Knee Replacement VA Rating: DC 5055 and 38 CFR 4.71a Guide

Complete knee replacement VA rating table (DC 5055 and analogous codes)

The table below lists every rating percentage and regulatory criterion for knee replacement and resurfacing under 38 CFR 4.71a (DC 5055 and referenced DCs 5256, 5261, and 5262) and 38 CFR 4.30.

Under the VA compensation schedule effective 2025-12-01, a veteran alone receives $552.47 per month at 30%, $795.84 at 40%, $1,132.90 at 50%, $1,435.02 at 60%, and $3,938.58 during the temporary 100% period.

The 2021 rule change: 4 months vs. 1 year at 100% after surgery

Veterans researching a claim often see conflicting statements about whether Diagnostic Code 5055 pays a 100% temporary rating for one year or four months. That change took effect on February 7, 2021, under 85 FR 76453:

• Before February 7, 2021: DC 5055 granted a 100% temporary rating for 1 year following implantation of a knee prosthesis (after the initial 1-month convalescent period under 38 CFR 4.30).
• On and after February 7, 2021 (current law): The VA amended DC 5055 and DC 5054 (hip replacement) to 4 months at 100% following implantation of the prosthesis or resurfacing.

Under 38 CFR 4.71a, Note (4) retains the 1-year period for shoulder (DC 5051), elbow (DC 5052), wrist (DC 5053), and ankle (DC 5056) replacements, whereas Note (5) governs hip and knee procedures: the 4-month 100% rating under DCs 5054 and 5055 commences after the initial 1-month total rating under 38 CFR 4.30 following hospital discharge, yielding five total months of 100% compensation after the month of surgical discharge.

Total knee replacement vs. partial replacement and resurfacing

Two rules in 38 CFR 4.71a separate total knee replacement from partial replacement or resurfacing:

• Note (3) to DCs 5051–5056: “The term ‘prosthetic replacement’ in diagnostic codes 5051–5053 and 5055–5056 means a total replacement of the named joint.”
• Note to DC 5055: “At the conclusion of the 100 percent evaluation period, evaluate resurfacing under diagnostic codes 5256 through 5262; there is no minimum evaluation for resurfacing.”

Under 38 CFR 4.71a (DC 5055 and Note (3)) and 85 FR 76453, surgeries are rated as follows:

• Total knee replacement (total knee arthroplasty): Receives the 100% temporary rating (1 month under § 4.30 + 4 months under DC 5055) and a mandatory 30% minimum permanent evaluation, or 40%, 50%, or 60% if chronic residuals meet higher criteria.
• Knee resurfacing: Receives the 100% temporary rating for 4 months under DC 5055 (after the 1-month § 4.30 period), but carries no 30% minimum rating. Afterward, resurfacing is rated under DCs 5256–5262 on actual functional impairment (including 0%, 10%, or 20%).
• Partial knee replacement (unicompartmental knee arthroplasty): Because Note (3) requires a total joint replacement, a partial replacement does not receive the 30% minimum under DC 5055. Recovery is evaluated for 1 to 3 months of temporary 100% convalescence under 38 CFR 4.30, and permanent residuals are rated under DCs 5256–5262 and 38 CFR 4.59.

How permanent residuals are rated: 30%, 40%, 50%, and 60% criteria

When the temporary 100% period ends—or when a veteran files a claim for an earlier total knee replacement—the VA evaluates permanent residuals under Diagnostic Code 5055:

• 30% minimum rating (total replacement only): The mandatory floor for any service-connected total knee replacement, even when post-operative motion is smooth and pain-free.
• 40% and 50% intermediate ratings by analogy (DCs 5256, 5261, and 5262): DC 5055 instructs raters: “With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to diagnostic codes 5256, 5261, or 5262.” (DC 5260 flexion is omitted because it caps at 30%). You qualify for 40% or 50% when your exam documents:
  • Limitation of extension (DC 5261): Extension limited to 30 degrees warrants 40%; extension limited to 45 degrees warrants 50%.
  • Ankylosis of the knee (DC 5256): Complete joint fixation in flexion between 10° and 20° warrants 40%; between 20° and 45° warrants 50% (45° or more warrants 60%).
  • Tibia and fibula impairment (DC 5262): Nonunion of the tibia and fibula with loose motion, requiring a brace, warrants 40%.
• 60% rating for severe painful motion or weakness: Awarded when a total knee replacement leaves “chronic residuals consisting of severe painful motion or weakness in the affected extremity.” The regulation sets no specific strength grade, atrophy measurement, or assistive-device threshold; raters decide whether the evidence shows severe painful motion or weakness, applying 38 CFR 4.40 and 4.45 on functional loss.

