BLS metro-level wage data places General Internal Medicine Physicians pay in Roanoke, VA at a median of $227,320 per year ($109.29/hr/hour), drawn from the OEWS May 2025 release for this Metropolitan Statistical Area. Compared to the national median of $256,560, Roanoke pays 11% below, which typically tracks with a lower local cost of living or smaller specialized-employer cluster. Approximately 90 general internal medicine physicianss are employed across the Roanoke MSA in SOC 29-1216.

The Roanoke pay distribution spans from $151,030 at the 10th percentile to $663,220 at the 90th — a 4.4× spread that reflects experience tenure, specialization, employer size, and the difference between public-sector, nonprofit, and private-sector compensation inside the metro. The 25th percentile sits at $208,670 and the 75th at $280,260, so half of Roanoke-based general internal medicine physicianss earn within that middle band.

Metro figures capture where you actually work, not just where you live — which matters for commuters. BLS draws metro boundaries from the OMB MSA definitions, so Roanoke, VA covers the central city plus outlying counties tied to the metro economically. Remember that OEWS wages reflect base pay only: employer-provided health insurance, retirement matches, stock options, signing bonuses, overtime, and tips are excluded and can add 20-40% to real total compensation. Before using this metro median as a negotiation anchor, triangulate against the same occupation's national profile (linked below), its state-wide VA data, and peer-metro comparisons — a median is a starting point, not a ceiling.