Tool · Investor Sam Taxes

Additional Medicare Tax (0.9%) Exposure Calculator

July 1, 2026 • By the Investor Sam Editorial Team • Reviewed by Berly Sam Varghese, Editor
Since 2013, the Additional Medicare Tax adds 0.9% on top of regular Medicare tax for wages and self-employment income above $200,000 (single) or $250,000 (married). Employers only withhold it on wages above $200,000 per employer — so dual-income couples and high self-employment earners often owe it at filing and face a surprise. This tool calculates your surtax exposure and effective total Medicare rate.

Example: Annual W-2 wages: 200000 $ · Net self-employment income: 0 $ · Filing status (0 = Single, 1 = Married Filing Jointly): 0

Additional Medicare Tax owed (0.9%)$0
Income threshold for your filing status$200,000
Income above threshold subject to surtax$0
Effective total Medicare tax rate on all income1.45%

Worked example

A single filer with $240,000 in W-2 wages: $240,000 − $200,000 threshold = $40,000 subject to the 0.9% surtax. Additional Medicare Tax: $40,000 × 0.9% = $360. This often catches people by surprise at filing — their employer withheld 1.45% Medicare on all wages, but the 0.9% extra only applies to amounts above $200,000, and reconciliation happens on Form 8959. A dual-income couple each earning $150,000 combined at $300,000 would owe 0.9% on $50,000 = $450 despite neither employer withholding it.

Frequently asked questions

Why might I owe this at filing even if my employer withheld from my paycheck?

Employers withhold the 0.9% Additional Medicare Tax only when an individual employee's wages from that employer exceed $200,000 in a calendar year. If you work two jobs earning $130,000 each, neither employer withholds the surtax — but your combined income of $260,000 exceeds the $200,000 threshold. The $60,000 excess is calculated on Form 8959 at tax time.

Does this apply to investment income?

No — the 0.9% Additional Medicare Tax applies only to wages and self-employment income. Investment income (dividends, interest, capital gains, rental income) is subject to the separate 3.8% Net Investment Income Tax, not the 0.9% Medicare surtax. Use the NIIT calculator for investment income.

Is there a way to reduce Additional Medicare Tax?

Pre-tax 401(k) or 403(b) contributions reduce W-2 wages for FICA purposes — which reduces the income subject to the threshold comparison. However, the Additional Medicare Tax has no wage base cap (unlike Social Security), so higher earnings always trigger it once above the threshold. Pre-tax retirement contributions are the most direct reduction lever.

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Sources

Berly Sam Varghese · Editor, Investor Sam

Berly Sam Varghese is an engineer who treats money the way he treats any hard problem — something to be engineered, not gambled on. He funded years of education and built real financial stability the patient way, by living below his means and investing rather than borrowing. He writes for the person trying to plan around a tax bill that feels immovable. He reviews and approves every article on Investor Sam and checks the figures against primary sources before anything is published. More about our standards.