Introduction · CST Exam Prep
About the CST Exam
Everything you need to know about the NBSTSA Certified Surgical Technologist® examination — structure, content, eligibility, and fees — straight from the official Candidate Handbook.
What Is the CST Exam?
The Certified Surgical Technologist (CST®) exam is administered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA) and is the nationally recognized gold-standard credential for surgical technology professionals in the United States.
Passing the CST exam demonstrates that you have acquired both the theoretical knowledge and practical competence required for safe, entry-level surgical technology practice. The NBSTSA’s certification program is accredited by the National Commission for Certifying Agencies (NCCA), the gold standard for professional certification accreditation.
The Exam at a Glance
175
Total Questions
150
Scored Questions
25
Unscored Pretest Items
4 hrs
Time Limit
✅ Passing Score
Candidates must correctly answer at least 102 out of 150 scored questions to pass. The 25 pretest items are unscored and randomly distributed throughout the exam — you will not know which questions they are.
Note: The passing score is set by the NBSTSA Board of Directors following a rigorous standard-setting process conducted by subject matter experts. Always verify the current passing score at nbstsa.org before your exam date.
Exam Content Distribution (Official 2025 Blueprint)
The CST exam is organized into three major domains. This is what Coy Academy’s course is built around — every module maps directly to these content areas.
Domain I — Perioperative Care
97 items · 64.7% of exam
| Subdomain | Items |
|---|---|
| A. Preoperative Preparation | 19 |
| B. Intraoperative Procedures | 68 |
| C. Postoperative Procedures | 10 |
Domain II — Ancillary Duties
23 items · 15.3% of exam
| Subdomain | Items |
|---|---|
| A. Administrative and Personnel | 7 |
| B. Equipment Sterilization and Maintenance | 16 |
Domain III — Basic Science
30 items · 20.0% of exam
| Subdomain | Items |
|---|---|
| A. Anatomy and Physiology | 18 |
| B. Microbiology | 6 |
| C. Surgical Pharmacology | 6 |
Eligibility Requirements
To sit for the CST exam, you must meet one of the following eligibility criteria. The NBSTSA has sole authority over eligibility determinations.
Military Surgical Technology Program Graduate
Completion of a formal military surgical technology training program. Documentation required: DD-214 or Joint Services Transcript, which must state the base location where the program was completed.
Current or Previously Certified CST
Individuals who currently hold or previously held a valid CST credential are eligible to test. This pathway is commonly used for recertification by examination.
⚠️ Important: The NBSTSA eliminated the work-experience-only (“alternate pathway”) eligibility route in 2021. A formal education credential from an accredited program or qualifying military training is now required.
Official NBSTSA Exam Fees
⚠️ Fee Disclaimer — Please Read
NBSTSA exam fees are paid directly to the NBSTSA and are completely separate from your Coy Academy course fee. Enrolling in this course does not register you for the exam. Fees are non-refundable once your application is processed and an Authorization to Test (ATT) is issued.
Fees verified from the official 2025 NBSTSA CST Candidate Handbook (V4). A non-refundable application processing fee of $60 is included within the amounts above. Always confirm current fees at nbstsa.org before submitting your application, as fees are subject to change.
💡 Pro Tip: Becoming an AST (Association of Surgical Technologists) member before applying saves you $110 on the initial exam fee and provides additional discounts on renewal and CE credits. If you plan to maintain your certification long-term, AST membership typically pays for itself.
Key Exam Policies to Know
Retesting
Candidates who do not pass may retest up to 3 times per calendar year. There is no mandatory waiting period. Each attempt requires a new application and full payment of fees.
Authorization to Test (ATT)
Once your application is approved, you will receive an ATT email. You must schedule and complete your exam within 6 months of receiving your ATT. Examinations are offered year-round at PSI testing centers nationwide (Mon–Sat by appointment).
Identification Requirements
Two forms of current ID are required on exam day (one must include a current photograph). The name on both forms of ID must match your ATT exactly. Failure to present proper ID results in forfeiture of all exam fees.
Recertification
The CST credential must be renewed every 2 years by submitting 30 CE credits (including 4 live credits) through AST, or by retaking and passing the exam. Renewal fee: $40. Late renewal (within 90 days of expiration): $140 total.
NBSTSA-Referenced Study Resources
The following texts are used by the NBSTSA Exam Review Committee to develop CST exam questions. Study from the most current editions available.
Alexander’s Care of the Patient in Surgery, 17th Ed. — Jane C. Rothrock (2022)
Surgical Technology: Principles and Practice, 8th Ed. — Joanna Kotcher (2021)
Surgical Technology for the Surgical Technologist: A Positive Care Approach, 5th Ed. — Kevin Frey / AST (2018)
Principles of Anatomy and Physiology, 16th Ed. — Tortora & Derrickson (2020)
Pharmacology for the Surgical Technologist, 6th Ed. — Howe & Burton (2023)
Surgical Instrumentation: An Interactive Approach, 4th Ed. — Nemitz (2022)
📝 Knowledge Check
Select the best answer, then reveal the explanation.
Question 1: How many total questions are on the CST exam, and how many of those are scored?
A. 150 total; 125 scored
B. 175 total; 150 scored
C. 200 total; 175 scored
D. 175 total; 125 scored
Reveal Answer
✅ Correct Answer: B
The CST exam consists of 175 total multiple-choice questions. Of these, 150 are scored and 25 are unscored “pretest” items used in future exam development. Pretest items are randomly distributed — you will not know which questions are unscored.
Question 2: What is the NBSTSA exam fee for a non-AST member?
A. $99
B. $190
C. $230
D. $340
Reveal Answer
✅ Correct Answer: D
The current NBSTSA exam fee for non-members is $340. AST members pay $230. Remember: $99 is the Coy Academy course prep fee only — it is not paid to NBSTSA and does not register you for the exam. Always verify current fees at nbstsa.org before applying.
You’re Ready to Begin!
Now that you understand the exam structure, content distribution, and policies, proceed to the next lesson to begin building your domain-by-domain knowledge base.