38 CFR Part 4 — 38 CFR § 4.97

Sinusitis, maxillary, chronic — VA Diagnostic Code 6513

ENT / airway

Diagnostic code

6513

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38 CFR § 4.97 lists Diagnostic Code 6513 as “Sinusitis, maxillary, chronic.” It does not print its own percentages. Diagnostic codes 6510 through 6514 use the General Rating Formula for Sinusitis. VA’s Fiscal Year 2024 Annual Benefits Report lists “Maxillary sinusitis” with 231,275 among respiratory disabilities of all compensation recipients. The report is on [benefits.va.gov](https://www.benefits.va.gov/REPORTS/abr/docs/2024-abr.pdf).

Reviewed 2026-10-03. Text checked against eCFR on 2026-10-05; Title 38 last amended 2026-08-27. On that date the titles list showed Title 38 up to date as of 2026-10-01 (latest issue date 2026-08-27).

The rating criteria at each level

General Rating Formula for Sinusitis (DCs 6510 through 6514)

Rating %: 50

Criteria (verbatim). Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries

Rating %: 30

Criteria (verbatim). Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting

Rating %: 10

Criteria (verbatim). One or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting

Rating %: 0

Criteria (verbatim). Detected by X-ray only

Rating %	Criteria (verbatim)
50	Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries
30	Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting
10	One or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting
0	Detected by X-ray only

Note: An incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician.

DC 6510 is pansinusitis, DC 6511 is ethmoid, DC 6512 is frontal, DC 6513 is maxillary, and DC 6514 is sphenoid. The formula caption names DCs 6510 through 6514.

Source: 38 CFR § 4.97 (Schedule of ratings—respiratory system), General Rating Formula for Sinusitis, eCFR full-text XML for 2026-08-27. Prevalence count: VBA Annual Benefits Report, Fiscal Year 2024.

What the words mean in your records

Incapacitating episode

The note defines it as one that requires bed rest and treatment by a physician. The 30 and 10 percent lines also describe prolonged antibiotic treatment lasting four to six weeks.

Non-incapacitating episodes

The 30 percent alternative is more than six non-incapacitating episodes per year characterized by headaches, pain, and purulent discharge or crusting. The 10 percent alternative is three to six such episodes per year.

Detected by X-ray only

That is the entire 0 percent line.

Evidence that speaks to each level

What the rater needs to see. Following radical surgery with chronic osteomyelitis, or near constant sinusitis characterized by headaches, pain and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries.

Where that usually lives. Operative reports and treatment notes that describe the surgeries, osteomyelitis, headaches, pain, tenderness, and purulent discharge or crusting.

What the rater needs to see. Three or more incapacitating episodes per year requiring prolonged antibiotic treatment lasting four to six weeks, or more than six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting.

Where that usually lives. Physician treatment notes showing bed rest, and antibiotic dates long enough to meet the “four to six weeks” words, or a count of the non-incapacitating episodes.

What the rater needs to see. One or two incapacitating episodes per year with that prolonged antibiotic treatment, or three to six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting.

Where that usually lives. The same notes.

0 — X-ray only

What the rater needs to see. The printed 0 percent line is “Detected by X-ray only.”

Where that usually lives. Imaging without the episode findings in the higher lines.

Level	What the rater needs to see	Where that usually lives
50	Following radical surgery with chronic osteomyelitis, or near constant sinusitis characterized by headaches, pain and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries.	Operative reports and treatment notes that describe the surgeries, osteomyelitis, headaches, pain, tenderness, and purulent discharge or crusting.
30	Three or more incapacitating episodes per year requiring prolonged antibiotic treatment lasting four to six weeks, or more than six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting.	Physician treatment notes showing bed rest, and antibiotic dates long enough to meet the “four to six weeks” words, or a count of the non-incapacitating episodes.
10	One or two incapacitating episodes per year with that prolonged antibiotic treatment, or three to six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting.	The same notes.
0 — X-ray only	The printed 0 percent line is “Detected by X-ray only.”	Imaging without the episode findings in the higher lines.

