38 CFR Part 4 — 38 CFR § 4.115b

Malignant neoplasms of the genitourinary system — VA Diagnostic Code 7528

Genitourinary

Diagnostic code

7528

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38 CFR § 4.115b lists Diagnostic Code 7528 as “Malignant neoplasms of the genitourinary system,” rated 100. The note continues that rating after surgery, X-ray, antineoplastic chemotherapy, or other therapeutic procedure stops, and it requires a VA examination at the expiration of six months. If there has been no local reoccurrence or metastasis, rate on residuals as voiding dysfunction or renal dysfunction, whichever is predominant. The schedule does not print the words “prostate cancer” or “bladder cancer” on this line.

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 § 4.115b source note prints 59 FR 2527, Jan. 18, 1994, as amended at 86 FR 54086, Sept. 30, 2021. The § 3.320a source note prints 90 FR 29, Jan. 2, 2025.

The rating criteria at each level

Malignant neoplasms of the genitourinary system — DC 7528

Rating %: 100

Criteria (verbatim). Malignant neoplasms of the genitourinary system

Rating %	Criteria (verbatim)
100	Malignant neoplasms of the genitourinary system

Renal dysfunction — § 4.115a, when the DC 7528 note rates residuals that way

Rating %: 100

Criteria (verbatim). Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient

Rating %: 80

Criteria (verbatim). Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months

Rating %: 60

Criteria (verbatim). Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months

Rating %: 30

Criteria (verbatim). Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months

Rating %: 0

Criteria (verbatim). GFR from 60 to 89 mL/min/1.73 m² and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m² and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m² and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months

Rating %	Criteria (verbatim)
100	Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient
80	Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months
60	Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months
30	Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months
0	GFR from 60 to 89 mL/min/1.73 m² and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m² and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m² and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months

Urine leakage, frequency, or obstructed voiding — § 4.115a voiding dysfunction

Rating %: 60

Criteria (verbatim). Requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day

Rating %: 40

Criteria (verbatim). Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day

Rating %: 20

Criteria (verbatim). Requiring the wearing of absorbent materials which must be changed less than 2 times per day

Rating %: 40

Criteria (verbatim). Daytime voiding interval less than one hour, or; awakening to void five or more times per night

Rating %: 20

Criteria (verbatim). Daytime voiding interval between one and two hours, or; awakening to void three to four times per night

Rating %: 10

Criteria (verbatim). Daytime voiding interval between two and three hours, or; awakening to void two times per night

Rating %: 30

Criteria (verbatim). Urinary retention requiring intermittent or continuous catheterization

Rating %: 10

Criteria (verbatim). Marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of stream) with any one or combination of the following: 1. Post void residuals greater than 150 cc. 2. Uroflowmetry; markedly diminished peak flow rate (less than 10 cc/sec). 3. Recurrent urinary tract infections secondary to obstruction. 4. Stricture disease requiring periodic dilatation every 2 to 3 months

Rating %: 0

Criteria (verbatim). Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year

Rating %	Criteria (verbatim)
60	Requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day
40	Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day
20	Requiring the wearing of absorbent materials which must be changed less than 2 times per day
40	Daytime voiding interval less than one hour, or; awakening to void five or more times per night
20	Daytime voiding interval between one and two hours, or; awakening to void three to four times per night
10	Daytime voiding interval between two and three hours, or; awakening to void two times per night
30	Urinary retention requiring intermittent or continuous catheterization
10	Marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of stream) with any one or combination of the following: 1. Post void residuals greater than 150 cc. 2. Uroflowmetry; markedly diminished peak flow rate (less than 10 cc/sec). 3. Recurrent urinary tract infections secondary to obstruction. 4. Stricture disease requiring periodic dilatation every 2 to 3 months
0	Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year

Note: Following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure, the rating of 100 percent shall continue with a mandatory VA examination at the expiration of six months. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local reoccurrence or metastasis, rate on residuals as voiding dysfunction or renal dysfunction, whichever is predominant.

The voiding and renal lines are § 4.115a. The DC 7528 note uses them only for residuals, and only as voiding dysfunction or renal dysfunction, whichever is predominant, if there has been no local reoccurrence or metastasis. They are not additional percentages printed on the 100 percent line.

