38 CFR Part 4 — 38 CFR § 4.71a

Astragalectomy — VA Diagnostic Code 5274

Musculoskeletal

Diagnostic code

5274

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38 CFR § 4.71a lists Diagnostic Code 5274 in the table captioned “The Ankle.” The line is “Astragalectomy.” It does not end with a colon, and it does not end with a period. The rating cell is 20. That 20 has no superscript. The row is the last row of The Ankle table. Appendix B to Part 4 indexes “Astragalectomy.” 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 source note uses a comma, not a semicolon, before 85 FR 85523 and before 86 FR 8142.

The rating criteria at each level

5274 Astragalectomy

Rating %: 20

Criteria (verbatim). Astragalectomy

Rating %	Criteria (verbatim)
20	Astragalectomy

The Ankle table has one Rating column. It does not split Major and Minor.

The title does not end with a colon. DC 5270, DC 5271, DC 5272, and DC 5273 titles in the same table do end with a colon.

The 20 is not marked with footnote 3. Footnote 3, “Also entitled to special monthly compensation,” is printed on the shortening table that follows, on the 60 and the 50. It is not printed on DC 5274.

DC 5273 is the row above: “Os calcis or astragalus, malunion of:”, marked deformity 20 and moderate deformity 10. DC 5272 is subastragalar or tarsal joint, ankylosis of: 20 in poor weight-bearing position and 10 in good weight-bearing position. DC 5270 is ankle, ankylosis of. DC 5271 is ankle, limited motion of: marked is 20, and moderate is 10, each with a parenthetical about degrees. DC 5274 does not print marked, moderate, or those degrees.

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 does not contain “astragalectomy” or “5274.” 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 5274, eCFR full-text XML for 2026-10-01.

What the words mean in your records

One word, 20

The criteria cell and the title are the same word: Astragalectomy. There is no second percentage on this row.

No colon on this row

The four ankle codes above it end their titles with a colon. DC 5274 does not. Appendix B adds a period the rating row does not have.

Malunion is a different code

DC 5273 rates malunion of the os calcis or astragalus at 20 or 10. DC 5274 does not use the words marked or moderate.

Evidence that speaks to each level

What the rater needs to see. Astragalectomy, which is the whole DC 5274 line.

Where that usually lives. The operative record of removal of the astragalus.

Level	What the rater needs to see	Where that usually lives
20	Astragalectomy, which is the whole DC 5274 line.	The operative record of removal of the astragalus.

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

The exam form

DC 5274 prints one line at 20 percent. This page does not say the ankle form replaces that word.

Related codes and how they interact

The ankle table ends on this row.

DC 5270 through DC 5274 sit under “The Ankle.” The next table is shortening of the lower extremity, DC 5275. Its footnote 3 is not on the DC 5274 20.

Secondary conditions and presumptions

Section 3.309 does not contain “astragalectomy” or “5274.” DC 5274 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

How does VA rate an astragalectomy?

Under 38 CFR § 4.71a, Diagnostic Code 5274 is 20 percent for astragalectomy. Education only. VA decides on the evidence.

Does Appendix B add a period?

The rating row does not end with a period. Appendix B indexes “Astragalectomy.” with a period.

FAQ

What percentage does DC 5274 print?

20. The line is the single word Astragalectomy. It does not end with a colon or a period. Education only.

Is malunion of the astragalus this code?

Malunion of the os calcis or astragalus is DC 5273. Marked deformity is 20 and moderate deformity is 10. DC 5274 does not print those words.

Does the 20 carry the special-monthly-compensation footnote?

No. The DC 5274 20 has no superscript. Footnote 3 is on the shortening table, on 60 and 50, and it says “Also entitled to special monthly compensation.”

Next steps

Read the decision for DC 5274 and whether the finding it used is astragalectomy.
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 5274 • 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.