US malpractice payment risk map
Where medical malpractice payments happen, how large they are, and which way each state is heading, from the National Practitioner Data Bank Public Use Data File, 2017–2026.
United States
- Payments per 1,000 physicians
- 5.00
- Average payment
- $503,053
- 5-year trend in the rate
- -2.6%
2025:4,907 payments totaling $2.5B982,240 patient-care physicians (2023)
Hover or tap a state to preview it; click to keep it selected while you move to its link.
What the colors mean
ranges shown for 2025Fill color: how often payments happenwhy0.23 per 1,000 physiciansMaine · from 1 payment17.97 per 1,000 physiciansNew Mexico · from 93 payments
Each state is shaded by malpractice payments per 1,000 patient-care physicians. Dividing by physician count is what keeps the comparison fair between large and small states. Texas has far more payments than Wyoming and far more doctors to go with them.
$ symbol: the average payment sizeoff$32,500North Dakota · average of 1 payment$1,356,296Wisconsin · average of 27 payments
The AVERAGE size of a single payment that year, shown as a colored “$” at each state’s center. Not the total paid out, which is a much bigger number. Kept separate from the fill color on purpose: a state can have many small payments (dark fill, green $) or rare but enormous ones (pale fill, red $). Those are different environments, and a single blended score would hide the difference. Small states swing a lot here: one very large settlement moves a state that saw only a handful of payments all year.
Inner glow: which way it is headingoff-92.6%Maine · from 1 payment+108.3%New Jersey · from 254 payments
Change in the payment RATE over five years, not in the raw number of payments, which would partly be measuring growth in the physician workforce. Green is steady or falling, amber is moderate growth, red is rising fast. The glow points inward so each state’s reading stays inside its own borders; an outward glow would sit on the line shared with its neighbor, describing neither state clearly.
Weather icon: the state’s damages capoffHostileWeakMixedFavorableNo enforceable capStrong, broad, stable cap
A single-factor read on the statutory environment: how strong the state’s cap on noneconomic (pain-and-suffering) damages is. Strong caps limit the ceiling on an award; weak or absent caps leave it open. This is hand-curated legal research, not payment data, and it does not change with the year slider. It is a research tool, not legal advice. Verify any row with counsel before relying on it.
State rankings
States ranked by payments per 1,000 physicians in 2025, the measure behind the map’s fill color.
| # | State | Payments per 1,000 physicians | Average payment | Payments reported | 5-yr trend | Damages cap |
|---|---|---|---|---|---|---|
| 1 | New Mexico | 17.97 | $325,336 | 93 | +93.2% | Favorable |
| 2 | Pennsylvania | 13.22 | $455,476 | 605 | +29.0% | Hostile |
| 3 | Louisiana | 11.96 | $503,792 | 165 | -5.2% | Favorable |
| 4 | Florida | 9.01 | $393,825 | 576 | -2.1% | Mixed |
| 5 | New Jersey | 8.34 | $647,564 | 254 | +108.3% | Hostile |
| 6 | New York | 8.21 | $651,551 | 651 | -35.0% | Hostile |
| 7 | Indiana | 8.03 | $328,278 | 127 | -21.9% | Favorable |
| 8 | West Virginia | 7.27 | $440,372 | 37 | -18.2% | Favorable |
| 9 | Kentucky | 7.15 | $428,979 | 82 | +57.9% | Hostile |
| 10 | Oklahoma | 6.14 | $560,920 | 53 | -59.6% | Hostile |
| 11 | Alaska | 5.94 | $1,096,591 | 11 | -7.6% | Favorable |
| 12 | Montana | 5.88 | $272,574 | 17 | +42.2% | Favorable |
| 13 | Kansas | 5.82 | $294,378 | 45 | -2.3% | Hostile |
