The Certified Surgical Technologist credential is issued by the National Board of Surgical Technology and Surgical Assisting (NBSTSA), which describes it as the leading national credential for surgical technologists, preferred or required by many employers and required by many states. This guide covers eligibility, the exam, what it costs, and how renewal actually works. Verify current figures with NBSTSA before you write a check; fees and policy move.
Item |
Current figure |
|---|---|
Issuing body |
NBSTSA (AST handles continuing education policy) |
Exam length |
175 questions: 150 scored, 25 unscored pretest items |
Scored content split |
97 perioperative care, 23 ancillary duties, 30 basic science |
First-time pass rate |
68.6% (2025); 71.8% (2024); 69.1% (2023); 70.0% (2022) |
Exam fee |
$230 AST members / $340 non-members |
Renewal cycle |
30 CE credits every two years, including 4 live credits |
Renewal fee |
$40, plus a $100 late fee inside the allowed late period |
Renewal by exam |
$440 AST members / $540 non-members |
175 multiple-choice questions, 150 of them scored, 25 unscored pretest items distributed throughout. Content is built from job-analysis data collected from practicing surgical technologists nationwide, across three domains: perioperative care, ancillary duties, and basic science.
The weighting is the useful part. Perioperative care carries 97 of the 150 scored questions, which is 65 percent of your score. Basic science carries 30 and ancillary duties 23. Candidates who fail typically over-studied instrumentation and under-studied workflow, because instrumentation is what they touched every day in clinicals and workflow is what they watched someone else run.
The exam reaches further than most candidates expect: pre-op preparation, intra-op procedure, post-op responsibility, sterilization and maintenance, anatomy and physiology, microbiology, and pharmacology. Test close to graduation, while the coursework is still loaded.
First-time pass rates have sat between roughly 69 and 72 percent in recent years, with 68.6 percent the most recent published figure. That is not a gate designed to fail you, and it is not a formality either. Roughly three in ten first-time takers do not clear it.
The candidates who pass study against the official content outline rather than against their program's final exam. If you graduated from a solid program, know your perioperative workflow cold, and work the NBSTSA reference list, you are positioned. Cramming does not work on a test built from a job analysis.
Content outline, sample questions, and the recommended reference list. This is the first document every candidate should open and the one most skip. It tells you the weighting.
NBSTSA publishes the exam breakdown so you know which subject areas appear and how heavily each is weighted. Allocate study time to match the weighting, not to match what you find interesting.
Official online practice examinations plus a mobile study app with more than 300 questions. Use these to find your weak domain, then go back to the texts for that domain rather than reviewing everything evenly.
The current handbook references Alexander's Care of the Patient in Surgery, Surgical Technology: Principles and Practice, Surgical Technology for the Surgical Technologist: A Positive Care Approach, Pharmacology for the Surgical Technologist, and Surgical Instrumentation: An Interactive Approach.
AST states that CST professionals must earn 30 continuing education credits every two years, including 4 live credits, before the cycle expires. Once AST approves the credits, you file the renewal application with NBSTSA and pay the $40 renewal fee.
Miss the window and there is a $100 late fee inside the allowed late period. Miss the CE requirement entirely and renewal may require sitting the exam again. Renewal by examination is available at $440 for AST members and $540 for non-members, which is roughly eleven times the cost of renewing on CE credits. Track the credits. It is not close.
NBSTSA's published data shows a 68.6% national first-time pass rate in 2025, 71.8% in 2024, 69.1% in 2023, and 70.0% in 2022. Describing it as roughly 70 percent is fair, but the most current published figure is 68.6%.
$230 for AST members and $340 for non-members, per the current NBSTSA candidate handbook. The application processing fee is non-refundable once processed, so confirm your eligibility documentation is in order before you submit.
By CE, for nearly everyone working. It costs $40 against $440 for members renewing by exam, and it does not put your credential at risk on a single test day. Renewal by exam exists for people who let the CE cycle lapse, not as a shortcut around it.
Yes, and the state requirement is the wrong thing to optimize against. Employers and credentialing departments set the real bar, and many require it regardless of state law. A credential you can carry across state lines is also worth more than one calibrated to the market you happen to live in today. Check your state requirements, then check what local hospitals actually post.
Yes. NBSTSA explicitly recognizes completion of a military surgical technology training program as an eligibility pathway with the required documentation, and applicants stationed overseas may in certain circumstances test through a base education office. It is one of the cleanest credential translations available to service members moving into civilian healthcare. See the military certification pathway.