Yes, it is possible for a neurosurgeon, particularly those specializing in cranial surgery, to earn around $1 million annually, especially with significant experience and a strong reputation. While academic neurosurgeons often have salaries on the lower end, typically starting around $500,000 in their first year, surgeons working in private practice or high-volume hospitals can reach or exceed the $1 million mark through a combination of high surgical volume, bonuses, and other incentives. Factors such as geographic location, subspecialty expertise, and the ability to attract high-paying patients also influence earning potential. Therefore, while not common for all neurosurgeons, reaching a $1 million annual income is achievable for those who excel in their field and work in lucrative settings.