Revision knee replacement rules (Note 2) and anti-pyramiding (Note 1)

Two introductory notes to Diagnostic Codes 5051–5056 in 38 CFR 4.71a control separate ratings and surgical revisions:

• Note (1) — No additional § 4.71a ratings on the same knee: When a knee is rated under DC 5055, an additional musculoskeletal rating under 38 CFR 4.71a (such as DC 5260 flexion, DC 5261 extension, or DC 5257 instability) cannot be stacked on that same knee. Separate ratings outside § 4.71a remain available, including 10% to 30% for a painful or unstable surgical scar under 38 CFR 4.118, Diagnostic Code 7804, or a separate rating for peripheral nerve damage (saphenous, peroneal, or tibial neuropathy) under 38 CFR 4.124a.
• Note (2) — Revision total knee arthroplasty: A revision surgery is evaluated like an original replacement under DC 5055 only if all original components are replaced, triggering a new 1-month § 4.30 + 4-month DC 5055 temporary 100% rating. A partial revision (such as an isolated liner exchange) does not trigger DC 5055, though it may qualify for a 1- to 3-month convalescent rating under 38 CFR 4.30 when requiring at least one month of convalescence or leaving severe postoperative residuals.

Proving service connection and what the Knee DBQ measures

To qualify for a knee replacement VA rating under DC 5055, the underlying knee condition must be service connected via one of three routes:

1. Progression of an already service-connected knee disability: If you already hold a rating for knee pain, meniscus tears, instability, or arthritis, submitting your operative report and hospital discharge summary establishes entitlement to the temporary 100% rating and the 30%–60% DC 5055 evaluation.
2. Direct service connection (38 CFR 3.303): Requires an in-service knee injury or documented symptoms, post-service progression to osteoarthritis requiring arthroplasty, and a medical nexus opinion.
3. Secondary service connection (38 CFR 3.310): If a service-connected disability in your opposite knee, hip, ankle, foot, or spine caused an altered gait that caused or aggravated the osteoarthritis requiring total knee replacement, a medical nexus opinion can establish secondary entitlement.

During a C&P examination, the clinician completes the Knee and Lower Leg Conditions Disability Benefits Questionnaire:

• Section 9 (Surgical Procedures): Records Total Knee Joint Replacement or Knee Joint Resurfacing (9A), surgery date, and checkboxes for DC 5055 “chronic residuals consisting of severe painful motion or weakness” (60%), intermediate degrees of residual weakness, pain, or limitation of motion, or no residuals.
• Section 3 (Range of Motion and Functional Limitation): Uses a goniometer to measure active and passive flexion (140° normal) and extension (0° normal), testing whether extension is limited to 30° (40%) or 45° (50%), plus repetitive-use (3B), repeated-use (3C), flare-up (3D), and additional disability factors (3E, including weakened movement).
• Section 4 (Muscle Atrophy): Records whether muscle atrophy is attributable to the claimed knee condition (4A–4B) and measures limb circumference in centimeters (4C, normal side vs. atrophied side at maximum muscle bulk) to document atrophy.
• Sections 10 & 11 (Scars and Assistive Devices): Section 10 (10B) records whether surgical scars or skin disfigurement are present and directs the examiner to complete the dermatological questionnaire for evaluation under DC 7804, while Section 11 (11A–11B, along with Section 6 Items 6D and 6G) documents prescribed or regularly used braces, canes, crutches, walkers, or wheelchairs.

Stop moving your knee when pain begins during goniometer testing, and explain how weakness, swelling, or stiffness limits weight-bearing.

Secondary conditions, bilateral factor, and accredited help

Under 38 CFR 3.310, a service-connected knee replacement may cause or aggravate secondary conditions when supported by a medical nexus opinion:

• Opposite knee osteoarthritis or replacement: Shifting weight off a prosthetic knee places extra load on the opposite leg, which may cause or accelerate contralateral knee arthritis.
• Hip, ankle, and lumbar spine conditions: Altered gait mechanics or limb-length changes after arthroplasty may cause or aggravate secondary hip arthritis, ankle strain, or lumbar spine degenerative disc disease.
• Painful surgical scars (DC 7804) and saphenous neuropathy (DC 8527): Incisional nerve damage or painful anterior knee scarring may warrant separate ratings.
• Depressive or anxiety disorders (38 CFR 4.130): Chronic post-surgical pain and reduced mobility may cause or aggravate secondary mental health conditions.

Multiple ratings combine under 38 CFR 4.25, which you can calculate with our VA combined rating calculator. When compensable disabilities affect both lower extremities—such as a bilateral total knee replacement, or a replaced knee on one leg and a service-connected knee, hip, or ankle condition on the other—38 CFR 4.26 adds a 10% bilateral factor. Two 30% ratings combine to 51%, plus a 5.1% bilateral factor for 56.1%, rounding to 60% ($1,435.02 per month for a veteran alone); a 60% and 30% bilateral combination totals 79.2%, rounding to 80% ($2,102.15 per month).

Veterans Service Organizations (VSOs) such as the DAV, VFW, and American Legion provide claim representation free of charge, while VA-accredited claims agents and attorneys handle appeals. No representative can promise an outcome; verify credentials through the VA Office of General Counsel Accreditation Search.