Steps to become a surgical tech
Becoming a surgical tech takes five steps, from a high school diploma through an accredited program, the CST exam and any state registration to renewal every two years.[ooh_surg][nbstsa_elig] The order matters, because the exam is open only to graduates of accredited programs.
- Finish high school or a GED. Surgical technology programs are postsecondary, and BLS lists a postsecondary nondegree award (a certificate or diploma) as the typical entry-level education.[ooh_surg]
- Complete an accredited surgical technology program. To be eligible for the CST you must graduate from a program accredited by CAAHEP or ABHES.[nbstsa_elig] The ARC/STSA, the review committee that works with CAAHEP, recognizes about 400 programs in surgical technology and surgical assisting combined.[arcstsa] What an accredited program must include, from the associate degree rule to the 120-case rotation, is on surgical tech programs.
- Pass the CST exam. The exam has 175 multiple-choice questions, 150 of them scored, and a 4-hour limit; a score of 98 on the scored questions passes.[nbstsa_cert]
- Meet your state's rules and get hired. Some states regulate the job (see the table below); elsewhere, the employer decides whether certification is required.
- Renew every two years. CSTs renew on a 2-year cycle with 30 continuing education credits, 4 of them live, for a $40 fee, or by retaking the exam for $540.[nbstsa_renew]
CST exam cost and rules
The CST exam costs $340 for first-time candidates and $230 for members of the Association of Surgical Technologists (AST), and both prices include a $100 non-refundable processing fee.[nbstsa_faq] Retakes cost $300, and you can sit the exam up to three times in a calendar year; a discounted $160 rate exists for military students.[nbstsa_app]
| Item | Amount or rule |
|---|---|
| First-time exam, non-member | $340 (includes $100 non-refundable processing) |
| First-time exam, AST member | $230 |
| Military student rate | $160 |
| Retake | $300; up to 3 attempts per calendar year |
| Exam format | 175 questions (150 scored), 4 hours, pass = 98 scored correct |
| Renewal | Every 2 years: 30 CE credits (4 live) and $40, or re-exam for $540 |
From January 5, 2027, CSTs will log continuing education in their NBSTSA account instead of through AST.[nbstsa_renew]
Surgical technologist requirements by state
Surgical technologist requirements depend on the state, and where the law is silent the employer sets the standard.[tx_259][va_st][wa_st] Three examples show the range:
| State | Rule | Law |
|---|---|---|
| Texas | Licensed health care facilities may not employ a person to practice surgical technology unless the person completed an accredited program and holds national certification (with listed exceptions) | Health & Safety Code §259.002 |
| Virginia | Only people certified by the Board of Medicine may use the title "surgical technologist" | Code of Virginia §54.1-2956.12 |
| Washington | No one may represent themselves as a surgical technologist without registering with the Department of Health | RCW 18.215 |
Because these laws change, check your state's statute or health department before you enroll, and ask local hospitals whether they hire only CSTs.
Surgical tech school cost and payback
Surgical tech school cost is the program's tuition, fees, books and uniforms plus the $340 exam.[nbstsa_faq] Program prices vary widely between community colleges and private schools, so take the published cost of attendance from each program you consider and run it through the calculator. It adds tuition, the pay you give up while in clinicals and any loan interest, then divides by the after-tax raise a surgical tech job brings. The default salary is the national 25th percentile, $54,690, a cautious first-year figure.[onet_surg]
Enter your program's published cost and length. Defaults are an example, not a quote.
School payback · 2026 tax on the raise
2.6 years after graduation
Break-even about 47 months after the first class · 10-year gain after costs $134,404
| Tuition, fees, books, exams | $15,000 |
|---|---|
| Pay given up while in school | $30,000 |
| Loan interest | $2,910 |
| Total cost | $47,910 |
| Raise after tax, per year | $18,231 |
| Loan payment | $91/mo (2.0% of gross) |
After-tax share of the raise: 80.3% (single filer, federal + FICA). Nominal dollars, no discounting.
Estimate, not a pay offer. Arithmetic on your inputs. Raise is taxed with 2026 federal income tax and FICA for a single filer.
Federal Direct loans for undergraduates first disbursed between July 1, 2026 and June 30, 2027 carry a 6.52% fixed rate, the calculator's default.[fsa]
What surgical techs earn
Surgical techs earn $64,650 at the national median, from $45,940 at the 10th percentile to $96,940 at the 90th (BLS, May 2025), across 117,460 jobs.[onet_surg][oews_api] BLS projects 5% employment growth for surgical assistants and technologists combined from 2025 to 2035, faster than the average for all occupations.[ooh_surg] State and metro pay are on surgical tech salary, California's detail is on surgical tech salary in California, and other short health programs are compared on the allied health salary overview.
Common mistakes
- Enrolling in an unaccredited program. NBSTSA eligibility requires CAAHEP or ABHES accreditation; check the accreditor's listing, not just the school's website.[nbstsa_elig]
- