{"disclaimer":"This is my working reading of Minnesota Rule chapter 5223. I keep checking it against the official rule text and published decisions. If a category, percent, or combination looks wrong, email hello@mncompbuddy.com and say what you found. A mismatch is a reason to look again, not a reason to treat this tool or a doctor rating as automatically correct.","manifest":{"part":"5223.0500","title":"Hip and upper leg permanency rule 5223.0500","status":"published","publishedOn":"2026-08-18","auditDocument":"docs/audits/ppd-rule-5223-0500-attack.md"},"graph":{"part":"5223.0500","slug":"hip","title":"Hip and upper leg","summary":"Rule 5223.0500 rates the hip and upper leg under exclusive categories (painful organic syndrome, the femoral/obturator/sciatic entrapment ladder, femoral shaft nonunion at 20 percent), combinable categories (leg length discrepancy bands up to 9 percent, arthroplasty at 8, the fracture group at 12/6/3/0), and loss of measured motion under subpart 4. Combinable categories also take a subpart 4 rating; distinct impairing conditions combine under 5223.0300, subpart 3, item E; and the whole part is capped at 40 percent, the amputation value for the leg at the hip.","generalAuthority":{"part":"5223.0500","path":"1","quote":"Subpart 1. General. For permanent partial impairment to the hip and upper leg, disability of the whole body is as provided in subparts 2 to 4. The percent of whole body disability under this part may not exceed the percent of whole body disability for amputation of the leg at the hip under part 5223.0550. Each mutually exclusive impairing condition must be rated separately and the ratings must be combined as described in part 5223.0300, subpart 3, item E. If an impairing condition is represented by a category designated as exclusive under subpart 2, it must be rated by that category only and that rating may not be combined with a rating under any other category of this part for that impairing condition. If an impairing condition is represented by a category designated as combinable under subpart 3, it must be rated under that category and under the appropriate categories describing loss of function under subpart 4. The ratings obtained must be combined as described in part 5223.0300, subpart 3, item E. If an impairing condition is not represented by a category designated either exclusive or combinable, it must be rated only under the appropriate categories describing loss of function under subpart 4.","textHash":"3d17b26c","url":"https://www.revisor.mn.gov/rules/5223.0500/"},"facts":[{"id":"medical.painfulOrganicSyndrome","label":"Painful organic syndrome (as defined at 5223.0310, subp. 40), substantiated by consistent, reproducible clinical or imaging findings, with persistent limitation of active motion or deviation of gait","type":"boolean","evidence":["exam notes","imaging reports"]},{"id":"medical.passiveRomLimited","label":"Passive range of motion of the hip is limited","type":"boolean","evidence":["exam notes with passive range of motion measurements"]},{"id":"medical.hipEntrapment","label":"Nerve entrapment syndrome of the femoral, obturator, or sciatic nerve at the pelvis, hip, or upper leg","type":"enum","options":[{"value":"none","label":"No entrapment syndrome claimed"},{"value":"resolved","label":"Resolved with treatment"},{"value":"persistent-no-emg","label":"Pain and paresthesia persist or recur despite treatment, not substantiated by electrodiagnostic testing"},{"value":"persistent-emg","label":"Pain and paresthesia persist despite treatment, substantiated by persistent findings on electrodiagnostic testing"},{"value":"motor-sensory-loss","label":"Objectively demonstrable motor or sensory loss (rated under the nerve tables, 5223.0420 and 5223.0430)"}],"evidence":["EMG/nerve conduction study","exam notes"]},{"id":"medical.femoralShaftNonunionOrthosis","label":"Nonunion