What locum rate beats your employed offer?

Your numbers

Employer-paid malpractice is assumed on the employed side, so it is not entered. Nothing here is saved.

Edit the numbers, then click Compare.

Result

Side by side (per year)

Sensitivity: weeks worked as a locum

How it is calculated

Locum: gross pay is hourly rate times guaranteed hours times weeks worked. Net profit subtracts malpractice, other business costs, and your unreimbursed travel. Self-employment tax is 12.4% Social Security (to the $184,500 2026 wage base) plus 2.9% Medicare on 92.35% of profit, plus 0.9% above the Additional Medicare threshold. Half of it, the self-employed health insurance premium and your retirement contribution come off before the standard deduction and 2026 brackets. Employed: FICA on salary less the pre-tax health share, income tax on salary less health share, 401(k) deferral and the standard deduction.

Total value is after-tax cash plus retirement money saved (yours and the employer match) plus employer-paid health insurance and CME. The break-even locum rate is the hourly rate at which locum total value equals the employed total value at your weeks worked. Compared this way, retirement saved counts as value rather than as money lost.

Not modelled: state and local tax, the 20% qualified business income deduction, itemised deductions, credits, spouse income, catch-up contributions, bonuses and relocation, per-diem tax-home rules, disability and life insurance. Unverified: checked by hand calculation and unit tests only; the 2026 brackets, standard deduction and wage base were copied from sibling tools in this catalogue and should be confirmed against current IRS and SSA publications.

Common questions

Is a locum tenens 1099 contract really worth more than an employed job?

Only if the higher hourly rate survives four things: unpaid gaps between assignments, self-employment tax on both halves of Social Security and Medicare, benefits you now buy yourself (health insurance, retirement match, CME, malpractice), and your own travel costs. This calculator puts both offers on the same yearly basis so you can see the gap and the hourly rate at which they tie.

What is the break-even locum rate?

The hourly rate at which a locum year gives the same total value as the employed offer at the number of weeks you enter. Total value is after-tax cash plus everything saved for retirement (yours plus the employer match) plus employer-paid health insurance and CME. Change the weeks worked and the break-even moves: the fewer weeks you work, the higher the rate must be.

How does self-employment tax change the comparison?

A 1099 contractor pays both halves of Social Security (12.4% up to the wage base) and Medicare (2.9%), applied to 92.35% of net profit, plus 0.9% Additional Medicare above the threshold. An employee pays half. Half of the self-employment tax is deductible for income tax, which softens but does not remove the difference.

Why does malpractice tail coverage matter?

Claims-made policies need tail coverage when a contract ends unless the agency or facility provides it. Enter what you expect to pay per year for premiums or an annualised tail. It is a deductible business cost on the locum side and is assumed to be employer-paid on the employed side.

How are travel and lodging stipends treated?

The tool compares what the agency reimburses per week against what you actually spend. A shortfall is treated as a deductible business cost; reimbursement above cost is treated as income. Real per-diem and tax-home rules are more complicated, so confirm yours with a tax professional.

Which retirement contributions does it allow?

Locum: a traditional solo 401(k) or SEP contribution up to the $24,500 deferral plus roughly 20% of net earnings, and never above $72,000. Employed: your own 401(k) deferral up to $24,500 plus the match you enter. Catch-up contributions are not modelled.

What does the sensitivity table show?

The locum year at 24 to 52 weeks worked: take-home, total value, the difference from the employed offer, and the break-even hourly rate. Fixed costs such as malpractice, health insurance and your retirement contribution stay the same; travel scales with weeks worked.

What does this leave out?

State and local tax, the 20% qualified business income deduction, itemised deductions, credits, spouse income, catch-up contributions, signing bonuses, bonuses and relocation, the value of paid holidays beyond PTO, disability and life insurance, and Social Security credits. It is rough federal arithmetic, not advice.

Is my data uploaded anywhere?

No. Everything you type stays in this browser tab. There are no accounts, cookies or analytics vendors.