The TS-C, Tech in Surgery-Certified, is the surgical technologist credential issued by the National Center for Competency Testing. Its real advantage is eligibility: where the CST funnels almost everyone through an accredited program, the TS-C opens routes for experienced techs, military-trained candidates, and instructors. The tradeoff is portability, and that is the part most candidates find out too late.
NCCT positions the surgical technologist as an allied health professional handling pre-op, intra-op, and post-op tasks: maintaining asepsis, anticipating the surgeon's needs, and supporting safe surgical care. The exam fee NCCT lists is $199. NCCT states its certification programs are accredited by the National Commission for Certifying Agencies (NCCA), and in a 2025 letter to employers it identifies two NCCA-accredited surgical technologist certifications currently in the U.S.: the CST through NBSTSA and the TS-C through NCCT.
This is the reason the credential exists. NCCT recognizes multiple routes to sit for the exam, each with its own documentation requirements.
Current student or graduate within the past five years of an NCCT-authorized high school Tech in Surgery program. After graduation you submit proof of completion plus a critical skills competency form.
Graduates of an NCCT-authorized postsecondary program within the past five years. The main education-based route, and the one most candidates use.
Three years of full-time employment or equivalent, 6,240 hours, as a Tech in Surgery within the past five years, under direct supervision of a licensed physician, surgeon, or RN circulator. Employer verification is required before you test.
Completed a Tech in Surgery program or equivalent during U.S. military service within the past five years, with supporting documentation such as a SMART transcript or DD214. See the military surgical tech certification guide.
Three years of current verifiable teaching experience in surgical technology at an NCCT-authorized organization within the last five years, plus three years of verifiable experience working as a surgical technologist.
NCCT's candidate handbook describes a computer-based, three-hour exam: 125 scored items plus 25 pretest items, mixing multiple-choice with multiple-select, hotspot, and drag-and-drop formats. Scores report on a 200 to 720 scale with the passing point scaled to 575. NCCT builds exams from test plans grounded in job analysis studies, refreshed every five years.
NCCT's published first-time pass-rate data separates candidates by how they qualified, and the spread is the most useful number on this page. In 2025 the experience route passed at 91.7%, the education route at 77.4%, and the high school route at 50.0%. The 2024 figures show the same pattern: 90.7% experience, 69.6% education, 37.8% high school.
Read that spread as a readiness signal, not a difficulty ranking. Experienced techs pass because they have scrubbed thousands of cases before they ever open a book, which is the same reason hiring managers value the experience-route TS-C without hesitation. The high school pass rate is the one to take seriously: if you are testing straight out of a secondary program, budget real study time and get clinical reps first. A failed attempt is a delay you do not need on a résumé that is already thin.
The distinction is eligibility, not prestige. NBSTSA states that only a surgical technologist certified by NBSTSA may use the CST title, and its handbook limits eligibility to current or previously certified CSTs, graduates of CAAHEP or ABHES accredited surgical technology programs, and graduates of military surgical technology training programs. NCCT's model is broader on purpose.
Qualify through an authorized education program, documented experience, military training, or instructor status. Exam runs 125 scored items plus 25 pretest. Fee is $199.
Tied to CAAHEP or ABHES accredited programs, prior CST status, or military training. No experience-only route. Exam runs 175 multiple-choice questions, 150 scored and 25 unscored pretest items.
Both are nationally accredited surgical technologist certifications according to NCCT's employer-facing letter. The full side-by-side lives in the CST vs. TS-C comparison.
There is no single national rule treating TS-C and CST identically. Surgical technologist regulation is state-specific, and in many markets the employer, not the state, sets the certification requirement. The Bureau of Labor Statistics notes that some states regulate surgical technologists while employers elsewhere require or prefer certification on their own.
Verify current law against your target state before you enroll or test. Start with the surgical tech state requirements page.
Tenet Healthcare lists certification as either CST through NBSTSA or TS-C through NCCT. Hospital Sisters Health System requires one of CST or TS-C. Trinity Health and Saint Alphonsus accept either. VCU Health has posted roles requiring CST, TS-C, or CORST within a defined window after hire. Plenty of postings still name CST alone, particularly in markets where that credential is entrenched or where internal policy simply has not been updated.
Yes. NCCT states its certification programs are accredited by the National Commission for Certifying Agencies, and its 2025 employer letter identifies the TS-C and the CST as the two NCCA-accredited surgical technologist certifications in the United States.
Yes, through the experience pathway. NCCT's handbook allows qualification with three years of full-time employment or equivalent, 6,240 hours, as a Tech in Surgery within the past five years, under direct supervision of a licensed physician, surgeon, or RN circulator, with employer verification required before testing. This route does not exist under the CST.
It depends entirely on where you work. If your local employers accept either credential, the TS-C supports hiring the same way the CST does. If you target a state or system whose language names CST specifically, the TS-C is less portable to that employer. Compare the credential against the actual states and hospitals you want, not against a national average.
NCCT lists the exam fee at $199. The exam is computer-based and runs three hours, with 125 scored items and 25 pretest items, including multiple-select, hotspot, and drag-and-drop question types alongside standard multiple choice.
NCCT reports scores on a 200 to 720 scale with the passing point scaled to 575. Scaled scoring means your raw number correct is not the number you see, and the pass point does not move with your cohort's performance.
NCCT's 2026 recertification guide shows TS-C certificants must complete 14 contact hours annually, higher than the 12 required for many other NCCT credentials. Recertification is yearly, not on a multi-year cycle, so build it into your schedule from the first year rather than scrambling at renewal.
The experience route, by a wide margin. NCCT's first-time pass-rate data shows the experience route at 91.7% in 2025 and 90.7% in 2024, against 77.4% and 69.6% for the education route. The high school route trails both, at 50.0% in 2025 and 37.8% in 2024.