of a femoral shaft fracture requiring a nonweight-bearing orthosis for ambulation","type":"boolean","evidence":["follow-up imaging describing nonunion","orthotic prescription"]},{"id":"medical.legLengthDiscrepancyCm","label":"Traumatic or surgical leg length discrepancy, in centimeters (0 means none; measurements are conventionally recorded to 0.1 centimeter)","type":"number","unit":"centimeters","evidence":["scanogram or standing x-ray leg length measurement"]},{"id":"surgical.hipArthroplasty","label":"Hip arthroplasty performed","type":"enum","options":[{"value":"none","label":"No arthroplasty"},{"value":"total","label":"Total hip arthroplasty"},{"value":"partial","label":"Partial (hemi) arthroplasty"}],"evidence":["operative report"]},{"id":"medical.hipFractureNonunion","label":"Nonunion of a hip fracture","type":"boolean","evidence":["follow-up imaging describing nonunion"]},{"id":"surgical.femoralEndoprosthesis","label":"A fracture required a femoral endoprosthesis","type":"boolean","evidence":["operative report"]},{"id":"surgical.hipPinning","label":"Hip pinning performed for a fracture","type":"boolean","evidence":["operative report"]},{"id":"medical.unratableFemurFractureOrDislocation","label":"Fracture or dislocation involving the femur not otherwise ratable under this part or 5223.0510","type":"boolean","evidence":["x-ray or CT report"]},{"id":"medical.acetabularFracture","label":"A fracture into the acetabulum (rated under 5223.0490, subp. 2.E as the higher of the hip motion loss or the pelvis categories)","type":"boolean","evidence":["x-ray or CT report"]},{"id":"medical.unlistedSoftTissueCondition","label":"A hip or upper leg soft tissue condition no category of subparts 2 or 3 represents (bursitis, labral tear, avascular necrosis), rated only on measured loss of motion under subpart 4","type":"boolean","evidence":["diagnosis records","range of motion measurements"]}],"nodes":[{"kind":"discrete","endpointId":"hip-painful-organic-syndrome","role":"base","exclusiveFamily":"hip-pain-syndrome","when":{"all":[{"fact":"medical.painfulOrganicSyndrome","op":"eq","value":true},{"fact":"medical.passiveRomLimited","op":"eq","value":false}]}},{"kind":"discrete","endpointId":"hip-nerve-entrapment-resolved","role":"base","exclusiveFamily":"hip-entrapment","when":{"fact":"medical.hipEntrapment","op":"eq","value":"resolved"}},{"kind":"discrete","endpointId":"hip-nerve-entrapment-symptoms-no-emg","role":"base","exclusiveFamily":"hip-entrapment","when":{"fact":"medical.hipEntrapment","op":"eq","value":"persistent-no-emg"}},{"kind":"discrete","endpointId":"hip-nerve-entrapment-persistent","role":"base","exclusiveFamily":"hip-entrapment","when":{"fact":"medical.hipEntrapment","op":"eq","value":"persistent-emg"}},{"kind":"discrete","endpointId":"hip-nonunion-femoral-shaft","role":"base","exclusiveFamily":"hip-femoral-shaft-nonunion","when":{"fact":"medical.femoralShaftNonunionOrthosis","op":"eq","value":true}},{"kind":"discrete","endpointId":"hip-leg-length-lt1cm","role":"base","exclusiveFamily":"hip-leg-length","when":{"all":[{"fact":"medical.legLengthDiscrepancyCm","op":"gte","value":0.1},{"fact":"medical.legLengthDiscrepancyCm","op":"lt","value":1}]}},{"kind":"discrete","endpointId":"hip-leg-length-1-1.9cm","role":"base","exclusiveFamily":"hip-leg-length","when":{"all":[{"fact":"medical.legLengthDiscrepancyCm","op":"gte","value":1},{"fact":"medical.legLengthDiscrepancyCm","op":"lte","value":1.9}]}},{"kind":"discrete","endpointId":"hip-leg-length-2-3.2cm","role":"base","exclusiveFamily":"hip-leg-length","when":{"all":[{"fact":"medical.legLengthDiscrepancyCm","op":"gte","value":2},{"fact":"medical.legLengthDiscrepancyCm","op":"lte","value":3.2}]}},{"kind":"discrete","endpointId":"hip-leg-length-3.3-4.4cm","role":"base","exclusiveFamily":"hip-leg-length","when":{"all":[{"fact":