Hip Condition

Hip conditions are rated under 38 CFR § 4.71a using the hip and thigh codes, DCs 5250 through 5255, plus the arthritis codes and, after a prosthesis, DC 5054.

The musculoskeletal schedule was substantially rewritten effective February 7, 2021, and DC 5054 was one of the codes changed. A law firm page ranking on the first page for this condition still states that the 100 percent runs for one year following a hip replacement. Under the current code it runs four months. That page is not unusual; superseded criteria are the dominant pattern across the results for this search.

TL;DR

• Hip ratings are driven by measured range of motion, not by pain reports or imaging alone.
• DC 5252, limitation of flexion of the thigh, is the common route: 10, 20, 30, and 40 percent.
• DC 5253 has three separate criteria measuring abduction, adduction, and rotation.
• DC 5251, limitation of extension, has one level, 10 percent.
• Ankylosis under DC 5250 reaches 60, 70, or 90 percent. The 90 percent level carries special monthly compensation.
• DC 5254, hip flail joint, is a flat 80 percent.
• DC 5255, femur impairment, reaches 60 and 80 percent for nonunion and false joint. Its malunion criterion no longer has its own tiers.
• DC 5054 gives 100 percent for four months after implantation, then 90, 70, 50, or a 30 percent minimum.
• Resurfacing has no minimum evaluation. Total replacement does.
• Normal hip flexion is 125 degrees and normal abduction is 45 degrees.

How Hips Get Rated

The hip is rated by what it can measurably do. A C&P examiner measures flexion, extension, abduction, adduction, and rotation with a goniometer, and the recorded degrees drive the percentage.

DC 5252, limitation of flexion of the thigh. This is the workhorse code.

• Flexion limited to 10 degrees: 40 percent
• Flexion limited to 20 degrees: 30 percent
• Flexion limited to 30 degrees: 20 percent
• Flexion limited to 45 degrees: 10 percent

Normal hip flexion is 125 degrees. The thresholds are severe, which is why so many hip claims produce 10 percent or a noncompensable evaluation even when the veteran has real functional loss.

DC 5251, limitation of extension of the thigh. One level only: extension limited to 5 degrees is 10 percent.

DC 5253, impairment of the thigh. Three separate criteria:

• Limitation of abduction, motion lost beyond 10 degrees: 20 percent
• Limitation of adduction, cannot cross legs: 10 percent
• Limitation of rotation, cannot toe-out more than 15 degrees on the affected leg: 10 percent

These are distinct findings, and the examiner has to measure each one. A veteran who cannot cross their legs has a specific, checkable criterion available. This code is also the source of a common confusion: if none of the three criteria is met, the result is a 0 percent evaluation for thigh impairment, which is an assigned rating rather than a denial of service connection.

DC 5250, ankylosis of the hip. Ankylosis means the joint is fused.

• Unfavorable, extremely unfavorable ankylosis, the foot not reaching ground, crutches necessitated: 90 percent, and the schedule footnotes this level as entitled to special monthly compensation
• Intermediate: 70 percent
• Favorable, in flexion at an angle between 20 and 40 degrees, and slight adduction or abduction: 60 percent

DC 5254, hip flail joint. A flat 80 percent.

DC 5255, impairment of the femur. Fracture of the shaft or anatomical neck with nonunion and loose motion is 80 percent. Nonunion without loose motion, weight bearing preserved with a brace, is 60 percent. Fracture of the surgical neck with a false joint is 60 percent. For malunion, the current code instructs: evaluate under DCs 5256, 5257, 5260, or 5261 for the knee, or 5250 through 5254 for the hip, whichever results in the highest evaluation. The separate slight, moderate, and marked malunion tiers that older sources describe are gone.

Arthritis in the Hip

DC 5003, degenerative arthritis other than post-traumatic. Arthritis established by X-ray is rated on limitation of motion under the codes for the joint involved. Where limitation of motion is noncompensable under those codes, 10 percent applies for each major joint affected by limitation of motion, and the limitation must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. The hip is a major joint.

In the absence of limitation of motion, DC 5003 provides 20 percent for X-ray evidence involving two or more major joints with occasional incapacitating exacerbations, and 10 percent for two or more major joints without them. Note (1) is important: those X-ray-based ratings do not combine with ratings based on limitation of motion.

DC 5010, post-traumatic arthritis. Rated as limitation of motion, dislocation, or other specified instability under the affected joint. Where two or more joints are affected, each rating is combined under 38 CFR § 4.25.

Hip Replacement and Resurfacing Under DC 5054

This is where the published guidance is most often out of date.

The current DC 5054, titled "Hip, resurfacing or replacement (prosthesis)," assigns:

• 100 percent for four months following implantation of prosthesis or resurfacing.
• 90 percent where prosthetic replacement of the head of the femur or of the acetabulum is followed by painful motion or weakness such as to require the use of crutches. This level carries special monthly compensation.
• 70 percent for markedly severe residual weakness, pain, or limitation of motion following implantation.
• 50 percent for moderately severe residuals of weakness, pain, or limitation of motion.
• 30 percent as the minimum evaluation, total replacement only.

Two current provisions do not appear on the pages ranking for this condition.

