California Medical Malpractice Payments

California accounts for 10.1% of all NPDB malpractice payments nationwide, with 53,536 total payment reports totaling $7.5B. The state ranks #4 nationally by total payout volume.

The average malpractice payment in California is $141K, which is 45% below the national average of $258K. The median payment is $28K, compared to the national median of $98K. This lower average may reflect the impact of damage caps, tort reform, or case mix differences in California.

The largest single payment in California’s NPDB records is $27.5M. Payments of this magnitude typically involve catastrophic outcomes — permanent brain injury, wrongful death, or birth injuries requiring lifetime care.

California has a damage cap on malpractice awards: MICRA: $250K until 2023, now $350K-$750K (sliding scale). States with damage caps average $217K per payment, compared to $292K in states without caps — a 34% difference. This cap directly impacts the settlement landscape in California.

This analysis is based on the National Practitioner Data Bank (NPDB) Public Use Data File, maintained by the Health Resources and Services Administration (HRSA). The NPDB contains every medical malpractice payment report filed in the United States since September 1, 1990.

Our dataset covers 529,804 payment reports from 2000 through 2025, totaling $136.4B in payments. State attribution is based on the practitioner’s work state at the time of the incident.

Important Caveats

• Payments include settlements, judgments, and arbitration awards — not all represent proven malpractice.
• The NPDB does not capture cases settled without payment or dismissed claims.
• State-level averages can be heavily influenced by a small number of very large payments.
• Damage caps affect the maximum recoverable amount and therefore the average, but not the case count.