| 14 | Delaware | 5.76 | $509,844 | 16 | +43.6% | Hostile |
| 15 | Mississippi | 5.07 | $289,911 | 31 | +62.2% | Mixed |
| 16 | Nevada | 5.02 | $445,810 | 34 | +4.5% | Mixed |
| 17 | Missouri | 4.98 | $472,033 | 92 | +16.9% | Mixed |
| 18 | Georgia | 4.97 | $883,990 | 130 | -4.5% | Hostile |
| 19 | Hawaii | 4.78 | $622,288 | 20 | -0.9% | Weak |
| 20 | Illinois | 4.40 | $731,155 | 171 | +35.7% | Hostile |
| 21 | Idaho | 4.36 | $912,188 | 16 | +33.5% | Mixed |
| 22 | Utah | 4.33 | $420,714 | 35 | +28.9% | Mixed |
| 23 | Wyoming | 4.21 | $366,000 | 5 | +18.0% | Hostile |
| 24 | California | 4.09 | $353,171 | 477 | +0.5% | Mixed |
| 25 | Michigan | 3.93 | $290,144 | 130 | +14.9% | Mixed |
| 26 | Alabama | 3.85 | $618,370 | 46 | +95.9% | Hostile |
| 27 | Connecticut | 3.66 | $728,800 | 50 | +75.0% | Hostile |
| 28 | Maryland | 3.53 | $436,330 | 78 | -5.1% | Weak |
| 29 | Nebraska | 3.51 | $654,342 | 19 | +60.0% | Favorable |
| 30 | South Carolina | 3.46 | $474,462 | 46 | -22.4% | Mixed |
| 31 | Oregon | 3.27 | $494,881 | 42 | +4.9% | Hostile |
| 32 | Arkansas | 3.07 | $323,523 | 22 | -10.3% | Hostile |
| 33 | Washington | 3.06 | $872,330 | 66 | +15.9% | Hostile |
| 34 | Texas | 3.02 | $268,280 | 218 | -26.4% | Favorable |
| 35 | Massachusetts | 2.84 | $730,286 | 90 | +73.1% | Mixed |
| 36 | Arizona | 2.78 | $504,712 | 52 | -38.6% | Hostile |
| 37 | South Dakota | 2.65 | $281,167 | 6 | -36.1% | Mixed |
| 38 | New Hampshire | 2.50 | $856,818 | 11 | -29.6% | Hostile |
| 39 | Virginia | 2.06 | $539,566 | 49 | +8.0% | Favorable |
| 40 | Ohio | 1.91 | $444,931 | 72 | -14.8% | Mixed |
| 41 | Iowa | 1.91 | $533,482 | 14 | -31.6% | Weak |
| 42 | Tennessee | 1.73 | $558,438 | 32 | -34.5% | Weak |
| 43 | Colorado | 1.64 | $468,879 | 29 | +19.2% | Mixed |
| 44 | Wisconsin | 1.61 | $1,356,296 | 27 | -3.1% | Mixed |
| 45 | Rhode Island | 1.58 | $703,571 | 7 | -38.7% | Hostile |
| 46 | District of Columbia | 1.38 | $812,071 | 7 | +54.6% | Hostile |
| 47 | North Carolina | 1.11 | $430,492 | 32 | -44.5% | Weak |
| 48 | Minnesota | 0.87 | $425,984 | 16 | -28.1% | Hostile |
| 49 | North Dakota | 0.52 | $32,500 | 1 | -68.2% | Mixed |
| 50 | Vermont | 0.39 | $145,000 | 1 | -69.4% | Hostile |
| 51 | Maine | 0.23 | $135,000 | 1 | -92.6% | Hostile |
Where these numbers come from
Payments come from the NPDB Public Use Data File: every malpractice payment made for a physician after a written claim or judgment, by the state they worked in and the year it was reported. NPDB revises past years each quarter, so numbers can shift slightly. 2026 covers only 3 months, scaled to a full year and marked “est.”; read single states in that year with caution.
Physician counts, the denominator under every rate, are non-federal patient-care M.D.s and D.O.s from HRSA’s Area Health Resources Files. The newest measured year is 2023. 2024, 2025 and 2026 carry it forward, so their rates are approximate.
Colors are scaled within each year. A state can change color because it was re-ranked, not because its own rate changed. To compare a state with itself over time, use the numbers.
Damages caps come from a hand-curated scorecard, version v0.3, as of 2026-06-07, and don’t change with the year.
What this is not. Not a measure of medical quality, not a prediction of any individual’s risk of being sued, and not legal or actuarial advice. Payment data reflects historical payouts after a written claim or judgment, which is a narrower thing than “malpractice happened here.” The damages-cap scorecard is a research tool. Verify any row with counsel before relying on it.