Spending on premium-rate overtime by hospitals in England has risen by more than a third in the past two years, a Freedom of Information request has found.
Hospitals can pay consultants a higher-than-normal rate for extra shifts.
Some hospitals have paid up to £1,000 for four hours' work, research by the BBC found, while rates of £600 a shift is common - three or four times consultants' normal rate of pay.
The average amount paid in high-cost overtime last year was £13,356 per consultant.
One doctor at Lancashire Teaching Hospitals NHS Foundation Trust made £375,000 on top of their salary from the shifts.
Figures from 114 of the 186 trusts and health boards show the amount hospitals spend on high-cost overtime is increasing.
In 2015-16, £168m was spent, up from £125m in 2013-14.
Not all hospitals pay overtime at higher rates.
Wrightington, Wigan and Leigh NHS Foundation Trust stopped paying premium rates in 2010.
Andrew Foster, the trust's chief executive, told the BBC: "I don't think it is very defensible to pay a huge premium to one group of staff and not to other groups of staff."
The British Medical Association (BMA) said the payments were a sign of doctor shortages.
Keith Brent, the BMA consultants' leader, said: "These payments are made because there simply are not enough doctors and hospitals are under pressure to meet waiting time targets."
The UK's Department of Health said the NHS would have over 11,000 more doctors by 2020.
A spokesman said: "Consultants do a vital job and should be properly rewarded, but this analysis shows why we are working with the BMA to replace a unique evening and weekend 'opt-out' in the existing contract.
"This will allow us all to promise patients urgent and emergency care of a consistently high standard across the week, and - as the hospitals themselves say - make better use of operating theatres while reducing big overtime bills."