First, the temporary total period is four months. It was one year before the February 7, 2021 revision, which is why older sources say otherwise. If your surgery predates the change, check which version applied at the time.

Second, the note attached to DC 5054 reads: "At the conclusion of the 100 percent evaluation period, evaluate resurfacing under diagnostic codes 5250 through 5255; there is no minimum evaluation for resurfacing." Total hip replacement keeps the 30 percent floor. Hip resurfacing does not. A veteran who had resurfacing rather than a total replacement returns to the ordinary motion-based codes with no protective minimum, and can end up noncompensable.

That distinction is worth confirming in your operative report before you assume a 30 percent floor applies.

Functional Loss Beyond the Goniometer

Measured motion is the starting point, not the whole analysis.

38 CFR § 4.59 directs that painful motion be entitled to at least the minimum compensable rating for the joint. Sections 4.40 and 4.45 require VA to consider functional loss from pain, weakness, fatigability, and incoordination, including additional loss during flare-ups and after repeated use.

That is why the examination matters more than the diagnosis. Ask that the examiner measure motion after repetitive use, and describe flare-ups specifically: how often, how long, what you cannot do during one, and how the joint behaves afterward. An examination that records a single best-effort measurement on a good day understates a hip that fails under load.

Bilateral Hips and Combined Ratings

If both hips are service connected, 38 CFR § 4.26 applies the bilateral factor. VA combines the ratings for the paired extremities under § 4.25, adds 10 percent of that combined value, and then combines the result with any other ratings. This is a real increase and it is applied automatically, but it is worth checking on the rating code sheet that it was applied.

The Differential That Decides Hip Claims

Hip pain and lumbar radiculopathy overlap. Lumbar nerve root compression refers pain into the hip and groin, and it is rated under the peripheral nerve codes, not the hip codes.

Imaging of the hip joint itself is what separates them. A claim for hip pain supported only by lumbar imaging invites a finding that the pain originates in the spine, which is a different rating under a different code. Distinguish hip joint pathology from trochanteric bursitis and sacroiliac joint dysfunction as well.

On bursitis specifically: DC 5019 exists, but 38 CFR § 4.14 prohibits rating the same disability under multiple diagnoses. Trochanteric bursitis can be separately rated where the disability picture is genuinely distinct from the hip joint rating, and cannot where it is the same functional loss under a second name.

Service Connection

Direct. Running, rucking, jumping, parachute landings, and sustained heavy load bearing damage the hip joint over time. Under 38 CFR § 3.303, this needs in-service hip complaints in the record, a current hip diagnosis on imaging, and a nexus opinion. Airborne, infantry, and heavy equipment specialties have the strongest factual basis.

Secondary. Altered gait from a service-connected knee, ankle, or foot condition places compensatory stress on the hip. Under 38 CFR § 3.310, a nexus opinion addressing gait biomechanics specifically is the strongest evidence. Section 3.310(b) also supports aggravation of a hip condition that is not service connected. VA's claims manual, M21-1 V.ii.2.D (changed May 1, 2026 to follow Spicer v. McDonough), asks whether the increase would not have happened, or the hip condition would be less severe, but for the service-connected knee, ankle, or foot condition, including when it got in the way of treatment. VA no longer considers natural progress in these claims, even though the text of § 3.310(b) still mentions it, and the worsening does not have to be permanent. VA still needs a baseline and rates the difference between the baseline and the current severity; an increase too small to change the rating level is granted at 0 percent.

Common Failure Modes

• Relying on the pre-2021 one-year temporary total period for a replacement.
• Assuming a 30 percent minimum after resurfacing, which has none.
• Filing on pain alone without measured range of motion in the record.
• Accepting an examination that never tested motion after repetitive use.
• Not describing flare-ups in the terms § 4.45 asks about.
• Claiming hip pain that imaging attributes to the lumbar spine.
• Missing that DC 5253 has three separate criteria, only one of which may have been measured.
• Not checking whether the bilateral factor was applied when both hips are rated.
• Combining DC 5003 X-ray ratings with limitation-of-motion ratings, which Note (1) prohibits.

Bottom Line

Hip ratings come down to measured degrees, and the thresholds are demanding. DC 5252 flexion is the usual route, DC 5253's three criteria are frequently under-measured, and DC 5255 now cross-references rather than assigning its own malunion tiers. After a prosthesis, DC 5054 governs, and the two facts most sources get wrong are the length of the temporary total period, four months, and the absence of any minimum evaluation for resurfacing. Build the examination record around function under load, not a single measurement on a good day.

Related Conditions and Tools

Compare knee, back, ankle, and arthritis, and rule out radiculopathy and sciatica as the true source of groin and hip pain. Review DC 5252 and DC 5003, and prepare for the range-of-motion examination with the C&P Exam Prep tool and the Symptom Tracker.

Legal sources: 38 CFR § 4.71a, § 4.14, § 4.25, § 4.26, § 4.40, § 4.45, § 4.59, § 3.303, and § 3.310, checked against the eCFR snapshot for August 14, 2026. Secondary aggravation guidance from M21-1 V.ii.2.D (change date May 1, 2026), checked September 24, 2026.