British Columbia ENT Specialist Billings Reach C$771,834, 31% Above Manitoba

New physician payment data show otolaryngologists generated substantially higher median gross billings in British Columbia than in Manitoba.

Otolaryngologists (ENT specialists) recorded median gross physician billings of C$771,834 in British Columbia, compared with C$590,994 in Manitoba, according to a new analysis of Canadian physician payment disclosures. While the figures represent gross fee-for-service billings rather than take-home income, they provide a valuable benchmark for ENT specialists comparing practice revenue across provincial healthcare systems.

Key findings

A new analysis of public physician payment disclosures found that otolaryngologists recorded median gross fee-for-service billings of C$771,834 per physician in British Columbia. The analysis uses official physician payment disclosures from the British Columbia Medical Services Plan Blue Book (2024) and Manitoba Health (2024/25) to compare physician billings by specialty.

The findings place otolaryngology among the highest-billing physician specialties in both provinces, reflecting the specialty's combination of surgical procedures, outpatient interventions and specialist consultations within Canada's fee-for-service healthcare system.

British Columbia versus Manitoba

British Columbia recorded median gross physician billings of C$771,834 for otolaryngologists, compared with C$590,994 in Manitoba.

The C$180,840 difference means median ENT billings were approximately 31% higher in British Columbia than in Manitoba. While provincial fee schedules, reimbursement systems, patient volumes and practice models differ, the findings illustrate how gross physician billings can vary across Canadian healthcare systems.

It is important to note that these figures represent gross fee-for-service billings before practice overhead, rather than physician salary or take-home income. Practice expenses—including staffing, premises, clinical equipment and other operating costs—will significantly reduce the amount ultimately retained by individual physicians.

Why ENT billings are at this level

Otolaryngology combines specialist consultations with a broad range of diagnostic, outpatient and surgical procedures, creating multiple billable activities across the patient pathway.

Endoscopic examinations, hearing and balance assessments, airway procedures, sinus surgery, head and neck operations and ongoing outpatient management all contribute to fee-for-service activity. The combination of procedural work and specialist consultations can support consistently high levels of gross billings.

Gross billings are not take-home pay

The figures reported represent gross physician billings, not physician salaries or personal income.

These billings typically cover the cost of operating an ENT practice, including:

• Clinical and administrative staff

• Practice premises

• Procedure and surgical facilities

• Diagnostic and endoscopic equipment

• Consumables

• Professional indemnity and other overheads
  

Consequently, an otolaryngologist's net income will be substantially lower than the published billing figures.

The analysis also primarily reflects fee-for-service payments and does not fully capture physicians working under salaried or alternative funding arrangements.

What this means for ENT specialists

For otolaryngologists benchmarking their practice or evaluating opportunities in different provinces, the findings provide a useful indication of how gross fee-for-service billings can vary across Canada.

However, billing figures should be interpreted as a measure of practice revenue rather than personal earnings. Differences in reimbursement schedules, case mix, procedural activity and operating costs all influence the amount physicians ultimately retain.

As additional provincial payment disclosures become available, specialty-specific comparisons will help build a more comprehensive picture of how ENT billings vary across Canada's healthcare systems.

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