38 CFR Part 4 — 38 CFR § 4.119

Hyperparathyroidism — VA Diagnostic Code 7904

Endocrine

Diagnostic code

7904

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38 CFR § 4.119 lists Diagnostic Code 7904 as “Hyperparathyroidism:”. The title ends with a colon. The rating cell on that title is empty. The next lines are 100, 60, 10, and 0, with four notes. Appendix B to Part 4 indexes “Hyperparathyroidism.”

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 § 4.119 source note prints 61 FR 20446, May 7, 1996, as amended at 82 FR 50804, Nov. 2, 2017.

The rating criteria at each level

7904 Hyperparathyroidism

Rating %: 100

Criteria (verbatim). For six months from date of discharge following surgery

Rating %: 60

Criteria (verbatim). Hypercalcemia (indicated by at least one of the following: Total Ca greater than 12 mg/dL (3-3.5 mmol/L), Ionized Ca greater than 5.6 mg/dL (2-2.5 mmol/L), creatinine clearance less than 60 mL/min, bone mineral density T-score less than 2.5 SD (below mean) at any site or previous fragility fracture)

Rating %: 10

Criteria (verbatim). Symptoms such as fatigue, anorexia, nausea, or constipation that occur despite surgery; or in individuals who are not candidates for surgery but require continuous medication for control

Rating %: 0

Criteria (verbatim). Asymptomatic

Rating %	Criteria (verbatim)
100	For six months from date of discharge following surgery
60	Hypercalcemia (indicated by at least one of the following: Total Ca greater than 12 mg/dL (3-3.5 mmol/L), Ionized Ca greater than 5.6 mg/dL (2-2.5 mmol/L), creatinine clearance less than 60 mL/min, bone mineral density T-score less than 2.5 SD (below mean) at any site or previous fragility fracture)
10	Symptoms such as fatigue, anorexia, nausea, or constipation that occur despite surgery; or in individuals who are not candidates for surgery but require continuous medication for control
0	Asymptomatic

Note (1) is printed between the 100 percent line and the 60 percent line: After six months, rate on residuals under the appropriate diagnostic code(s) within the appropriate body system(s) based on a VA examination.

Note (2) is printed after the 60 percent line: Where surgical intervention is indicated, this evaluation shall continue until the day of surgery, at which time the provisions pertaining to a 100-percent evaluation shall apply.

Note (3) is printed after Note (2) and before the 10 percent line: Where surgical intervention is not indicated, this evaluation shall continue for six months after pharmacologic treatment begins. After six months, rate on residuals under the appropriate diagnostic code(s) within the appropriate body system(s) based on a VA examination.

Note (4) is printed after the 0 percent line: Following surgery or other treatment, evaluate chronic residuals, such as nephrolithiasis (kidney stones), decreased renal function, fractures, vision problems, and cardiovascular complications, under the appropriate diagnostic codes.

The 100, 60, 10, and 0 percent criteria cells do not end with a period. Notes (1) through (4) do. Note (2) prints “100-percent” with a hyphen.

The 60 percent cell prints the laboratory ranges in parentheses as “(3-3.5 mmol/L)” after total calcium greater than 12 mg/dL, and “(2-2.5 mmol/L)” after ionized calcium greater than 5.6 mg/dL. It also prints “T-score less than 2.5 SD (below mean).” 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 § 4.14 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.

DC 7905 is “Hypoparathyroidism:”. Its 100 percent line is “For three months after initial diagnosis”. That cell does not end with a period. It is not the DC 7904 line. DC 7904’s 100 percent line counts six months from the date of discharge following surgery. DC 7912 says to evaluate polyglandular syndrome according to major manifestations, “to include, but not limited to, Type I diabetes mellitus, hyperthyroidism, hypothyroidism, hypoparathyroidism, or Addison's disease.” That list names hypoparathyroidism. It does not name hyperparathyroidism.

DC 7903 is hypothyroidism. DC 7914 is “Neoplasm, malignant, any specified part of the endocrine system,” at 100, with its own six-month examination note. Neither title is hyperparathyroidism.

The 2026-10-01 text of 38 CFR § 3.309 lists “Endocrinopathies.” It does not contain “hyperparathyroidism” or “parathyroid,” and it does not assign DC 7904. 38 CFR § 3.311(b)(2) says the term “radiogenic disease” shall include “(xix) Parathyroid adenoma.” That item does not say hyperparathyroidism and does not assign DC 7904. 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 § 4.119, Diagnostic Code 7904, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Six months from discharge

The 100 percent line is “For six months from date of discharge following surgery”. The cell does not end with a period. Note (1) then says to rate residuals under the appropriate diagnostic code within the appropriate body system, based on a VA examination.

The 60 percent findings are listed in one cell

The cell says hypercalcemia indicated by at least one of the listed findings. The findings are total calcium, ionized calcium, creatinine clearance less than 60 mL/min, bone mineral density T-score less than 2.5 SD (below mean) at any site, or previous fragility fracture.

