Astragalectomy VA Disability Rating
Diagnostic Code 5274 · 38 CFR §4.71a
What Is It?
Astragalectomy is the surgical removal of the talus bone, which sits between the ankle bones and the heel bone. The talus is critical for transferring weight from the leg to the foot. Removal is typically a last resort after severe fractures, avascular necrosis where the bone lost its blood supply, or infection. Without the talus, the ankle and foot mechanics are fundamentally altered, and the foot sits lower than normal. Veterans who undergo this procedure usually had severe traumatic injuries to the ankle or foot during service.
Rating Criteria
| Rating | Criteria |
|---|---|
| 20% | Astragalectomy — removal of the talus bone. This is the only rating level under this code. |
Evidence Needed
- Surgical records documenting the talus removal
- Post-operative imaging confirming the bone is absent
- Functional assessment of ankle and foot mechanics after the procedure
- Records of any assistive devices or orthotic footwear needed
- Statements describing limitations in walking and standing
C&P Exam Tips
- Bring your surgical records confirming the talus was removed
- Describe how the loss of the bone affects your walking stability
- Report your maximum standing and walking tolerance
- Mention any special shoes or braces you require
- Describe any pain in surrounding joints that have taken on additional stress
How to File
File under DC 5274 with surgical records and post-operative evidence. Since this code caps at 20 percent, also evaluate whether the resulting ankle or foot dysfunction qualifies for additional ratings under other diagnostic codes.
Common Mistakes
Filing only under this code when the altered mechanics have caused additional ratable conditions Not documenting the functional impact on adjacent joints Failing to claim secondary conditions that develop from the altered biomechanics Not pursuing special monthly compensation if the foot becomes functionally useless
Frequently Asked Questions
Is astragalectomy still performed today?
It is uncommon in modern orthopedics as ankle fusion and ankle replacement have become preferred alternatives. However, veterans who had this procedure during an earlier era of service or in emergency combat situations may still carry this diagnosis.
Can I get a higher rating than 20 percent for my ankle after this surgery?
While DC 5274 is capped at 20 percent, if the surgery resulted in ankle ankylosis or other distinct conditions, those may be ratable under separate codes. Consult with a veterans service organization about the best coding strategy.