38 CFR Part 4 — 38 CFR § 4.71a

Ring or little finger, ankylosis — VA Diagnostic Code 5227

Musculoskeletal

Diagnostic code

5227

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38 CFR § 4.71a lists Diagnostic Code 5227 under “III. Ankylosis of Individual Digits.” The title is “Ring or little finger, ankylosis of:”. The line is “Unfavorable or favorable,” 0 in the Major column and 0 in the Minor column. The note under that line says to consider evaluation as amputation, and an additional evaluation for resulting limitation of motion of other digits or interference with overall function of the hand.

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.71a source note prints 29 FR 6718, May 22, 1964, as amended at 34 FR 5062, Mar. 11, 1969; 40 FR 42536, Sept. 15, 1975; 41 FR 11294, Mar. 18, 1976; 43 FR 45350, Oct. 2, 1978; 51 FR 6411, Feb. 24, 1986; 61 FR 20439, May 7, 1996; 67 FR 48785, July 26, 2002; 67 FR 54349, Aug. 22, 2002; 68 FR 51456, Aug. 27, 2003; 69 FR 32450, June 10, 2004; 80 FR 42041, July 16, 2015; 85 FR 76460, Nov. 30, 2020, 85 FR 85523, Dec. 29, 2020, 86 FR 8142, Feb. 4, 2021. The source note uses a comma, not a semicolon, before 85 FR 85523 and before 86 FR 8142. The § 4.69 source note prints 62 FR 30239, June 3, 1997. The § 4.71 source note prints 29 FR 6718, May 22, 1964, as amended at 43 FR 45349, Oct. 2, 1978; 67 FR 48785, July 26, 2002. The § 4.68 XML for this date does not print a Federal Register source note.

The rating criteria at each level

5227 Ring or little finger, ankylosis of — Major and Minor columns

Rating %: 0 major, 0 minor

Criteria (verbatim). Unfavorable or favorable

Rating %	Criteria (verbatim)
0 major, 0 minor	Unfavorable or favorable

Note: Also consider whether evaluation as amputation is warranted and whether an additional evaluation is warranted for resulting limitation of motion of other digits or interference with overall function of the hand.

(3) Evaluation of ankylosis of the index, long, ring, and little fingers: (i) If both the metacarpophalangeal and proximal interphalangeal joints of a digit are ankylosed, and either is in extension or full flexion, or there is rotation or angulation of a bone, evaluate as amputation without metacarpal resection, at proximal interphalangeal joint or proximal thereto. (ii) If both the metacarpophalangeal and proximal interphalangeal joints of a digit are ankylosed, evaluate as unfavorable ankylosis, even if each joint is individually fixed in a favorable position. (iii) If only the metacarpophalangeal or proximal interphalangeal joint is ankylosed, and there is a gap of more than two inches (5.1 cm.) between the fingertip(s) and the proximal transverse crease of the palm, with the finger(s) flexed to the extent possible, evaluate as unfavorable ankylosis. (iv) If only the metacarpophalangeal or proximal interphalangeal joint is ankylosed, and there is a gap of two inches (5.1 cm.) or less between the fingertip(s) and the proximal transverse crease of the palm, with the finger(s) flexed to the extent possible, evaluate as favorable ankylosis.

The 0 and 0 are printed for both words, “Unfavorable or favorable.” Paragraph (3)(ii), (iii), and (iv) still distinguish unfavorable ankylosis from favorable ankylosis. On DC 5227 those two results use the same numbers. Paragraph (3)(i) is a different instruction: evaluate as amputation without metacarpal resection, at the proximal interphalangeal joint or proximal thereto. DC 5155 is “Ring finger, amputation of:”. DC 5156 is “Little finger, amputation of:”. Each prints 20 for “With metacarpal resection (more than one-half the bone lost)” and 10 for “Without metacarpal resection, at proximal interphalangeal joint or proximal thereto.” The amputation note says the single finger amputation ratings are the only applicable ratings for amputations of whole or part of single fingers. Paragraph (3)(i) names the without-metacarpal-resection evaluation. It does not name the 20 percent metacarpal-resection line.

DC 5227 is one digit. When two digits of the same hand are ankylosed, the multiple-digit rows are separate. DC 5219 is “Two digits of one hand, unfavorable ankylosis of:”. Its line “Long and ring; long and little; or ring and little fingers” is 20 major and 20 minor. DC 5223 is the favorable-ankylosis code for two digits. The same “ring and little fingers” line is 10 major and 10 minor. Paragraph (2) covers a combination of amputation, ankylosis, or limitation of motion of two or more digits of the same hand that is not otherwise specified in the rating schedule. Paragraph (5) says that if there is limitation of motion of two or more digits, evaluate each digit separately and combine the evaluations.

DC 5226 is “Long finger, ankylosis of:”. Unfavorable or favorable is 10 major and 10 minor. DC 5230 is “Ring or little finger, limitation of motion:”. The line is “Any limitation of motion,” 0 major and 0 minor. 38 CFR § 4.71 says motion of the thumb and fingers should be described by appropriate reference to the joints, and it points to Plate III. 38 CFR § 4.69 determines the dominant hand. It does not use the words “Major” and “Minor.” Those are the column headings. 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just.

