Optometrist.
San Francisco.
$173,000
median salary, 35% above the national average
$146,000 to $213,000. Updated for 2026.
The numbers.
Everything you need to negotiate with confidence.
A Optometrist in San Francisco earns a median of $173,000 in 2026. That is 35% above the national average. The range runs from $146,000 to $213,000, and where you land depends on your experience, your skills, and how well you negotiate. Practice ownership versus employment is the largest income differentiator for optometrists.
Salary range
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How San Francisco compares
San Francisco, CA
$173,000
Cost of living: 35% above average
National Average
$128,000
San Francisco is $45,000 above
What you should know
The Optometrist landscape in San Francisco is not what most salary sites will tell you. San Francisco is the epicenter of venture capital and startup innovation, consistently producing the highest tech salaries in the nation. The city's concentration of AI labs, SaaS companies, and fintech firms creates intense competition for talent. Despite remote work trends, SF still commands the steepest salary premiums for engineering and product roles. Practice ownership versus employment is the largest income differentiator for optometrists. States with expanded scope allowing therapeutic procedures and medical management increase earning potential. Optometrists specializing in ocular disease management, specialty contact lenses, or pediatric vision earn above those in routine refraction-only settings.
New associate optometrists start at $105,000 to $120,000 on base plus production models. Experienced ODs with strong patient loyalty earn $130,000 to $155,000 after five to seven years. Practice owners or partners in multi-doctor practices can reach $170,000 to $250,000 depending on revenue and overhead management. In San Francisco, those numbers run higher. The cost of living here is 35% above average, and employers adjust to compete.
Base salary is not the full picture. Employed optometrists typically receive production bonuses of 15 to 25% above a base salary guarantee. Benefits include vision and health insurance, CE allowances, malpractice coverage, and optical frame discounts. Practice owners retain higher gross income but manage significant overhead. And on the tax side: california's top marginal state income tax rate is 13.3%, the highest in the U.S. San Francisco has no additional city income tax, but overall tax burden remains steep. When someone quotes you $173,000, ask what the total package looks like. The gap between base and total comp is where real money hides.
On negotiation: Leverage competing offers aggressively. SF employers expect candidates to shop around, and matching or beating a rival offer is standard practice here. The range for Optometrists in San Francisco runs from $146,000 to $213,000. That is not a narrow window. Where you land inside it depends almost entirely on whether you negotiate and how well you prepare.
Top industries in San Francisco
Negotiating in San Francisco
Leverage competing offers aggressively. SF employers expect candidates to shop around, and matching or beating a rival offer is standard practice here.