Medical Device Sales Commission Structure Explained
Understand OTE, quotas, accelerators, and commission caps, plus the questions to ask and red flags to watch for before you accept a medical device comp plan.
Anthony Giglia
· 4 min read
In medical device sales, compensation is often described in terms of on-target earnings, or OTE. That’s your base salary plus the commission you would earn if you hit your sales target.
There are also roles that are 100% commission. A base salary gives you some stability: you know a minimum amount is coming in each month to cover your expenses. Commission is a double-edged sword. Some months can be weak, while others can be very strong. If you exceed expectations, a commission-heavy or commission-only role can be extremely lucrative.
What are quota and OTE?
Your quota is the sales target the company assigns you for a specific period, usually tied to the revenue or product sales it expects from your territory. You may have an annual quota that’s also broken into quarters or months.
Your OTE is what the compensation plan says you would make if you achieve 100% of that target. For example:
- A $90,000 base salary plus $60,000 in commission at quota equals $150,000 OTE.
- A $65,000 base salary plus $85,000 in commission at quota also equals $150,000 OTE.
Those plans have the same OTE, but they will feel very different month to month. The first gives you more guaranteed income. The second puts more of your compensation at risk, with potentially greater upside depending on how the plan works.
And here’s the question you need to ask: How realistic is that quota? An OTE number looks great on paper, but you need to know whether reps in comparable territories are actually earning it.
What are accelerators and commission caps?
An accelerator increases your commission rate after you reach a certain sales threshold. For example, once you hit quota, the company may pay you at a higher rate on additional sales. Some plans also have different rates for particular products or categories, so you need to understand what you’re being rewarded to sell. (Selling capital equipment versus implants and disposables can shape how that works.)
Many roles offer uncapped commission, meaning there’s no stated ceiling on what you can earn through sales. Other plans have a cap that limits your commission even if you continue to exceed your target.
Personally, I would not be thrilled about joining a team that puts a ceiling on what I can earn for being an exceptional rep.
What should you ask before accepting a comp plan?
Don’t stop at the OTE number. Ask how the plan works in the territory you would actually inherit:
- What percentage of reps hit quota last year? Ask about reps in similar roles and territories, not just the top performer.
- What did this territory produce previously? Are you taking over established business or building it from scratch?
- When is commission earned and paid? Understand whether credit is tied to an order, a completed case, an invoice, or another event.
- How are sales credited? If you share an account or work with another rep, who gets paid on that business?
- What support do you get while you ramp up? It may take time to learn the products and build relationships before you can produce at full quota.
- Can the company change your quota, territory, or commission rates? Ask how changes are communicated and what happens to business you’ve already generated.
Red flags to watch for
A commission cap is one for me. Another is a big OTE number that nobody on the team can seem to reach.
I’d also be cautious if the company can’t clearly explain how commission is calculated, when it’s paid, or which accounts belong to you. If a territory has little existing business but you’re being held to the same quota as someone with established accounts, you need to understand why. And if the company frequently changes the plan, that makes it harder to know what your work will actually pay.
Medical device sales can pay extremely well. But before you get excited about the OTE, make sure you understand the base salary, the quota, the commission rates, the territory, and how many reps are really hitting their numbers. That will tell you much more than the headline compensation figure.