38 CFR § 4.115a says: “Diseases of the genitourinary system generally result in disabilities related to renal or voiding dysfunctions, infections, or a combination of these. Where diagnostic codes refer the decision maker to these specific areas of dysfunction, only the predominant area of dysfunction shall be considered for rating purposes. Distinct disabilities may be evaluated separately under this section, pursuant to § 4.14, if the symptoms do not overlap.”

A change in evaluation based on the six-month examination, or a later one, is subject to § 3.105(e). That paragraph is titled “Reduction in evaluation—compensation.” Where a reduction in evaluation of a service-connected disability is considered warranted and the lower evaluation would result in a reduction or discontinuance of compensation payments currently being made, a rating proposing the reduction or discontinuance will be prepared setting forth all material facts and reasons.

The note spells it “reoccurrence.”

Source: 38 CFR § 4.115b, Diagnostic Code 7528, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Six months

The note says the 100 percent rating shall continue with a mandatory VA examination at the expiration of six months after cessation of surgical, X-ray, antineoplastic chemotherapy, or other therapeutic procedure. It does not say the 100 percent ends on the day treatment stops.

Local reoccurrence or metastasis

If there has been no local reoccurrence or metastasis, the note says to rate on residuals as voiding dysfunction or renal dysfunction, whichever is predominant. The note does not name a residual diagnostic code in that sentence. DC 7527 is a different code. It rates prostate gland injuries, infections, hypertrophy, postoperative residuals, and bladder outlet obstruction as voiding dysfunction or urinary tract infection, whichever is predominant.

GFR

The renal-dysfunction note in § 4.115a says GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes under that section when determined to be appropriate and calculated by a medical professional.

When two evaluations are close

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.

Evidence that speaks to each level

100

What the rater needs to see. A malignant neoplasm of the genitourinary system. After treatment stops, the note keeps 100 percent until a mandatory VA examination at the expiration of six months.

Where that usually lives. Pathology and the treatment summary, including the date treatment stopped.

Residuals after the examination

What the rater needs to see. If there has been no local reoccurrence or metastasis, voiding dysfunction or renal dysfunction, whichever is predominant. A change is subject to § 3.105(e).

Where that usually lives. The VA examination and the § 4.115a findings the note uses.

Level	What the rater needs to see	Where that usually lives
100	A malignant neoplasm of the genitourinary system. After treatment stops, the note keeps 100 percent until a mandatory VA examination at the expiration of six months.	Pathology and the treatment summary, including the date treatment stopped.
Residuals after the examination	If there has been no local reoccurrence or metastasis, voiding dysfunction or renal dysfunction, whichever is predominant. A change is subject to § 3.105(e).	The VA examination and the § 4.115a findings the note uses.

VA’s public DBQ list, checked October 5, 2026, names “Urinary Tract Conditions” and “Male Reproductive Organ Conditions (Including Prostate Cancer)” under Genitourinary. The DC 7528 note separately requires a mandatory VA examination six months after treatment stops.

The exam form

Those public forms are Urinary Tract Conditions and Male Reproductive Organ Conditions (Including Prostate Cancer). This page does not say a public form replaces the mandatory VA examination in the DC 7528 note.

Related codes and how they interact

Benign neoplasms and prostate residuals

DC 7529 is benign neoplasms of the genitourinary system: rate as voiding dysfunction or renal dysfunction, whichever is predominant.

DC 7527 is prostate gland injuries, infections, hypertrophy, postoperative residuals, and bladder outlet obstruction. It uses voiding dysfunction or urinary tract infection, not the DC 7528 residual pair of voiding dysfunction or renal dysfunction.

The opening note of § 4.115b refers loss or loss of use of one or more creative organs to § 3.350. DC 7522 is erectile dysfunction at 0, with a footnote to review special monthly compensation. The public page is the erectile dysfunction guide.

Secondary conditions and presumptions

Three different lists use cancer words, and they are not the same list.

38 CFR § 3.309(e) names “Prostate cancer” for herbicide exposure when § 3.307(a)(6) is met and § 3.307(d) is satisfied. The same paragraph does not name bladder cancer. 38 U.S.C. § 1116(a)(2), read on the Legal Information Institute page on 2026-10-05, names “Bladder cancer” in paragraph (2)(J). That statutory list does not use the words “prostate cancer.”

