Comparative data on surgeon payments for operative procedures are not well documented. We sought to assess variations in surgeon payments after common general and orthopedic operations using a nationally representative sample of privately insured patients. A total of 486,506 patients who underwent a general (appendectomy, cholecystectomy, colectomy) or orthopedic (total knee replacement, total hip replacement) operation between 2010-2012 were identified from the Truven Health MarketScan database. Median age was 54years (general operation, 44years vs orthopedic operation, 58years; P<.001). Patients had an average Charlson Comorbidity Index of 0 (interquartile range [IQR]: 0, 1). Median duration of stay was 3days (IQR: 2, 4) (general operation, 3days [IQR: 1, 5] vs orthopedic operation, 3days [IQR: 2, 3]; P<.001). Total hospital payments averaged $18,209 (IQR: $11,751, $26,598) (general operation: $12,744 [IQR: $8,402, $19,896] vs orthopedic operation: $22,386 [IQR: $16,888, $30,100]; P<.001). Median surgeon reimbursement was $1,923 (IQR: $1,146, $2,676), with orthopedic surgeon payments being on average twice as high as general surgeon payments ($2,349 vs $1,191; P<.001). Median surgeon payment varied among both general (appendectomy: $903 vs cholecystectomy: $1,125 vs colectomy: $2,209; P<.001) and orthopedic operations (total knee replacement: $2,282 vs total hip replacement: $2,392; P<.001). The presence of a postoperative complication resulted in an increase in hospital payments by 25% and surgeon payments by 11%. Hospital and surgeon payments following routine general and orthopedic operations vary greatly. Patients with comorbid conditions and those who experienced a postoperative complication resulted in higher overall payments. Though significant variability existed at the surgeon level, hospital payments were responsible for the highest source of variability.