Tax Planning for Gastroenterologists (2026)
Gastroenterology practices often own endoscopy centers and pathology or anesthesia services, and private equity has been active in the specialty.
Tax planning priorities for gastroenterologists
Endoscopy center ownership
ASC income and depreciation are central; participation determines passive status.
Ancillaries
In-house anesthesia or pathology adds income streams that need entity and compliance planning.
Retirement design
Profitable GI groups are strong candidates for cash balance plans.
Sale planning
PE transactions require early allocation and rollover planning.
Strategies that apply to every specialty
- Know your marginal rate. In 2026 the 37% federal bracket starts at $640,600 (single) and $768,700 (joint); see how much tax doctors pay.
- Fill every tax-advantaged account: 401(k)/403(b) ($24,500 in 2026), 457(b), HSA and a backdoor Roth.
- Match the plan to how you are paid: W-2, 1099 or practice owner.
- Use your state's rules; see our 50-state guides.
Frequently asked questions
Is ASC income subject to the net investment income tax?
If the income is passive to you, it generally is. Material participation can make it non-passive.
Get a tax plan built for your situation
GenWealth 360 builds proactive, tax-first plans for physicians, dentists and medical practice owners in all 50 states. Start with a conversation about your income, entity and goals.
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Sources
This article is for general educational purposes and is not tax, legal or investment advice. Tax law changes often and its application depends on your facts. Figures reflect 2026 rules as published by the sources listed above. Consult a qualified professional before acting. See our editorial policy.