"medical.legLengthDiscrepancyCm","op":"gte","value":3.3},{"fact":"medical.legLengthDiscrepancyCm","op":"lte","value":4.4}]}},{"kind":"discrete","endpointId":"hip-leg-length-4.5plus","role":"base","exclusiveFamily":"hip-leg-length","when":{"fact":"medical.legLengthDiscrepancyCm","op":"gte","value":4.5}},{"kind":"discrete","endpointId":"hip-total-arthroplasty","role":"base","exclusiveFamily":"hip-prosthesis","when":{"fact":"surgical.hipArthroplasty","op":"eq","value":"total"}},{"kind":"discrete","endpointId":"hip-partial-arthroplasty","role":"base","exclusiveFamily":"hip-prosthesis","when":{"fact":"surgical.hipArthroplasty","op":"eq","value":"partial"}},{"kind":"discrete","endpointId":"hip-endoprosthesis","role":"base","exclusiveFamily":"hip-prosthesis","when":{"fact":"surgical.femoralEndoprosthesis","op":"eq","value":true}},{"kind":"discrete","endpointId":"hip-nonunion-fracture","role":"base","exclusiveFamily":"hip-fracture-nonunion","when":{"fact":"medical.hipFractureNonunion","op":"eq","value":true}},{"kind":"discrete","endpointId":"hip-pinning","role":"base","exclusiveFamily":"hip-fracture-fixation","when":{"fact":"surgical.hipPinning","op":"eq","value":true}},{"kind":"discrete","endpointId":"hip-other-0","role":"base","exclusiveFamily":"hip-fracture-other","when":{"fact":"medical.unratableFemurFractureOrDislocation","op":"eq","value":true}},{"kind":"discrete","endpointId":"hip-acetabulum-rom","role":"base","exclusiveFamily":"hip-acetabulum","when":{"fact":"medical.acetabularFracture","op":"eq","value":true}},{"kind":"discrete","endpointId":"hip-soft-tissue-rom","role":"base","exclusiveFamily":"hip-soft-tissue","when":{"any":[{"fact":"medical.unlistedSoftTissueCondition","op":"eq","value":true},{"all":[{"fact":"medical.painfulOrganicSyndrome","op":"eq","value":true},{"fact":"medical.passiveRomLimited","op":"eq","value":true}]}]}}],"extraEdges":[{"kind":"capBy","from":"5223.0500","to":"5223.0550","note":"Subp. 1: the whole-part total may not exceed the whole-body percent for amputation of the leg at the hip, 40 percent (R. 5223.0550, subp. 1.B)."},{"kind":"crossReference","from":"5223.0500","to":"5223.0420","note":"Subp. 2.B(4): entrapment with objectively demonstrable motor loss rates under the motor nerve table of 5223.0420 (femoral, obturator, sciatic rows)."},{"kind":"crossReference","from":"5223.0500","to":"5223.0430","note":"Subp. 2.B(4): entrapment with objectively demonstrable sensory loss rates under the sensory nerve table of 5223.0430, including the lateral femoral cutaneous nerve (meralgia paresthetica) at subp. 2.C."},{"kind":"crossReference","from":"5223.0500","to":"5223.0490","note":"A fracture into the acetabulum rates under 5223.0490, subp. 2.E as the higher of the hip motion loss under subpart 4 of this part or the pelvis categories; the two may not be added or combined."},{"kind":"crossReference","from":"5223.0500","to":"5223.0510","note":"Subp. 3.C(4) excludes femur fractures ratable under the knee part (distal femur fractures rate there)."}],"examples":[{"id":"hip-tha","label":"Total hip arthroplasty, category alone (audit S1 before the motion rating)","dateOfInjury":"2024-01-01","facts":{"surgical.hipArthroplasty":"total"},"expectedTotalPercent":8},{"id":"hip-shaft-nonunion","label":"Femoral shaft nonunion requiring a nonweight-bearing orthosis","dateOfInjury":"2024-01-01","facts":{"medical.femoralShaftNonunionOrthosis":true},"expectedTotalPercent":20},{"id":"hip-tha-plus-leg-length","label":"Total arthroplasty (8) combined with a 2.5 centimeter leg length discrepancy (4.5), distinct conditions","dateOfInjury":"2024-01-01","facts":{"surgical.hipArthroplasty":"total","medical.legLengthDiscrepancyCm":2.5},"expectedTotalPercent":12.14},{"id":"hip-entrapment-emg","label":"Sciatic entrapment persisting despite treatment, substantiated by electrodiagnostic