Base, variable, OTE, and accelerators explained. How medical sales comp plans actually pay, why two reps on the same plan earn differently, and what to check before you sign.
The short version
- A comp plan is base plus variable, and in field sales the variable half does most of the work.
- A full-line rep's variable runs near 111 percent of base, so hitting plan roughly doubles salary.
- The strongest plans are uncapped, which is where $300,000-plus totals come from.
- Two reps on the same plan can finish $100,000 apart, because commission is earned.
- Before signing, check whether commission is uncapped, whether the quota is realistic, and where the plan pays.
Two reps take the same job on the same day. Same base, same OTE. A year later one has made $150,000 and the other $250,000, on the identical plan. The difference is that one of them read it.
A compensation plan is a set of rules for how you get paid, and in medical sales those rules do most of the work. Base salary is the floor. The plan is where the money is.
01What makes up a medical sales paycheck?
Two parts: base and variable. Base is fixed salary. Variable is commission and bonus tied to what you sell. The mix shifts sharply as you move into the field. An associate rep is more base-weighted, with variable around 44 percent of the package. A full-line sales rep flips that, with variable near 111 percent of base, so hitting plan roughly doubles the salary.
OTE, or on-target earnings, is base plus that commission at plan. It is a target, not a guarantee. The headline OTE tells you what the company thinks a solid year looks like. The plan tells you how likely you are to hit it and what happens if you beat it.
02How does the commission half actually work?
You carry a quota. Hit plan and you earn your target variable. The plan is also a map of what the company wants sold, because it pays more on the products, new launches, and accounts that matter most to them. Read that map and you know where to spend your week.
The strongest plans are uncapped, so beating quota pays accelerators instead of stopping at target. That is where the big totals come from: reps clearing $300,000, and some 1099 reps on a low base of $50,000 to $60,000 breaking $250,000 on commission alone. Low base, high ceiling, all of it earned.
03Why do two reps on the same plan earn so differently?
Because the commission half is earned, not promised. Two reps with the same OTE can finish $100,000 apart. Territory quality, how hard the accelerators kick, and whether a rep sells into the part of the plan that actually pays all decide the gap.
This is why the plan matters as much as the base. A high base on a weak plan can pay less over a career than a modest base on an uncapped plan in a strong territory.
04What should you check before you sign a comp plan?
Ask four questions before the offer, not after your first check. Is commission uncapped, or does it stop at target? What is the base, and can you cover your bills on it during ramp? How realistic is the quota, given the territory's history? And where does the plan pay, meaning which products and accelerators move your number most?
A recruiter or a rep already on the team can usually answer these honestly. The reps who earn the most are rarely the ones who negotiated the highest base. They are the ones who understood the plan and sold into it.
Frequently Asked Questions
How does medical sales commission work?
You carry a quota, and hitting plan earns your target commission on top of base. The plan pays more on the products and accounts the company most wants sold. Strong plans are uncapped, so beating quota triggers accelerators. In field sales, commission often roughly doubles base at plan.
What is a good base-to-commission ratio in medical sales?
It depends on the role. Entry roles are more base-weighted, with variable around 44 percent of the package, which trades upside for stability. Full-line field reps run variable near 111 percent of base, trading a lower guaranteed floor for a much higher ceiling. Neither is better; it depends on your appetite for risk.
Is medical sales commission capped?
On the strongest plans, no. Uncapped commission means beating quota keeps paying through accelerators, which is where the largest totals come from. Some plans do cap or decelerate above target, so it is worth confirming before you sign, since an uncapped plan in a strong territory can outpay a higher base.
What should you look for in a sales comp plan?
Four things: whether commission is uncapped, whether the base covers your bills during ramp, how realistic the quota is given the territory's history, and where the plan pays, meaning which products and accelerators move your number most. Understanding the plan matters more than negotiating the highest base.
About This Series
This piece is part of The Lobby’s series on how the medical sales business actually works, built from verified compensation data and practitioner accounts.
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