BLS metro-level wage data places General Internal Medicine Physicians pay in Sacramento-Roseville-Folsom, CA at a median of $361,590 per year ($173.84/hr/hour), drawn from the OEWS May 2025 release for this Metropolitan Statistical Area. Compared to the national median of $256,560, Sacramento-Roseville-Folsom pays +41% above, signaling either concentrated employer demand, a cost-of-living premium, or both.

The Sacramento-Roseville-Folsom pay distribution spans from $131,080 at the 10th percentile to $476,930 at the 90th — a 3.6× 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 $174,960 and the 75th at $390,630, so half of Sacramento-Roseville-Folsom-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 Sacramento-Roseville-Folsom, CA 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 CA data, and peer-metro comparisons — a median is a starting point, not a ceiling.