38 CFR Part 4 — 38 CFR § 4.71a

Hip, flail joint — VA Diagnostic Code 5254

Musculoskeletal

Diagnostic code

5254

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38 CFR § 4.71a lists Diagnostic Code 5254 in the table captioned “The Hip and Thigh.” The row is “Hip, flail joint.” It does not end with a period. The table has one Rating column. The number is 80. That cell has no superscript. Appendix B indexes “Hip, flail joint.” and does end with a period.

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 § 4.69 source note prints 62 FR 30239, June 3, 1997. The 2026-10-01 XML for § 4.68 prints no source note. The § 4.63 source note prints 29 FR 6718, May 22, 1964, as amended at 43 FR 45349, Oct. 2, 1978.

The rating criteria at each level

5254 Hip, flail joint — one Rating column

Rating %: 80

Criteria (verbatim). Hip, flail joint

Rating %	Criteria (verbatim)
80	Hip, flail joint

DC 5250 is “Hip, ankylosis of:”. Unfavorable, extremely unfavorable ankylosis, the foot not reaching ground, crutches necessitated, is 90, and that 90 carries superscript 3. Intermediate is 70. Favorable, in flexion at an angle between 20° and 40°, and slight adduction or abduction, is 60. Those are ankylosis lines. DC 5254 does not use the words “unfavorable,” “intermediate,” or “favorable.”

Footnote 3 of the hip-and-thigh table reads: Entitled to special monthly compensation. It does not say “Also.” It is printed on the DC 5250 unfavorable 90. It is not printed on the DC 5254 80.

The DC 5255 malunion instruction says: “Evaluate under diagnostic codes 5256, 5257, 5260, or 5261 for the knee, or 5250-5254 for the hip, whichever results in the highest evaluation.” DC 5254 is inside that hip range. The instruction is about femur malunion. It is not a second rating line under DC 5254.

DC 5251 is thigh limitation of extension, extension limited to 5°, at 10. DC 5252 is thigh limitation of flexion, from 40 down to 10. Those are limitation-of-motion codes. DC 5254 is the flail-joint row.

DC 5250 is hip ankylosis. Its highest line is 90 with footnote 3. Its other lines are 70 and 60. DC 5255 includes fracture of the shaft or anatomical neck with nonunion and loose motion at 80, the same number DC 5254 prints, and it includes the malunion sentence that names diagnostic codes 5250-5254. DC 5258 is dislocated semilunar cartilage, at 20. That is a knee code. It is not the hip flail-joint row.

Footnote 3 does not name § 3.350 and does not name an SMC level. 38 CFR § 3.350(a) says special monthly compensation under 38 U.S.C. 1114(k) is payable for each anatomical loss or loss of use of one hand, one foot, and the other losses that sentence lists. The DC 5254 cell does not carry footnote 3. This page does not state a payment amount. 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.

The code prints no 0 percent line. 38 CFR § 4.31 says that in every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. The 2026-10-01 text of 38 CFR § 3.309 lists “Arthritis.” as a chronic disease. It does not contain “flail.” It does not name DC 5254. 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.

Source: 38 CFR § 4.71a, Diagnostic Code 5254, eCFR full-text XML for 2026-10-01.

What the words mean in your records

One number, 80

The row does not split favorable and unfavorable. The ankylosis code, DC 5250, is the code that uses those words.

No superscript on the 80

Footnote 3 is on the DC 5250 unfavorable 90. The DC 5254 cell is 80 with no superscript.

5250-5254 in the femur note

That range is in the DC 5255 malunion instruction. It tells the reader to evaluate femur malunion under the knee codes it lists or under 5250-5254 for the hip, whichever results in the highest evaluation.

Evidence that speaks to each level

What the rater needs to see. A flail hip joint. The row is “Hip, flail joint.” It does not add favorable, unfavorable, or a degree of motion.

Where that usually lives. The hip examination and the imaging or operative record that uses that finding.

A different hip code, when the finding is ankylosis or motion

What the rater needs to see. DC 5250 is ankylosis, at 90, 70, or 60. DC 5251 and DC 5252 are limitation of extension and flexion. DC 5255 is femur impairment.

Where that usually lives. The same records. Footnote 3 is on the DC 5250 unfavorable line, not on DC 5254.

Level	What the rater needs to see	Where that usually lives
80	A flail hip joint. The row is “Hip, flail joint.” It does not add favorable, unfavorable, or a degree of motion.	The hip examination and the imaging or operative record that uses that finding.
A different hip code, when the finding is ankylosis or motion	DC 5250 is ankylosis, at 90, 70, or 60. DC 5251 and DC 5252 are limitation of extension and flexion. DC 5255 is femur impairment.	The same records. Footnote 3 is on the DC 5250 unfavorable line, not on DC 5254.

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

The exam form

DC 5254 prints 80 for hip, flail joint. It does not print footnote 3. This page does not say the form replaces that row.

Related codes and how they interact

Ankylosis of the hip is DC 5250.

That code prints 90, 70, and 60. The 90 carries footnote 3. DC 5254 prints 80 and does not carry the footnote. The words “flail joint” are not the ankylosis lines.

Secondary conditions and presumptions

Section 3.309(a) lists “Arthritis.” The 2026-10-01 text does not contain “flail,” and it does not name DC 5254. This page does not assign the arthritis listing to a flail joint.

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

How does VA rate a flail hip joint?

Under 38 CFR § 4.71a, Diagnostic Code 5254 is 80 percent. The cell has no superscript. Education only. VA decides on the evidence.

Where does the schedule mention codes 5250 through 5254 together?

In the DC 5255 instruction for malunion: evaluate under diagnostic codes 5256, 5257, 5260, or 5261 for the knee, or 5250-5254 for the hip, whichever results in the highest evaluation. That sentence is about femur malunion.

FAQ

What rating does a flail hip joint print?

80, in the single Rating column. The row does not end with a period, and the 80 has no footnote. Education only.

Is the 90 percent ankylosis line this code?

That 90 is DC 5250, unfavorable, extremely unfavorable ankylosis, the foot not reaching ground, crutches necessitated. It carries footnote 3. DC 5254 is “Hip, flail joint,” at 80, without that footnote.

Does section 3.309 list a flail joint?

The 2026-10-01 text lists “Arthritis.” It does not contain “flail,” and it does not name DC 5254. The arthritis listing is not assigned to this code on this page.

Next steps

Read the decision for DC 5254 and whether a different hip code, such as DC 5250 or DC 5255, was used instead.
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 musculoskeletal 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 5254 • 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.