Minnesota Rule 5223.0370
Minnesota cervical spine PPD rating
Rule 5223.0370 rates permanent cervical impairment under one category of subpart 2 (fractures), 3 (cervical pain syndrome), or 4 (radicular syndromes), with once-only add-ons under items 4.D and 4.E and fusion add-ons under subpart 5. Items 4.E(2) and 4.E(3) were rewritten for dates of injury on or after August 9, 2010, so a fusion after that date stacks with the surgery add-on instead of replacing it.
Rule text from the Minnesota Revisor of Statutes, retrieved 2026-08-02.
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.
How the rule decides
Each group below is a set of alternatives: the facts select at most one category from each group. Add-ons attach to their base category as the rule directs and are added, not statutorily combined.
Choose one: cervical primary
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a); and Greatest loss of vertebral height, as a percent of 10 percent or less.
R. 5223.0370, subp. 2.A(1)
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a); and Greatest loss of vertebral height, as a percent above 10 percent; and Greatest loss of vertebral height, as a percent of 25 percent or less.
R. 5223.0370, subp. 2.A(2)
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a); and Greatest loss of vertebral height, as a percent above 25 percent; and Greatest loss of vertebral height, as a percent of 50 percent or less.
R. 5223.0370, subp. 2.A(3)
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a); and Greatest loss of vertebral height, as a percent above 50 percent.
R. 5223.0370, subp. 2.A(4)
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: posterior element fracture with dislocation (item b); and not: whether surgery was performed for the fracture; and Whether normal reduction was achieved.
R. 5223.0370, subp. 2.B(1)
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: posterior element fracture with dislocation (item b); and Whether surgery was performed for the fracture; and Whether normal reduction was achieved.
R. 5223.0370, subp. 2.B(2)
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: posterior element fracture with dislocation (item b); and not: whether surgery was performed for the fracture; and not: whether normal reduction was achieved.
R. 5223.0370, subp. 2.B(3)
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: posterior element fracture with dislocation (item b); and Whether surgery was performed for the fracture; and not: whether normal reduction was achieved.
R. 5223.0370, subp. 2.B(4)
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: other documented acute fracture (item c).
R. 5223.0370, subp. 2.C
Requires: Which cervical spine category family fits the condition: cervical spine pain syndrome (subpart 3); and not: persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings).
R. 5223.0370, subp. 3.A
Requires: Which cervical spine category family fits the condition: cervical spine pain syndrome (subpart 3); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: no radiographic abnormality.
R. 5223.0370, subp. 3.B
Requires: Which cervical spine category family fits the condition: cervical spine pain syndrome (subpart 3); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and Number of vertebral levels with the imaging abnormality is 1.
R. 5223.0370, subp. 3.C(1)
Requires: Which cervical spine category family fits the condition: cervical spine pain syndrome (subpart 3); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and Number of vertebral levels with the imaging abnormality of 2 or more.
R. 5223.0370, subp. 3.C(2)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and not: persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings).
R. 5223.0370, subp. 4.A
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: no radiographic abnormality.
R. 5223.0370, subp. 4.B
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and Number of vertebral levels with the imaging abnormality is 1; and not: a surgery other than a fusion was performed as part of the treatment.
R. 5223.0370, subp. 4.C(1)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and Number of vertebral levels with the imaging abnormality of 2 or more; and not: a surgery other than a fusion was performed as part of the treatment.
R. 5223.0370, subp. 4.C(2)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and A surgery other than a fusion was performed as part of the treatment; and Number of levels operated on (non-fusion surgery) is 1.
R. 5223.0370, subp. 4.C(3)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and A surgery other than a fusion was performed as part of the treatment; and Number of levels operated on (non-fusion surgery) of 2 or more.
R. 5223.0370, subp. 4.C(4)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a cervical nerve root, correlated with the exam.
R. 5223.0370, subp. 4.D
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam.
R. 5223.0370, subp. 4.E
Add-ons
Requires: Which cervical spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a) or posterior element fracture with dislocation (item b) or other documented acute fracture (item c); and Whether more than one vertebral level was fractured.
R. 5223.0370, subp. 2.D
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a cervical nerve root, correlated with the exam; and Chronic radicular pain or paresthesia persisting despite treatment.
R. 5223.0370, subp. 4.D(1)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a cervical nerve root, correlated with the exam; and A surgery other than a fusion was performed as part of the treatment; and not: a fusion was performed as part or all of the surgical treatment.
R. 5223.0370, subp. 4.D(2)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a cervical nerve root, correlated with the exam; and A surgery other than a fusion was performed as part of the treatment; and One or more additional surgeries, other than a fusion, after the first; and not: a fusion was performed as part or all of the surgical treatment.
R. 5223.0370, subp. 4.D(3)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a cervical nerve root, correlated with the exam; and An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level).
R. 5223.0370, subp. 4.D(4)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam; and Chronic radicular pain or paresthesia persisting despite treatment.
R. 5223.0370, subp. 4.E(1)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam; and An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level).
R. 5223.0370, subp. 4.E(4)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam; and A surgery other than a fusion was performed as part of the treatment; and not: a fusion was performed as part or all of the surgical treatment.
R. 5223.0370, subp. 4.E(2) (dates of injury on or before 2010-08-08)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam; and A surgery other than a fusion was performed as part of the treatment; and One or more additional surgeries, other than a fusion, after the first; and not: a fusion was performed as part or all of the surgical treatment.
