Settlement Insight Research

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

Name: U.S. Medical Malpractice Payment Analysis (2000–2025)
Creator: Settlement Insight
Published: 2026-03-18
License: https://creativecommons.org/publicdomain/zero/1.0/

A comprehensive analysis of every medical malpractice payment reported to the National Practitioner Data Bank from 2000 to 2025.

530K cases

Total Payments Analyzed

2000–2025

$136.4B

Total Dollars Paid

In malpractice payments

$258K

Average Payment

Across all cases

$98K

Median Payment

50th percentile

Key Findings

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

Average Payment by Year (2000–2025)

Average malpractice payment has increased steadily, with a notable dip during COVID-19 (2020–2021) followed by a sharp rebound.

Source: National Practitioner Data Bank (NPDB) Public Use Data File. Years shown as last two digits (e.g., "00" = 2000).

Payment Size Distribution

Most malpractice payments fall between $10,000 and $250,000. Only 0.1% of cases result in payments above $5 million.

Most common range

$10K–$50K (22.7% of all cases, 120,081 payments)

Largest payment in dataset

$37.5 million (single payment)

Malpractice Payments by State

Average and median payments vary dramatically by state. Tort reform, damage caps, and local jury tendencies all play a role. Click a column header to sort.

State	Cases	Average Payment▼	Median Payment
Massachusetts	10,019	$403,669	$185,000
Illinois	17,138	$403,557	$195,000
Connecticut	5,298	$397,592	$155,000
District of Columbia	1,575	$367,289	$145,000
Hawaii	1,273	$350,646	$97,500
Georgia	9,654	$338,498	$145,000
Alabama	2,254	$331,149	$125,000
Alaska	711	$323,369	$97,500
New York	60,690	$318,750	$145,000
New Jersey	19,899	$314,350	$145,000
Rhode Island	1,848	$313,571	$145,000
Maine	1,271	$311,271	$125,000
Delaware	1,038	$305,341	$145,000
Wisconsin	3,466	$301,445	$67,500
New Hampshire	1,726	$298,584	$135,000

Excludes U.S. territories. Sorted by average payment (highest first) by default.

Notable State Insights

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.

Data Source & Methodology

This analysis uses the National Practitioner Data Bank (NPDB) Public Use Data File, maintained by the Health Resources and Services Administration (HRSA), a division of the U.S. Department of Health and Human Services.

The NPDB was established by Congress in 1986 (Title IV of Public Law 99-660) and has collected reports on medical malpractice payments since September 1, 1990. Federal law requires all malpractice payments made on behalf of healthcare practitioners to be reported to the NPDB, regardless of payment size or whether the payment resulted from a settlement, judgment, or arbitration award.

What the data includes

Payment amount (in range-coded brackets)
State where the malpractice event occurred
Year of payment
Type of allegation (diagnosis, treatment, surgery, medication, etc.)

Important caveats

Payment amounts are range-coded in the public data file (e.g., $25,001–$50,000). We use the midpoint of each range for calculations.
The data includes payments only — cases dismissed without payment are not reported, so this dataset does not reflect the full universe of malpractice claims.
A payment does not necessarily indicate negligence or improper treatment — many payments are made as part of settlements without any admission of fault.

The complete public use data file is available for download from npdb.hrsa.gov.

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