Code	Condition	Tiers
5000	Osteomyelitis, acute, subacute, or chronic5000	5
5001	Bones and joints, tuberculosis of, active or inactive5001	formula
5002	Multi-joint arthritis (except post-traumatic and gout), 2 or more joints, as an active process5002	4
5003	Degenerative arthritis, other than post-traumatic5003	2
5004	Arthritis, gonorrheal.5004	formula
5005	Arthritis, pneumococcic.5005	formula
5006	Arthritis, typhoid.5006	formula
5007	Arthritis, syphilitic.5007	formula
5008	Arthritis, streptococcic.5008	formula
5009	Other specified forms of arthropathy (excluding gout).5009	formula
5010	Post-traumatic arthritis: Rate as limitation of motion, dislocation, or other specified instability under the affected joint. If there are 2 or more joints affected, each rating shall be combined in accordance with § 4.25.5010	formula
5011	Decompression illness: Rate manifestations under the appropriate diagnostic code within the affected body system, such as arthritis for musculoskeletal residuals; auditory system for vestibular residuals; respiratory system for pulmonary barotrauma residuals; and neurologic system for cerebrovascular accident residuals.5011	formula
5012	Bones, neoplasm, malignant, primary or secondary5012	1
5013	Osteoporosis, residuals of.5013	formula
5014	Osteomalacia, residuals of.5014	formula
5015	Bones, neoplasm, benign.5015	formula
5016	Osteitis deformans.5016	formula
5017	Gout.5017	formula
5018	[Removed]5018	formula
5019	Bursitis.5019	formula
5020	[Removed]5020	formula
5021	Myositis.5021	formula
5022	[Removed]5022	formula
5023	Heterotopic ossification.5023	formula
5024	Tenosynovitis, tendinitis, tendinosis or tendinopathy.5024	formula
5025	Fibromyalgia (fibrositis, primary fibromyalgia syndrome)5025	3
5051	Shoulder replacement (prosthesis).5051	3
5052	Elbow replacement (prosthesis).5052	3
5053	Wrist replacement (prosthesis).5053	3
5054	Hip, resurfacing or replacement (prosthesis)5054	4
5055	Knee, resurfacing or replacement (prosthesis)5055	3
5056	Ankle replacement (prosthesis).5056	2
5104	Anatomical loss of one hand and loss of use of one foot5104	1
5105	Anatomical loss of one foot and loss of use of one hand5105	1
5106	Anatomical loss of both hands5106	1
5107	Anatomical loss of both feet5107	1
5108	Anatomical loss of one hand and one foot5108	1
5109	Loss of use of both hands5109	1
5110	Loss of use of both feet5110	1
5111	Loss of use of one hand and one foot5111	1
5120	Complete amputation, upper extremity5120	2
5121	Arm, amputation of, above insertion of deltoid5121	2
5122	Arm, amputation of, below insertion of deltoid5122	2
5123	Forearm, amputation of, above insertion of pronator teres5123	2
5124	Forearm, amputation of, below insertion of pronator teres5124	2
5125	Hand, loss of use of5125	2
5126	Five digits of one hand, amputation of5126	2
5127	Four digits of one hand (thumb, index, long and ring), amputation of5127	2
5128	Four digits of one hand (thumb, index, long and little), amputation of5128	2
5129	Four digits of one hand (thumb, index, ring and little), amputation of5129	2
5130	Four digits of one hand (thumb, long, ring and little), amputation of5130	2
5131	Four digits of one hand (index, long, ring and little), amputation of5131	2
5132	Three digits of one hand (thumb, index and long), amputation of5132	2
5133	Three digits of one hand (thumb, index and ring), amputation of5133	2
5134	Three digits of one hand (thumb, index and little), amputation of5134	2
5135	Three digits of one hand (thumb, long and ring), amputation of5135	2
5136	Three digits of one hand (thumb, long and little), amputation of5136	2
5137	Three digits of one hand (thumb, ring and little), amputation of5137	2
5138	Three digits of one hand (index, long and ring), amputation of5138	2
5139	Three digits of one hand (index, long and little), amputation of5139	2
5140	Three digits of one hand (index, ring and little), amputation of5140	2
5141	Three digits of one hand (long, ring and little), amputation of5141	2
5142	Two digits of one hand (thumb and index), amputation of5142	2
5143	Two digits of one hand (thumb and long), amputation of5143	2
5144	Two digits of one hand (thumb and ring), amputation of5144	2
5145	Two digits of one hand (thumb and little), amputation of5145	2
5146	Two digits of one hand (index and long), amputation of5146	2
5147	Two digits of one hand (index and ring), amputation of5147	2
5148	Two digits of one hand (index and little), amputation of5148	2
5149	Two digits of one hand (long and ring), amputation of5149	2
5150	Two digits of one hand (long and little), amputation of5150	2
5151	Two digits of one hand (ring and little), amputation of5151	2
5152	Thumb, amputation of5152	3
