The arithmetic
| Line | Low | Median | High |
|---|---|---|---|
| Neurosurgery annual premium | $65,000 | $95,000 | $160,000 |
| After the Massachusetts multiplier (1.05×) | $68,250 | $99,750 | $168,000 |
| Tail at 2.0× | $136,500 | $199,500 | $336,000 |
The tail multiple is a planning assumption of 150%–250% of the mature annual premium; this page uses 2.0×. The carrier sets the actual price.
If the carrier uses a different tail multiple
| Tail multiple | Tail on the Massachusetts-adjusted premium |
|---|---|
| 150% of the annual premium | $149,625 |
| 200% of the annual premium | $199,500 |
| 250% of the annual premium | $249,375 |
The national benchmark estimate for Neurosurgery is $190,000. The Massachusettsmultiplier of 1.05× raises it by $9,500.
Example valuesjoinandwise.com/malpractice/massachusetts/neurosurgeryAndwise specialty benchmarks and state liability climatechecked November 2, 2026amounts entered are masked
Massachusetts liability climate
Standard liability environment
Tribunal screening requirement; statutory cap subject to exceptions.
A standard liability environment: the state has a mixed record on caps and venue, and the multiplier is near the national baseline.
The state multiplier is 1.05× the national baseline, a planning estimate for the state's claims environment rather than a rate filed by a carrier. A statutory cap limits some damages; it does not set the premium. Two policies with the same limits can still price differently by carrier, claim history and part-time status.
Example valuesjoinandwise.com/malpractice/massachusetts/neurosurgeryState medical liability statutes, NAIC loss-ratio filings and AMA liability tableschecked November 2, 2026amounts entered are masked
Neurosurgery malpractice profile
Highest overall malpractice premiums; tail liability easily exceeds $180,000–$300,000 upon exit.
The benchmark's procedural share is 85%, the share of wRVUs the benchmark treats as procedural. The specialty's claims profile sets the premium; the state multiplier and the tail multiple then set the exit estimate.
Exit liability by year
What the physician pays for tail on leaving at the end of year 1, 2 or 3, under three contract terms. The vesting column assumes a third of the employer's share vests each completed year.
| Leaving at | Physician pays 100% | 3-year vesting (negotiated) | Employer pays on without-cause termination |
|---|---|---|---|
| End of year 1 | $199,500 | $133,665 | $0 |
| End of year 2 | $199,500 | $65,835 | $0 |
| End of year 3+ | $199,500 | $0 | $0 |
Example valuesjoinandwise.com/malpractice/massachusetts/neurosurgeryAndwise specialty benchmarks and state liability climatechecked November 2, 2026amounts entered are masked
What changes the number
- Claims-made maturity: premiums step up until the policy matures, around year 5.
- Policy limits: the table assumes $1M per claim and $3M aggregate.
- Carrier and claim history: the carrier prices the policy, not the state table.
The Massachusetts page lists the other terms: part-time scope, the tail multiple and the contract's tail clause.
How this page is built
The estimate is arithmetic on two reference tables, each with its own check date. The page does not use a carrier quote or a lead form. The editorial policy explains how figures are checked and how a page is retired when its source changes.
How we check information · Medical advisory board · The benchmark data · Open data
Other states for Neurosurgery
Other specialties in Massachusetts
- OB/GYN$142,800
- Orthopedic Surgery$115,500
- General Surgery$100,800
- Cardiology (Interventional)$79,800
- Emergency Medicine$71,400
Questions to ask about the policy
The Massachusetts page lists the policy questions: claims-made or occurrence, the retroactive date, who pays tail on each termination, the vesting schedule, and the tail multiple.
Sources
- SourceAndwise specialty malpractice and wRVU benchmarkschecked October 21, 2026/data/specialty-benchmarks.json
- SourceState medical liability statutes, NAIC loss-ratio filings and AMA liability tableschecked November 2, 2026
- SourceIndiana State Medical Association e-Report, Negotiating tail coverage in your employment agreement (September 2026)checked October 26, 2026https://ismanet.org/ISMA/Resources/e-Reports/9-3-26/Negotiating_Tail_Coverage.aspx
Planning estimate, not a quote. Premiums and tail prices vary by carrier, coverage limits, claim history and the policy's own terms. The carrier's declarations page and the contract decide the actual amount. This page is general information, not legal or financial advice.