38 CFR Part 4 — 38 CFR § 4.71a

Ribs, removal of — VA Diagnostic Code 5297

Musculoskeletal

Diagnostic code

5297

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38 CFR § 4.71a lists Diagnostic Code 5297 in the table captioned “The Ribs.” The title is “Ribs, removal of:”. The colon is in the schedule. The rating cell on that title is empty. More than six is 50. Five or six is 40. Three or four is 30. Two is 20. One, or resection of two or more ribs without regeneration, is 10. None of those lines ends with a period. The table has one Rating column. Appendix B, under the heading “The Ribs,” indexes “Removal of.” and ends 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

5297 Ribs, removal of

Rating %: 50

Criteria (verbatim). More than six

Rating %: 40

Criteria (verbatim). Five or six

Rating %: 30

Criteria (verbatim). Three or four

Rating %: 20

Criteria (verbatim). Two

Rating %: 10

Criteria (verbatim). One or resection of two or more ribs without regeneration

Rating %	Criteria (verbatim)
50	More than six
40	Five or six
30	Three or four
20	Two
10	One or resection of two or more ribs without regeneration

Note (1): “The rating for rib resection or removal is not to be applied with ratings for purrulent pleurisy, lobectomy, pneumonectomy or injuries of pleural cavity.” The spelling in that note is “purrulent.” There is no comma before “or injuries.”

Note (2): “However, rib resection will be considered as rib removal in thoracoplasty performed for collapse therapy or to accomplish obliteration of space and will be combined with the rating for lung collapse, or with the rating for lobectomy, pneumonectomy or the graduated ratings for pulmonary tuberculosis.” There is a comma after “lung collapse,” and there is no comma before “or the graduated ratings.”

The word “Note” is in bold. “(1):” and “(2):” follow it outside that bold. Neither note prints a diagnostic code next to the conditions it names.

The table does not print a 0 percent line. [DC 5298](/conditions/diagnostic-codes/dc-5298-removal-of) is coccyx, removal of, and it does print 0 for “Without painful residuals.” That 0 is not on DC 5297.

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 § 4.31 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.

Note (1) says the rating for rib resection or removal is not to be applied with ratings for purrulent pleurisy, lobectomy, pneumonectomy or injuries of pleural cavity. Note (2) says rib resection will be considered as rib removal in thoracoplasty performed for collapse therapy or to accomplish obliteration of space, and will be combined with the rating for lung collapse, or with the rating for lobectomy, pneumonectomy or the graduated ratings for pulmonary tuberculosis. 38 CFR § 4.14 says the evaluation of the same disability under various diagnoses is to be avoided, and that the evaluation of the same manifestation under different diagnoses is to be avoided.

The 2026-10-01 text of 38 CFR § 3.309 does not contain “ribs” or “5297.” 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 5297, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Five lines, from more than six down to one

50, 40, 30, 20, and 10. The 10 percent line covers one rib, or resection of two or more ribs without regeneration.

The note spells purrulent

Note (1) prints “purrulent pleurisy.” That is the spelling in the 2026-10-01 row. The note does not assign a diagnostic code to that word.

Appendix B drops “Ribs”

The rating title is “Ribs, removal of:”. Appendix B places “Removal of.” under the heading “The Ribs.” The same two words, “Removal of.”, are the Appendix B entry under “The Coccyx” for DC 5298.

Evidence that speaks to each level

50, 40, 30, 20, or 10

What the rater needs to see. How many ribs were removed, or whether two or more were resected without regeneration. Note (2) treats rib resection as rib removal in the thoracoplasty it describes.

Where that usually lives. The operative record and the count of ribs the decision uses.

The two notes

What the rater needs to see. Whether the decision also rated purrulent pleurisy, lobectomy, pneumonectomy, injuries of the pleural cavity, lung collapse, or pulmonary tuberculosis. Note (1) and Note (2) are different sentences.

Where that usually lives. The same decision, read against both notes.

Level	What the rater needs to see	Where that usually lives
50, 40, 30, 20, or 10	How many ribs were removed, or whether two or more were resected without regeneration. Note (2) treats rib resection as rib removal in the thoracoplasty it describes.	The operative record and the count of ribs the decision uses.
The two notes	Whether the decision also rated purrulent pleurisy, lobectomy, pneumonectomy, injuries of the pleural cavity, lung collapse, or pulmonary tuberculosis. Note (1) and Note (2) are different sentences.	The same decision, read against both notes.

VA’s public DBQ list, checked October 5, 2026, names “Bones and Other Skeletal Conditions” and “Respiratory Conditions (other than tuberculosis and sleep apnea)” under separate headings. DC 5297 itself is in the musculoskeletal schedule.

The exam form

DC 5297 prints 50, 40, 30, 20, and 10, plus Note (1) and Note (2). This page does not say a form replaces those lines.

Related codes and how they interact

Coccyx removal is the next table.

DC 5298 is coccyx, removal of: 10 with painful residuals and 0 without painful residuals. DC 5297 does not print a painful-residuals line and does not print 0.

Secondary conditions and presumptions

Section 3.309 does not contain “ribs” or “5297.” DC 5297 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 removal of ribs under DC 5297?

Under 38 CFR § 4.71a, the lines are 50, 40, 30, 20, and 10 by the number of ribs, with the 10 percent line also covering resection of two or more ribs without regeneration. Note (1) and Note (2) limit how that rating is applied with the chest conditions they name. Education only. VA decides on the evidence.

Does Appendix B say “Ribs, removal of”?

Appendix B, under “The Ribs,” says “Removal of.” The rating title is “Ribs, removal of:” with a colon.

FAQ

What percentages does DC 5297 print?

More than six is 50. Five or six is 40. Three or four is 30. Two is 20. One, or resection of two or more ribs without regeneration, is 10. Education only.

How is the pleural note spelled?

Note (1) says the rib rating is not to be applied with ratings for purrulent pleurisy, lobectomy, pneumonectomy or injuries of pleural cavity. The spelling on the row is “purrulent.”

When does Note (2) treat resection as removal?

In thoracoplasty performed for collapse therapy or to accomplish obliteration of space. That resection is combined with the rating for lung collapse, or with the rating for lobectomy, pneumonectomy or the graduated ratings for pulmonary tuberculosis.

Next steps

Read the decision for DC 5297, the number of ribs, and whether Note (1) or Note (2) was the sentence it applied.
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 5297 • va.gov

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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.