testing","dateOfInjury":"2024-01-01","facts":{"medical.hipEntrapment":"persistent-emg"},"expectedTotalPercent":2},{"id":"hip-bellecourt","label":"Nonunion of a hip fracture (12) combined with arthroplasty (8), the Bellecourt v. Norcraft pattern","dateOfInjury":"2024-01-01","facts":{"medical.hipFractureNonunion":true,"surgical.hipArthroplasty":"total"},"expectedTotalPercent":19.04}],"faq":[{"question":"What does a total hip replacement rate?","answer":"Eight percent under subpart 3.B, plus the measured loss of motion under subpart 4, combined. The arthroplasty category is combinable, so a rating without the motion measurement is a floor, not a total."},{"question":"Does a partial (hemi) arthroplasty rate less than a total?","answer":"No. Subpart 3.B pays eight percent for arthroplasty without distinguishing total from partial. A partial arthroplasty later converted to a total is one impairing condition and rates once."},{"question":"A fracture failed to heal and then required a hip replacement. One rating or two?","answer":"Two, combined. In Bellecourt v. Norcraft Cos., Inc., No. WC10-5112 (W.C.C.A. Sept. 29, 2010), the court held that nonunion of a hip fracture (subpart 3.C(1), twelve percent) and arthroplasty (subpart 3.B, eight percent) may both be awarded for the same hip. Combined under the statutory formula, that is 19.04 percent before any motion rating."},{"question":"How is a fracture into the hip socket rated?","answer":"A fracture into the acetabulum is rated under the pelvis rule (5223.0490, subp. 2.E): once on the measured hip motion loss under subpart 4 of this part, and once under the pelvis categories. The final rating is the higher of the two, which may not be added or combined."},{"question":"What about a labral tear or avascular necrosis?","answer":"Neither has a listed category. Both are rated only on the measured loss of hip motion under subpart 4, per the final paragraph of subpart 1. This tool reports the zero percent gateway plus the motion rating rather than inventing a category percent."},{"question":"How high can a hip rating go?","answer":"Subpart 1 caps the whole part at the amputation value for the leg at the hip: 40 percent (R. 5223.0550, subp. 1.B). Categories and motion ratings that combine past that number are reduced to it."}],"notes":["Subpart 4 (loss of function) is delegated to the ROM module, including the flexion, extension, abduction, adduction, and rotation arcs.","Subpart 3 categories representing distinct impairing conditions combine: Bellecourt v. Norcraft Cos., Inc., No. WC10-5112 (W.C.C.A. Sept. 29, 2010), allowed both fracture nonunion (3.C(1)) and arthroplasty (3.B) for the same hip. The prosthesis categories (3.B and the 3.C(2) endoprosthesis) describe one replacement and rate once.","The leg length bands leave measurement gaps (for example 1.95 centimeters falls between 1.9 and 2.0); clinical measurements are conventionally recorded to 0.1 centimeter, and the graph reports no match rather than rounding.","The entrapment ladder is one condition regardless of which of the three named nerves is involved; objectively demonstrable motor or sensory loss moves the rating to the nerve tables (2.B(4)), where meralgia paresthetica belongs to the lateral femoral cutaneous nerve row of 5223.0430."],"schemaVersion":"1.0.0","snapshotRetrievedOn":"2026-08-02","authorityByEndpoint":{"hip-painful-organic-syndrome":[{"part":"5223.0500","path":"2.A","quote":"A. Painful organic syndrome, as defined in part 5223.0310, subpart 40, not elsewhere specified and substantiated by appropriate, consistent, and reproducible clinical or medical imaging findings which results in persistent limitation of active range of motion or persistent deviation of gait but no limitation of passive range of motion, zero percent.","textHash":"72175df2","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-nerve-entrapment-resolved":[{"part":"5223.0500","path":"2.B.1","quote":"(1) resolved