38 CFR § 3.309(f)(8) names “Bladder cancer” for Camp Lejeune when § 3.307(a)(7) is met. The eight-disease list does not name prostate cancer. Paragraph (a)(7)(iii) requires no less than 30 days (consecutive or nonconsecutive) of service at Camp Lejeune from August 1, 1953, through December 31, 1987, including Marine Corps Air Station New River.

38 CFR § 3.320a is titled “Presumptive service connection for bladder, ureter, and related genitourinary cancers.” Paragraph (b) names two diseases: “(1) Urinary bladder cancer, including over-lapping sites of the bladder. (2) Ureter cancer, including the ureteric orifice, and urachus.” It does not name prostate cancer. Paragraph (c) defines a covered veteran as a veteran who, on or after August 2, 1990, performed active service while assigned to a duty station in, including airspace above, the Southwest Asia theater of operations as defined in § 3.317(e)(2) or Somalia; or who, on or after September 11, 2001, performed that service in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, or Uzbekistan. Paragraph (d) is the exception for affirmative evidence of a cause outside that service, a supervening condition or event, or willful misconduct. The section source note prints 90 FR 29, Jan. 2, 2025. The authority line cites 38 U.S.C. 501, 1119, 1120, and 1174.

38 CFR § 3.320 does not name bladder cancer, ureter cancer, or prostate cancer. 38 U.S.C. § 1120(b), read the same day, lists “Reproductive cancer of any type” and “Kidney cancer.” It does not name prostate cancer, bladder cancer, or ureter cancer in paragraphs (b)(1) through (b)(14). Paragraph (b)(15) is the Secretary’s authority to add another disease by regulation.

38 CFR § 3.309(a) lists “Tumors, malignant, or of the brain or spinal cord or peripheral nerves” among the chronic diseases, on the time limit in § 3.307(a)(3). That line does not name prostate cancer or bladder cancer.

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 DC 7528?

Under 38 CFR § 4.115b, a malignant neoplasm of the genitourinary system is rated 100 percent. The note keeps that rating through a mandatory VA examination six months after treatment stops. If there has been no local reoccurrence or metastasis, residuals are rated as voiding dysfunction or renal dysfunction, whichever is predominant. Education only. VA decides on the evidence.

Which list names prostate cancer, and which names bladder cancer?

Section 3.309(e) names prostate cancer and does not name bladder cancer. Section 1116(a)(2)(J) names bladder cancer and does not use the words prostate cancer. Section 3.309(f)(8) names bladder cancer for Camp Lejeune and does not name prostate cancer. Section 3.320a names urinary bladder cancer and ureter cancer and does not name prostate cancer.

FAQ

How does VA rate a malignant genitourinary neoplasm under DC 7528?

38 CFR § 4.115b rates DC 7528 at 100 percent. The note continues that rating for six months after surgical, X-ray, antineoplastic chemotherapy, or other therapeutic procedure stops, then requires a VA examination. If there has been no local reoccurrence or metastasis, rate residuals as voiding dysfunction or renal dysfunction, whichever is predominant. A change is subject to § 3.105(e). Education only.

Is prostate cancer on the herbicide list?

Section 3.309(e) names prostate cancer. The 2026-10-01 text of that paragraph does not name bladder cancer. 38 U.S.C. § 1116(a)(2)(J) names bladder cancer and does not use the words prostate cancer.

Is bladder cancer on the Camp Lejeune list?

Section 3.309(f)(8) names bladder cancer. That list does not name prostate cancer. Section 3.320a separately names urinary bladder cancer and ureter cancer for a covered veteran, as that section defines the term.

Does § 3.320a cover every genitourinary cancer?

Paragraph (b) names urinary bladder cancer, including over-lapping sites of the bladder, and ureter cancer, including the ureteric orifice and urachus. It does not name prostate cancer.

Next steps

Read the decision for DC 7528, the treatment stop date, and whether the note’s six-month examination has been done.
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. C&P prep (Founding Pass) is a separate worksheet. An accredited representative is at find a VSO.
Other genitourinary codes are on the genitourinary 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 Genitourinary, ordered by diagnostic code number. All Genitourinary codes

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

Source: 38 CFR Part 4, Diagnostic Code 7528 • va.gov

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