38 CFR § 4.68 says the combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed. The example in that section names diagnostic code 5165 and disabilities below the knee. It does not name DC 5227. The DC 5227 note does not name DC 5125.

Source: 38 CFR § 4.71a, Diagnostic Code 5227, eCFR full-text XML for 2026-10-01.

What the words mean in your records

One line covers both words

The rating line is “Unfavorable or favorable.” Major is 0. Minor is 0. The long-finger code, DC 5226, uses the same two words at 10 and 10.

The note is longer than the multiple-digit note

The DC 5227 note has two “whether” clauses: evaluation as amputation, and an additional evaluation for resulting limitation of motion of other digits or interference with overall function of the hand. The note under DC 5219 stops after “evaluation as amputation is warranted.”

Limitation of motion is a different code

DC 5230 is ring or little finger, limitation of motion. “Any limitation of motion” is 0 and 0. Ankylosis is DC 5227. The schedule prints both.

Evidence that speaks to each level

0 and 0

What the rater needs to see. Ankylosis of the ring finger or the little finger, unfavorable or favorable, when the evaluation stays on DC 5227.

Where that usually lives. The hand examination, including which joint is ankylosed and the gap the paragraph (3) rules use.

The amputation instruction in paragraph (3)(i)

What the rater needs to see. Both the metacarpophalangeal and proximal interphalangeal joints ankylosed, and either in extension or full flexion, or rotation or angulation of a bone. That paragraph says to evaluate as amputation without metacarpal resection.

Where that usually lives. The same examination, read against DC 5155 or DC 5156.

Two digits

What the rater needs to see. Ring and little together, or another pair the multiple-digit row names. Unfavorable ankylosis of ring and little is on DC 5219. Favorable ankylosis of that pair is on DC 5223.

Where that usually lives. The examination of both digits of the same hand.

Level	What the rater needs to see	Where that usually lives
0 and 0	Ankylosis of the ring finger or the little finger, unfavorable or favorable, when the evaluation stays on DC 5227.	The hand examination, including which joint is ankylosed and the gap the paragraph (3) rules use.
The amputation instruction in paragraph (3)(i)	Both the metacarpophalangeal and proximal interphalangeal joints ankylosed, and either in extension or full flexion, or rotation or angulation of a bone. That paragraph says to evaluate as amputation without metacarpal resection.	The same examination, read against DC 5155 or DC 5156.
Two digits	Ring and little together, or another pair the multiple-digit row names. Unfavorable ankylosis of ring and little is on DC 5219. Favorable ankylosis of that pair is on DC 5223.	The examination of both digits of the same hand.

VA’s public DBQ list, checked October 5, 2026, names “Hand and Finger” under Musculoskeletal. The file is Hand and Finger.

The exam form

DC 5227 prints 0 and 0 for unfavorable or favorable ankylosis, and the note about amputation and the other digits. This page does not say the form replaces that row.

Related codes and how they interact

The neighboring finger codes use different numbers.

Long-finger ankylosis is 10 and 10. Ring or little finger limitation of motion is 0 and 0 for any limitation. Ring and little unfavorable ankylosis together is 20 and 20. The same pair, favorable, is 10 and 10.

Secondary conditions and presumptions

The 2026-10-01 text of 38 CFR § 3.309 does not contain “ankylosis” or “finger.” DC 5227 is a rating-schedule line.

A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.

Short answers

What is the VA rating for ankylosis of the ring or little finger?

Under 38 CFR § 4.71a, Diagnostic Code 5227 is 0 percent major and 0 percent minor for unfavorable or favorable ankylosis. The note says to consider amputation and the effect on the other digits or the hand. Education only. VA decides on the evidence.

Is limitation of motion of the same finger a different number?

DC 5230 is limitation of motion of the ring or little finger. Any limitation of motion is also 0 major and 0 minor. The titles are different. Ankylosis is DC 5227.

FAQ

What percentage does DC 5227 print?

Unfavorable or favorable ankylosis of the ring or little finger is 0 percent in the Major column and 0 percent in the Minor column. Education only.

When does the note move the evaluation off that 0?

The note says to consider evaluation as amputation, and an additional evaluation for resulting limitation of motion of other digits or interference with overall function of the hand. Paragraph (3)(i) says to evaluate as amputation without metacarpal resection when both named joints are ankylosed and either is in extension or full flexion, or there is rotation or angulation of a bone.

What if both the ring and little fingers are ankylosed?

DC 5227 is ankylosis of an individual digit. Unfavorable ankylosis of ring and little fingers is a line under DC 5219, at 20 major and 20 minor. Favorable ankylosis of that pair is a line under DC 5223, at 10 major and 10 minor.

Next steps

Read the decision for DC 5227, whether the finding was unfavorable or favorable, and whether the note or paragraph (3)(i) pointed to an amputation code.
The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
Other hand codes are on the musculoskeletal diagnostic-code index. The category page is musculoskeletal conditions.

Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.

Other codes in this body system

Nearby catalog entries in Musculoskeletal, ordered by diagnostic code number. All Musculoskeletal codes

Also: DC code lookup (tools) lists the same index in a compact layout.

Source: 38 CFR Part 4, Diagnostic Code 5227 • va.gov

⚠️ Important Disclaimer

This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.