with treatment, zero percent;","textHash":"30c38a0f","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-nerve-entrapment-symptoms-no-emg":[{"part":"5223.0500","path":"2.B.2","quote":"(2) pain and paresthesia recurring or persisting despite treatment, but not substantiated by persistent findings on electrodiagnostic testing, zero percent;","textHash":"e043a58d","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-nerve-entrapment-persistent":[{"part":"5223.0500","path":"2.B.3","quote":"(3) pain and paresthesia persisting despite treatment, or recurring and persisting despite treatment and substantiated by persistent findings on electrodiagnostic testing, two percent;","textHash":"fc38b176","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-nonunion-femoral-shaft":[{"part":"5223.0500","path":"2.C","quote":"C. Nonunion of femoral shaft fracture requiring nonweight bearing orthosis for ambulation, 20 percent.","textHash":"9c559cdb","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-leg-length-lt1cm":[{"part":"5223.0500","path":"3.A.1","quote":"(1) less than 1.0 centimeters, zero percent;","textHash":"fa9189a9","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-leg-length-1-1.9cm":[{"part":"5223.0500","path":"3.A.2","quote":"(2) 1.0 centimeters to 1.9 centimeters, three percent;","textHash":"fabc5a22","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-leg-length-2-3.2cm":[{"part":"5223.0500","path":"3.A.3","quote":"(3) 2.0 centimeters to 3.2 centimeters, 4.5 percent;","textHash":"63f95b02","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-leg-length-3.3-4.4cm":[{"part":"5223.0500","path":"3.A.4","quote":"(4) 3.3 centimeters to 4.4 centimeters, six percent;","textHash":"703f9a31","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-leg-length-4.5plus":[{"part":"5223.0500","path":"3.A.5","quote":"(5) 4.5 centimeters and greater, nine percent.","textHash":"75d9d2ad","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-total-arthroplasty":[{"part":"5223.0500","path":"3.B","quote":"B. Arthroplasty, eight percent.","textHash":"4bf147b0","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-partial-arthroplasty":[{"part":"5223.0500","path":"3.B","quote":"B. Arthroplasty, eight percent.","textHash":"4bf147b0","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-endoprosthesis":[{"part":"5223.0500","path":"3.C.2","quote":"(2) fracture requiring femoral endoprosthesis, six percent;","textHash":"786363e0","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-nonunion-fracture":[{"part":"5223.0500","path":"3.C.1","quote":"(1) nonunion of hip fracture, 12 percent;","textHash":"d9b6ddfe","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-pinning":[{"part":"5223.0500","path":"3.C.3","quote":"(3) hip pinning for fracture, three percent;","textHash":"f12e5f84","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-other-0":[{"part":"5223.0500","path":"3.C.4","quote":"(4) fracture or dislocation involving the femur not otherwise ratable under subpart 2 or 3 or part 5223.0510, zero percent.","textHash":"ba3885c8","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-acetabulum-rom":[{"part":"5223.0500","path":"1","quote":"Subpart 1. General. For permanent partial impairment to the hip and upper leg, disability of the whole body is as provided in subparts 2 to 4. The percent of whole body disability under this part may not exceed the percent of whole body disability for amputation of the leg at the hip under part 5223.0550. Each mutually exclusive impairing condition must be rated separately and the ratings must be combined as described in part 5223.0300, subpart 3, item E. If an impairing condition is represented by a category designated as exclusive under subpart 2, it must be rated by that category only and