VA’s public DBQ list, checked October 3, 2026, names “Sinusitis, Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx” under Ear, Nose, Throat. This site’s page is the sinusitis DBQ guide.

The exam form

The formula’s own evidence words are the episode count, bed rest and treatment by a physician, antibiotic treatment lasting four to six weeks, headaches, pain, purulent discharge or crusting, surgery, and X-ray.

The pansinusitis guide is DC 6510. It uses this same formula. Maxillary sinusitis is DC 6513.

Related codes and how they interact

The other sinusitis codes

DC 6510 is chronic pansinusitis. The public page is the sinusitis guide.

DC 6511 is chronic ethmoid sinusitis. DC 6512 is chronic frontal sinusitis. DC 6514 is chronic sphenoid sinusitis. All four, with DC 6513, use the general formula.

38 CFR § 4.14 says the evaluation of the same disability under various diagnoses is to be avoided.

Secondary conditions and presumptions

38 CFR § 3.320(a)(2) lists “Sinusitis, to include rhinosinusitis” among the chronic diseases associated with exposure to fine particulate matter. The disease will be service connected if manifested to any degree, including non-compensable, at any time following separation from a qualifying period of service in paragraph (a)(5), except as paragraph (b) provides. Paragraph (a)(5) names service in the Southwest Asia theater of operations during the Persian Gulf War, and service in Afghanistan, Syria, Djibouti, or Uzbekistan on or after September 19, 2001, during the Persian Gulf War. Paragraph (a)(6) defines the Southwest Asia theater and the Persian Gulf War. Paragraph (b) says the presumption shall not apply if there is affirmative evidence that the disease was not incurred during or aggravated by a qualifying period of service, or was caused by a supervening condition or event, or is the result of the veteran’s own willful misconduct.

Section 3.309 does not name sinusitis. A secondary question that § 3.320 does not decide is a medical question on the facts under 38 CFR § 3.310.

Short answers

What is the VA rating for chronic maxillary sinusitis?

Under 38 CFR § 4.97, Diagnostic Code 6513 uses the General Rating Formula for Sinusitis: 50, 30, 10, and 0 percent. The note defines an incapacitating episode as one that requires bed rest and treatment by a physician. Education only. VA decides on the evidence.

Where does the 231,275 figure come from?

The Fiscal Year 2024 Annual Benefits Report lists “Maxillary sinusitis” with 231,275 among respiratory disabilities of all compensation recipients. That count is not a rating.

FAQ

How does VA rate chronic maxillary sinusitis under DC 6513?

DC 6513 uses the General Rating Formula for Sinusitis in 38 CFR § 4.97. The lines are 50, 30, 10, and 0 percent. The 0 percent line is “Detected by X-ray only.” An incapacitating episode means one that requires bed rest and treatment by a physician. Education only.

Do the other sinus codes use a different formula?

No. The formula caption says DCs 6510 through 6514. Pansinusitis, ethmoid, frontal, maxillary, and sphenoid sinusitis share these lines.

Is sinusitis named in the particulate-matter presumption?

Yes. Section 3.320(a)(2)(iii) lists sinusitis, to include rhinosinusitis, for a qualifying period of service, subject to the exceptions in paragraph (b).

Next steps

Read the decision for DC 6513 and the count of episodes, antibiotic dates, and whether bed rest and treatment by a physician are in the notes.
The free worksheet is a place to write the code, the measurements, and the records you already have. It does not file a claim or protect a filing date. C&P prep (Founding Pass) is a separate worksheet. An accredited representative is at find a VSO.
The sinusitis family page for pansinusitis is the sinusitis guide. The body-system list is the ENT / airway diagnostic-code index.

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 ENT / airway, ordered by diagnostic code number. All ENT / airway codes

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

Source: 38 CFR Part 4, Diagnostic Code 6513 • 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.