R. 5223.0370, subp. 4.E(3) (dates of injury on or before 2010-08-08)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam; and either A surgery other than a fusion was performed as part of the treatment, or A fusion was performed as part or all of the surgical treatment.
R. 5223.0370, subp. 4.E(2) (dates of injury on or after 2010-08-09)
Requires: Which cervical spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam; and either A surgery other than a fusion was performed as part of the treatment, or A fusion was performed as part or all of the surgical treatment; and One or more additional surgeries of any type after the first (post-2010 item 4.E(3)).
R. 5223.0370, subp. 4.E(3) (dates of injury on or after 2010-08-09)
Requires: Which cervical spine category family fits the condition: cervical spine pain syndrome (subpart 3) or radicular syndrome (subpart 4); and A fusion was performed as part or all of the surgical treatment; and Number of levels fused is 1.
R. 5223.0370, subp. 5.A
Requires: Which cervical spine category family fits the condition: cervical spine pain syndrome (subpart 3) or radicular syndrome (subpart 4); and A fusion was performed as part or all of the surgical treatment; and Number of levels fused of 2 or more.
R. 5223.0370, subp. 5.B
What the records must show
These are the facts the rule turns on. If one is unknown, the affected categories stay open questions with the document that would settle them; an unknown never counts as a no.
Proof: MRI report; CT scan report; x-ray report; myelogram report; clinic note documenting persistent findings; MMI report; IME report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: operative report
Proof: MRI report; CT scan report; x-ray report; myelogram report; operative report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: clinic note documenting persistent findings; MMI report; IME report; EMG report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: operative report
Proof: operative report
Proof: operative report
Proof: operative report
Proof: clinic note documenting persistent findings; MMI report; IME report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: operative report
Proof: operative report
Worked examples with receipts
Each example runs through the same engine the calculator uses. The category total, the components, and the citations are computed, not typed in.
Single-level ACDF for correlated stenosis, injury after August 9, 2010
whole-body total
Date of injury 2015-06-01
- Which cervical spine category family fits the condition: radicular syndrome (subpart 4)
- Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings): yes
- What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam
- A fusion was performed as part or all of the surgical treatment: yes
- Number of levels fused: 1
- A surgery other than a fusion was performed as part of the treatment: no
- One or more additional surgeries of any type after the first (post-2010 item 4.E(3)): no
- Chronic radicular pain or paresthesia persisting despite treatment: no
- An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level): no
- Cervical Radiculopathy E: Spinal Stenosis with Correlating Radicular or Myelopathic Findings: 17.5%
- Whole-body total: 17.5%
The same single-level ACDF with an injury before the 2010 amendment
whole-body total
Date of injury 2009-06-01
- Which cervical spine category family fits the condition: radicular syndrome (subpart 4)
- Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings): yes
- What imaging shows, at its most severe: spinal stenosis impinging a cervical nerve root or the spinal cord, correlated with the exam
- A fusion was performed as part or all of the surgical treatment: yes
- Number of levels fused: 1
- A surgery other than a fusion was performed as part of the treatment: no
- One or more additional surgeries, other than a fusion, after the first: no
- Chronic radicular pain or paresthesia persisting despite treatment: no
- An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level): no
- Cervical Radiculopathy E: Spinal Stenosis with Correlating Radicular or Myelopathic Findings: 12.5%
- Whole-body total: 12.5%
Two-level compression fracture with 30 percent height loss
whole-body total
Date of injury 2024-01-01
- Which cervical spine category family fits the condition: fracture (subpart 2)
- Type of vertebral fracture: compression fracture (item a)
- Greatest loss of vertebral height, as a percent: 30
- Whether more than one vertebral level was fractured: yes
- Cervical Compression Fracture: >25-50% Height Loss: 17%
- Whole-body total: 17%
Full 4.D ladder: base plus every subitem, no fusion
whole-body total
Date of injury 2024-01-01
- Which cervical spine category family fits the condition: radicular syndrome (subpart 4)
- Persistent objective clinical findings in the cervical spine (involuntary muscle tightness, or for radicular categories, objective radicular findings): yes
- What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a cervical nerve root, correlated with the exam
- Chronic radicular pain or paresthesia persisting despite treatment: yes
- A surgery other than a fusion was performed as part of the treatment: yes
- One or more additional surgeries, other than a fusion, after the first: yes
- An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level): yes
- A fusion was performed as part or all of the surgical treatment: no
- Cervical Radiculopathy D: Disc Herniation with Correlating Radicular Findings: 25%
- Whole-body total: 25%
Common questions
Why does the date of injury change the cervical surgery add-on?
Items 4.E(2) and 4.E(3) were rewritten effective August 9, 2010. Before that date the add-on covered only non-fusion surgery and a fusion was rated under subpart 5 instead. On or after that date the first surgery counts regardless of type and a fusion also adds the subpart 5 rating.
Is there a cervical spondylolisthesis category?
No. Unlike the lumbar rule (5223.0390, subp. 3.D), the cervical rule has no spondylolisthesis category. A cervical condition with imaging abnormality rates under 3.C or the radicular categories that fit the findings.
Interpretive notes
- Known simplification held over from the audited ppd-v2 model: the single fact medical.objectiveFindings stands in for both "persistent objective clinical findings confined to the region" (items B and C) and "objective radicular findings" (items D and E). Splitting these is an attorney-review decision; the graph flags it rather than changing audited rating behavior.
What to do next
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