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Medicare tax on your paycheck
Medicare tax looks simple — a flat 1.45% — until you earn enough to trigger the additional Medicare surtax. Here's both pieces, explained plainly.
The base rate: 1.45%, uncapped
Every paycheck, 1.45% of your wages goes to Medicare tax, matched by another 1.45% from your employer. Unlike Social Security, there's no wage base cap — Medicare tax applies to every dollar you earn, no matter how high your income goes.
The additional 0.9% surtax
Since 2013, an extra 0.9% Medicare surtax applies to wages above $200,000 for single filers or $250,000 for married filing jointly in 2026. This additional amount is paid by the employee only — employers don't match the extra 0.9%.
Importantly, this threshold is based on your total wages from that employer, not your combined household income — so a married couple each earning $150,000 (both under the individual $200,000 trigger their employers use) may still owe additional Medicare tax when they file jointly, since their combined income exceeds the $250,000 married threshold. Employers withhold based on what they pay you individually; the full household reconciliation happens on your tax return.
Why this rarely affects most paychecks
For the large majority of earners under the six-figure range, Medicare tax is simply the flat 1.45% — the additional surtax is specifically designed to apply only above the thresholds above.
Checking your own numbers
The calculator below applies both pieces automatically based on your income and filing status — enter your salary to see your exact Medicare withholding, including the surtax if it applies to you.