that rating may not be combined with a rating under any other category of this part for that impairing condition. If an impairing condition is represented by a category designated as combinable under subpart 3, it must be rated under that category and under the appropriate categories describing loss of function under subpart 4. The ratings obtained must be combined as described in part 5223.0300, subpart 3, item E. If an impairing condition is not represented by a category designated either exclusive or combinable, it must be rated only under the appropriate categories describing loss of function under subpart 4.","textHash":"3d17b26c","url":"https://www.revisor.mn.gov/rules/5223.0500/"}],"hip-soft-tissue-rom":[{"part":"5223.0500","path":"1","quote":"Subpart 1. General. For permanent partial impairment to the hip and upper leg, disability of the whole body is as provided in subparts 2 to 4. The percent of whole body disability under this part may not exceed the percent of whole body disability for amputation of the leg at the hip under part 5223.0550. Each mutually exclusive impairing condition must be rated separately and the ratings must be combined as described in part 5223.0300, subpart 3, item E. If an impairing condition is represented by a category designated as exclusive under subpart 2, it must be rated by that category only and that rating may not be combined with a rating under any other category of this part for that impairing condition. If an impairing condition is represented by a category designated as combinable under subpart 3, it must be rated under that category and under the appropriate categories describing loss of function under subpart 4. The ratings obtained must be combined as described in part 5223.0300, subpart 3, item E. If an impairing condition is not represented by a category designated either exclusive or combinable, it must be rated only under the appropriate categories describing loss of function under subpart 4.","textHash":"3d17b26c","url":"https://www.revisor.mn.gov/rules/5223.0500/"}]},"edges":[{"kind":"crossReference","from":"hip-painful-organic-syndrome","to":"5223.0310:40","note":"Term defined at Minn. R. 5223.0310, subp. 40."},{"kind":"lesserIncluded","from":"hip-partial-arthroplasty","to":"hip-total-arthroplasty"},{"kind":"lesserIncluded","from":"hip-endoprosthesis","to":"hip-total-arthroplasty"},{"kind":"crossReference","from":"hip-other-0","to":"5223.0510"},{"kind":"crossReference","from":"hip-acetabulum-rom","to":"5223.0550"},{"kind":"crossReference","from":"hip-acetabulum-rom","to":"5223.0300"},{"kind":"crossReference","from":"hip-soft-tissue-rom","to":"5223.0550"},{"kind":"crossReference","from":"hip-soft-tissue-rom","to":"5223.0300"},{"kind":"capBy","from":"5223.0500","to":"5223.0550","note":"Subp. 1: the whole-part total may not exceed the whole-body percent for amputation of the leg at the hip, 40 percent (R. 5223.0550, subp. 1.B)."},{"kind":"crossReference","from":"5223.0500","to":"5223.0420","note":"Subp. 2.B(4): entrapment with objectively demonstrable motor loss rates under the motor nerve table of 5223.0420 (femoral, obturator, sciatic rows)."},{"kind":"crossReference","from":"5223.0500","to":"5223.0430","note":"Subp. 2.B(4): entrapment with objectively demonstrable sensory loss rates under the sensory nerve table of 5223.0430, including the lateral femoral cutaneous nerve (meralgia paresthetica) at subp. 2.C."},{"kind":"crossReference","from":"5223.0500","to":"5223.0490","note":"A fracture into the acetabulum rates under 5223.0490, subp. 2.E as the higher of the hip motion loss under subpart 4 of this part or the pelvis categories; the two may not be added or combined."},{"kind":"crossReference","from":"5223.0500","to":"5223.0510","note":"Subp. 3.C(4) excludes femur fractures ratable under the knee part (distal femur fractures rate there)."}]}}