{
  "name": "Specialty malpractice and wRVU benchmarks",
  "description": "Planning estimates by specialty: mature annual malpractice premium range, typical tail multiple and annual wRVU target.",
  "source": "https://www.joinandwise.com/contracts/tail-coverage",
  "license": "https://creativecommons.org/licenses/by/4.0/",
  "attribution": "Andwise (https://www.joinandwise.com)",
  "citation": "Andwise, \"Specialty malpractice and wRVU benchmarks\" (2026-10-21). https://www.joinandwise.com/contracts/tail-coverage",
  "lastVerified": "2026-10-21",
  "scope": "Specialty-level planning estimates; not carrier quotes",
  "note": "Planning estimates, not quotes. Actual premiums and tail costs vary by carrier, coverage limits and state. Source: Andwise specialty benchmark table, last updated 2026-10-21.",
  "count": 15,
  "data": [
    {
      "id": "neurosurgery",
      "name": "Neurosurgery",
      "proceduralShare": 0.85,
      "annualPremiumLow": 65000,
      "annualPremiumMedian": 95000,
      "annualPremiumHigh": 160000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 9000,
      "notes": "Highest overall malpractice premiums; tail liability easily exceeds $180,000–$300,000 upon exit."
    },
    {
      "id": "obgyn",
      "name": "OB/GYN",
      "proceduralShare": 0.65,
      "annualPremiumLow": 45000,
      "annualPremiumMedian": 68000,
      "annualPremiumHigh": 110000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 6200,
      "notes": "Highest tail liability among common specialties. In high-risk states (NY, FL, IL), tail can exceed $150,000–$250,000."
    },
    {
      "id": "orthopedic-surgery",
      "name": "Orthopedic Surgery",
      "proceduralShare": 0.88,
      "annualPremiumLow": 38000,
      "annualPremiumMedian": 55000,
      "annualPremiumHigh": 85000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 7800,
      "notes": "Heavy procedural workload subject to 2026 efficiency cut. Tail exposure typically $100,000–$150,000+."
    },
    {
      "id": "general-surgery",
      "name": "General Surgery",
      "proceduralShare": 0.8,
      "annualPremiumLow": 32000,
      "annualPremiumMedian": 48000,
      "annualPremiumHigh": 72000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 6800,
      "notes": "80% procedural codes subject to 2026 CMS efficiency cut. Tail liability often exceeds $90,000–$100,000."
    },
    {
      "id": "cardiology-interventional",
      "name": "Cardiology (Interventional)",
      "proceduralShare": 0.85,
      "annualPremiumLow": 25000,
      "annualPremiumMedian": 38000,
      "annualPremiumHigh": 58000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 7500,
      "notes": "Heavy catheterization and structural heart procedures subject to 2026 CMS efficiency cut."
    },
    {
      "id": "emergency-medicine",
      "name": "Emergency Medicine",
      "proceduralShare": 0.3,
      "annualPremiumLow": 22000,
      "annualPremiumMedian": 34000,
      "annualPremiumHigh": 52000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 7200,
      "notes": "Higher malpractice risk; high frequency of private-equity staffing groups contracting inside nonprofit hospitals."
    },
    {
      "id": "anesthesiology",
      "name": "Anesthesiology",
      "proceduralShare": 0.3,
      "annualPremiumLow": 18000,
      "annualPremiumMedian": 28000,
      "annualPremiumHigh": 44000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 8500,
      "notes": "Base units plus time model; moderate tail liability. High PE consolidation."
    },
    {
      "id": "gastroenterology",
      "name": "Gastroenterology",
      "proceduralShare": 0.82,
      "annualPremiumLow": 18000,
      "annualPremiumMedian": 28000,
      "annualPremiumHigh": 44000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 7200,
      "notes": "Endoscopy and colonoscopy procedures subject to 2026 CMS cut; substantial production pay haircut if unadjusted."
    },
    {
      "id": "hospitalist",
      "name": "Hospitalist (Internal Medicine)",
      "proceduralShare": 0.15,
      "annualPremiumLow": 12000,
      "annualPremiumMedian": 18000,
      "annualPremiumHigh": 28000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 4800,
      "notes": "Inpatient initial/subsequent care visits exempt; bed procedures (lines, intubation, paracentesis) subject to 2.5% cut."
    },
    {
      "id": "ophthalmology",
      "name": "Ophthalmology",
      "proceduralShare": 0.9,
      "annualPremiumLow": 12000,
      "annualPremiumMedian": 18000,
      "annualPremiumHigh": 28000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 7000,
      "notes": "90% procedural volume (cataracts, refractive, retina); unadjusted contracts lose full 2.5% on nearly all surgical revenue."
    },
    {
      "id": "dermatology",
      "name": "Dermatology",
      "proceduralShare": 0.7,
      "annualPremiumLow": 10000,
      "annualPremiumMedian": 16000,
      "annualPremiumHigh": 26000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 6500,
      "notes": "High procedure volume (biopsies, excisions, Mohs, destruction) subject to 2026 CMS -2.5% efficiency cut."
    },
    {
      "id": "internal-medicine-outpatient",
      "name": "Internal Medicine (Outpatient)",
      "proceduralShare": 0.12,
      "annualPremiumLow": 8000,
      "annualPremiumMedian": 13000,
      "annualPremiumHigh": 20000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 4700,
      "notes": "Predominantly cognitive E/M and chronic care management; minimal exposure to 2026 CMS efficiency cut."
    },
    {
      "id": "family-medicine",
      "name": "Family Medicine",
      "proceduralShare": 0.12,
      "annualPremiumLow": 8000,
      "annualPremiumMedian": 12000,
      "annualPremiumHigh": 19000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 4800,
      "notes": "Routine outpatient care exempt from 2026 efficiency cut; in-office minor procedures subject to 2.5% cut."
    },
    {
      "id": "pediatrics",
      "name": "Pediatrics (General)",
      "proceduralShare": 0.1,
      "annualPremiumLow": 6000,
      "annualPremiumMedian": 10000,
      "annualPremiumHigh": 16000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 4600,
      "notes": "Low malpractice risk; predominantly time-based E/M codes largely exempt from 2026 CMS efficiency cut."
    },
    {
      "id": "psychiatry",
      "name": "Psychiatry",
      "proceduralShare": 0.05,
      "annualPremiumLow": 5000,
      "annualPremiumMedian": 8000,
      "annualPremiumHigh": 13000,
      "typicalTailMultiple": 2,
      "annualWrvuTarget": 4200,
      "notes": "Lowest malpractice premium and tail risk; psychotherapy and evaluation codes exempt from 2026 efficiency cut."
    }
  ]
}