We Analyzed 529,804 Medical Malpractice Payments Totaling $136.4 Billion

Using data from the National Practitioner Data Bank (NPDB), we analyzed every medical malpractice payment reported in the United States from 2000 through 2025. The NPDB is a federal database maintained by the Health Resources and Services Administration (HRSA) that tracks all malpractice payments made on behalf of healthcare practitioners.

Here are the most significant findings from our analysis:

• Average payments have risen 114% since 2000 — from $213,801 in 2000 to $457,362 in 2025
• The median payment is far lower than the average — $97,500 vs. $257,531, indicating a small number of very large payouts skew the average significantly
• New York leads the nation with the highest total payout ($19.3B) and the most cases (60,690), though Illinois and Massachusetts have higher average payments
• Fewer cases, bigger payouts — annual case volume dropped 40% from 2001 (20,412 cases) to 2025 (11,550 cases), but the average payment nearly doubled
• Only 2.7% of cases exceed $1 million, but those 14,640 cases account for a disproportionate share of total payouts

Highest average payments: Illinois ($403,557), Massachusetts ($403,669), and Connecticut ($397,592) lead the nation in average malpractice payment size. These states generally lack hard damage caps on malpractice awards.

Highest case volume: New York (60,690), California (53,535), and Pennsylvania (36,822) have the most reported cases, largely reflecting their population size and healthcare sector density.

California anomaly: Despite having the second-highest case count, California's average payment ($140,946) is among the lowest of major states. This is attributable to the MICRA cap (Medical Injury Compensation Reform Act), which limited non-economic damages to $250,000 from 1975 until 2023, when it was raised to $350,000–$750,000.

Median vs. average gap: In every state, the median is substantially lower than the average, confirming that a small number of high-value cases skew the averages upward. When evaluating a potential malpractice claim, the median is often a more representative benchmark.