The Additional Medicare tax threshold — a surtax with three different starting points
Tax year 2026 · federal income tax and FICA only
Threshold (single)
$200,000
Rate below
25.45%
Rate above
26.35%
You keep less
$737
of the next $1,000
What actually happens here
- This one is a surcharge rather than a bracket. Past the Additional Medicare threshold, an extra slice of Medicare tax applies to further pay, nudging the rate from about 25.45% up to about 26.35%. You keep $737 of the next thousand instead of $746. Small money. The trap is where the line sits, because it moves depending on how you file.
- This threshold sits above the point where Social Security stops being collected, and that changes the arithmetic. Social Security is already done being collected by the time anyone reaches it, so the step here is smaller than the same-sized bracket step lower down would be. The combined rate above the line is about 26.35%.
- Where you stand here depends heavily on how you file. Someone married and filing separately reaches this point at $125,000. Someone single reaches it at $200,000. That is a real penalty for a filing choice usually made for reasons that have nothing to do with this threshold at all.
- Above the Additional Medicare threshold an extra Medicare charge attaches to wage income, lifting the combined marginal rate from about 25.45% to about 26.35% and reducing retention on a thousand dollars from $746 to $737. Unlike the income tax brackets, the thresholds here bear no consistent ratio to one another across filing statuses, and the separate-return figure is the lowest in the federal system relative to the equivalent single figure. That asymmetry, rather than the rate, is what makes the threshold worth knowing.
- This boundary lies above the Social Security wage base, so OASDI has already ceased on both sides of it and only the Medicare component of FICA remains. The combined marginal rate above the threshold is about 26.35%. An identical income tax step lower in the schedule would therefore produce a larger combined rate, which is why marginal rates do not increase monotonically with income across the full federal system.
- This threshold is not proportional across filing statuses: married filing separately meets it at $125,000 while a single filer meets it at $200,000. The separate-return figure being the lowest of the four is unusual and produces a marginal rate increase at an income where no other status faces one. Anyone electing separate returns for student loan or liability reasons is exposed here without it appearing in the decision.
Which rung you are on
A $75,000 Texas salary
| This rung starts at | $66,500 |
|---|---|
| Next rung starts at | $121,800 |
| Room before it | $46,800 |
Federal only, measured on gross pay — so the first rung is what the standard deduction covers.
The tax with a ceiling
A $75,000 Texas salary
| Wage base | $184,500 |
|---|---|
| Social Security rate | 6.2% |
| Medicare surtax begins | $200,000 |
Social Security stops at the wage base. Medicare does not, and gains a surtax higher up.
The part never taxed
A $75,000 Texas salary
- Never taxed$16,100
- Taxable$58,900
| Share of your pay | 21.47% |
|---|---|
| Taxable after it | $58,900 |
Federal income tax only. Social Security and Medicare start at the first dollar you earn.
The same threshold, for all four filing statuses
The prose above speaks for a single filer, because four sets of figures in one sentence is unreadable. This is where the other three live. "Kept" means take-home out of the thousand dollars immediately below and immediately above the line.
| Filing status | Threshold | Rate below | Rate above | Kept below | Kept above |
|---|---|---|---|---|---|
| Single | $200,000 | 25.45% | 26.35% | $746 | $737 |
| Married filing jointly | $250,000 | 25.45% | 26.35% | $746 | $737 |
| Head of household | $200,000 | 25.45% | 26.35% | $746 | $737 |
| Married filing separately | $125,000 | 31.65% | 32.55% | $684 | $675 |
What this page does not cover
- Every figure on this page is federal tax and payroll tax only. State tax is left out on purpose — the Additional Medicare threshold is a federal line, and folding in one state's rates would turn each number into a claim about that state instead. If you live somewhere with an income tax, your real marginal rate is higher than what you see here, by your state's own rate. For a single filer that line sits at $200,000.
- These numbers describe wages from employment and nothing else. No pension contributions, no health savings account, no itemized deductions. Each of those changes where you stand against the Additional Medicare threshold, usually by pushing you further below it. Self-employment income and investment income follow different rules entirely. For a single filer that line sits at $200,000.
- This describes what you owe for the year, not what your employer takes each month. Withholding follows its own rules and often gets the timing wrong around the Additional Medicare threshold, particularly if your pay changes partway through the year or you have more than one job. The yearly total is what settles at filing. The monthly figure is only an estimate of it. For a single filer that line sits at $200,000.
- Figures here comprise federal income tax and FICA exclusively. State and local income taxes are deliberately excluded: the Additional Medicare threshold is defined federally, and incorporating any particular state's schedule would convert every figure into a statement about that jurisdiction rather than about the threshold. Residents of income-taxing states face correspondingly higher combined marginal rates, and the state layer is modeled separately elsewhere on this site. The single-filer figure is $200,000.
- The model assumes employment wages, the standard deduction, and no pre-tax retirement or HSA contributions. Any such contribution lowers taxable income and moves the filer's position relative to the Additional Medicare threshold accordingly. Self-employment income attracts both halves of the payroll tax under a separate regime, and investment income is outside FICA altogether, so neither is described by the figures shown. The single-filer figure is $200,000.
- These are annual liability figures, not withholding schedules. Employer withholding follows the IRS percentage or wage-bracket method applied to each pay period in isolation, so it commonly mistimes thresholds such as the Additional Medicare threshold — most visibly where pay varies during the year, or where a second employer withholds without knowledge of the first's wages. Any resulting over- or under-collection reconciles on the return; the annual figure is the quantity being modeled. The single-filer figure is $200,000.
Questions people ask
Does crossing this line change things gradually or all at once?
Differently from a bracket. The Additional Medicare threshold turns on or off at a point rather than phasing a rate in, so the reasoning that makes brackets harmless does not transfer.
Do we get twice this allowance as a couple?
No, and that gap is a real cost of filing together. The Additional Medicare threshold does not simply double for a couple, so two people with similar incomes reach it sooner jointly than they would have separately — the classic marriage penalty, and it is structural rather than accidental.
Would filing separately from my spouse help here?
No — separately is the lowest threshold of the four statuses here, so it bites first rather than last.
Is this threshold marginal or discrete in effect?
This threshold is not a marginal rate boundary. Its effect at the crossing point is determined by its own statutory mechanics — commencement, cessation or a cap — rather than by the bracket structure, so marginal-rate reasoning does not transfer to it.
Why does the joint threshold not equal twice the single one?
The joint threshold is less than twice the single threshold, producing a marriage penalty that is maximized where spousal incomes are equal and vanishes where one spouse has negligible income. The asymmetry is a design consequence of scaling thresholds sublinearly rather than an oversight.
How does married-filing-separately interact with this threshold?
Married-filing-separately carries the lowest threshold of any status at this provision, so it is reached earliest. ⚠️ Filing status affects many provisions simultaneously and cannot be optimized against one in isolation; separate filing also forecloses several credits entirely.