Note (2) uses a hyphen

Note (2) says that where surgical intervention is indicated, this evaluation continues until the day of surgery, and then “the provisions pertaining to a 100-percent evaluation shall apply.”

Evidence that speaks to each level

100 — six months from discharge after surgery

What the rater needs to see. Surgery for hyperparathyroidism, and the date of discharge that starts the six months.

Where that usually lives. The operative report and the discharge date. Note (1) is the residual instruction after those six months.

60 — hypercalcemia, at least one listed finding

What the rater needs to see. At least one finding named in the 60 percent cell. Note (2) and Note (3) say how long “this evaluation” continues when surgery is indicated and when it is not.

Where that usually lives. The laboratory report, the bone-density report, or the record of a previous fragility fracture, together with the treatment record Note (2) or Note (3) uses.

10 — named symptoms, or continuous medication

What the rater needs to see. Symptoms such as fatigue, anorexia, nausea, or constipation that occur despite surgery; or in individuals who are not candidates for surgery but require continuous medication for control.

Where that usually lives. The treatment record that describes those symptoms after surgery, or continuous medication when the person is not a candidate for surgery.

0 — asymptomatic

What the rater needs to see. The schedule cell is “Asymptomatic”. It does not end with a period.

Where that usually lives. The examination that supports that line. Note (4) is the instruction for chronic residuals after surgery or other treatment.

Level	What the rater needs to see	Where that usually lives
100 — six months from discharge after surgery	Surgery for hyperparathyroidism, and the date of discharge that starts the six months.	The operative report and the discharge date. Note (1) is the residual instruction after those six months.
60 — hypercalcemia, at least one listed finding	At least one finding named in the 60 percent cell. Note (2) and Note (3) say how long “this evaluation” continues when surgery is indicated and when it is not.	The laboratory report, the bone-density report, or the record of a previous fragility fracture, together with the treatment record Note (2) or Note (3) uses.
10 — named symptoms, or continuous medication	Symptoms such as fatigue, anorexia, nausea, or constipation that occur despite surgery; or in individuals who are not candidates for surgery but require continuous medication for control.	The treatment record that describes those symptoms after surgery, or continuous medication when the person is not a candidate for surgery.
0 — asymptomatic	The schedule cell is “Asymptomatic”. It does not end with a period.	The examination that supports that line. Note (4) is the instruction for chronic residuals after surgery or other treatment.

VA’s public DBQ list, checked October 5, 2026, names “Thyroid and Parathyroid” under Endocrinological. A separate form, “Endocrine (Other than Thyroid, Parathyroid or Diabetes Mellitus),” is listed beside it. The file for this heading is Thyroid and Parathyroid.

The exam form

DC 7904 prints 100, 60, 10, and 0, plus four notes. This page does not say the form replaces those lines.

Related codes and how they interact

Hypoparathyroidism is DC 7905.

Its 100 percent line is three months after initial diagnosis. DC 7904’s 100 percent line is six months from the date of discharge following surgery. DC 7912’s manifestation list names hypoparathyroidism and does not name hyperparathyroidism.

Secondary conditions and presumptions

Section 3.309(a) lists “Endocrinopathies” and does not assign DC 7904. Section 3.311(b)(2) lists parathyroid adenoma as a radiogenic disease and does not assign DC 7904.

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 hyperparathyroidism under DC 7904?

Under 38 CFR § 4.119, Diagnostic Code 7904 prints 100, 60, 10, and 0. The 100 percent line is six months from the date of discharge following surgery. The 60 percent line is the hypercalcemia cell. Notes (1) through (4) are printed among those lines. Education only. VA decides on the evidence.

Is hypoparathyroidism the same code?

No. DC 7905 is hypoparathyroidism. Its 100 percent line is three months after initial diagnosis. DC 7912 names hypoparathyroidism as one manifestation and does not name hyperparathyroidism.

FAQ

What percentages does DC 7904 print?

100 for six months from the date of discharge following surgery, 60 for hypercalcemia indicated by at least one listed finding, 10 for the named symptoms or continuous medication, and 0 when asymptomatic. Four notes sit among those lines. Education only.

What does the 60 percent cell put in parentheses?

“(3-3.5 mmol/L)” after total calcium greater than 12 mg/dL, “(2-2.5 mmol/L)” after ionized calcium greater than 5.6 mg/dL, and “(below mean)” after the T-score less than 2.5 SD. The cell does not end with a period.

Does § 3.311 call this code a radiogenic disease?

Section 3.311(b)(2) includes “(xix) Parathyroid adenoma” in the radiogenic-disease list. It does not say hyperparathyroidism and does not assign DC 7904.

Next steps

Read the decision for DC 7904 and whether it used the 100, 60, 10, or 0 percent line, and which note 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 endocrine codes are on the endocrine diagnostic-code index. The category page is endocrine 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 Endocrine, ordered by diagnostic code number. All Endocrine codes

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

Source: 38 CFR Part 4, Diagnostic Code 7904 • 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.