training and facility preference for fellowship-trained body imagers on complex cases.

*Rates sourced from AMN Healthcare and CompHealth assignment listings, NALTO industry benchmarks, ACR Workforce Survey 2026, Locums One placement data, and SIA Locum Tenens Market Report as of May 2026. Actual compensation varies by facility, sub-specialty, modality, location, and negotiation. Annualized estimates assume 44 working weeks. Malpractice, travel, and housing are typically covered by the agency on top of the hourly rates shown.*