5153	Index finger, amputation of5153	3
5154	Long finger, amputation of5154	2
5155	Ring finger, amputation of5155	2
5156	Little finger, amputation of5156	2
5160	Complete amputation, lower extremity5160	2
5161	Thigh, amputation of, upper third (one-third of the distance from perineum to knee joint measured from perineum)5161	1
5162	Thigh, amputation of, middle or lower thirds5162	1
5163	Leg, amputation of, with defective stump; thigh amputation recommended5163	1
5164	Leg, amputation of, not improvable by prosthesis controlled by natural knee action5164	1
5165	Leg, amputation of, at a lower level, permitting prosthesis5165	1
5166	Forefoot, amputation proximal to metatarsal bones (more than one-half of metatarsal loss)5166	1
5167	Foot, loss of use of5167	1
5170	Toes, all, amputation of, without metatarsal loss or transmetatarsal, amputation of, with up to half of metatarsal loss5170	1
5171	Toe, great, amputation of5171	2
5172	Toes, other than great, amputation of, with removal of metatarsal head5172	2
5173	Toes, three or four, amputation of, without metatarsal involvement5173	2
5200	Scapulohumeral articulation, ankylosis of5200	3
5201	Arm, limitation of motion of5201	3
5202	Humerus, other impairment of5202	5
5203	Clavicle or scapula, impairment of5203	2
5205	Elbow, ankylosis of5205	3
5206	Forearm, limitation of flexion of5206	6
5207	Forearm, limitation of extension of5207	5
5208	Forearm, flexion limited to 100° and extension to 45°5208	1
5209	Elbow, other impairment of Flail joint5209	2
5210	Radius and ulna, nonunion of, with flail false joint5210	1
5211	Ulna, impairment of5211	4
5212	Radius, impairment of5212	4
5213	Supination and pronation, impairment of5213	4
5214	Wrist, ankylosis of5214	3
5215	Wrist, limitation of motion of5215	1
5216	Five digits of one hand, unfavorable ankylosis of5216	1
5217	Four digits of one hand, unfavorable ankylosis of5217	2
5218	Three digits of one hand, unfavorable ankylosis of5218	3
5219	Two digits of one hand, unfavorable ankylosis of5219	3
5220	Five digits of one hand, favorable ankylosis of5220	1
5221	Four digits of one hand, favorable ankylosis of5221	2
5222	Three digits of one hand, favorable ankylosis of5222	3
5223	Two digits of one hand, favorable ankylosis of5223	3
5224	Thumb, ankylosis of5224	2
5225	Index finger, ankylosis of5225	1
5226	Long finger, ankylosis of5226	1
5227	Ring or little finger, ankylosis of5227	1
5228	Thumb, limitation of motion5228	3
5229	Index or long finger, limitation of motion5229	2
5230	Ring or little finger, limitation of motion5230	1
5235	Vertebral fracture or dislocation5235	formula
5236	Sacroiliac injury and weakness5236	formula
5237	Lumbosacral or cervical strain5237	formula
5238	Spinal stenosis5238	formula
5239	Spondylolisthesis or segmental instability5239	formula
5240	Ankylosing spondylitis5240	formula
5241	Spinal fusion5241	formula
5242	Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)5242	formula
5243	Intervertebral disc syndrome: Assign this diagnostic code only when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign diagnostic code 5242 for all other disc diagnoses.5243	formula
5244	Traumatic paralysis, complete5244	4
5250	Hip, ankylosis of5250	1
5251	Thigh, limitation of extension of5251	1
5252	Thigh, limitation of flexion of5252	4
5253	Thigh, impairment of5253	2
5254	Hip, flail joint5254	1
5255	Femur, impairment of5255	2
5256	Knee, ankylosis of5256	4
5257	Knee, other impairment of5257	3
5258	Cartilage, semilunar, dislocated, with frequent episodes of “locking,” pain, and effusion into the joint5258	1
5259	Cartilage, semilunar, removal of, symptomatic5259	1
5260	Leg, limitation of flexion of5260	4
5261	Leg, limitation of extension of5261	6
5262	Tibia and fibula, impairment of5262	5
5263	Genu recurvatum (acquired, traumatic, with weakness and insecurity in weight-bearing objectively demonstrated)5263	1
5269	Plantar fasciitis5269	3
5270	Ankle, ankylosis of5270	3
5271	Ankle, limited motion of5271	2
5272	Subastragalar or tarsal joint, ankylosis of5272	2
5273	Os calcis or astragalus, malunion of5273	formula
5274	Astragalectomy5274	1
5275	Bones, of the lower extremity, shortening of5275	4
5276	Flatfoot, acquired5276	2
5277	Weak foot, bilateral5277	1
5278	Claw foot (pes cavus), acquired5278	formula
5279	Metatarsalgia, anterior (Morton's disease), unilateral, or bilateral5279	1
5280	Hallux valgus, unilateral5280	1
5281	Hallux rigidus, unilateral, severe5281	formula
5282	Hammer toe5282	1
5283	Tarsal, or metatarsal bones, malunion of, or nonunion of5283	formula
5284	Foot injuries, other5284	formula
5296	Skull, loss of part of, both inner and outer tables5296	2
5298	Coccyx, removal of5298	2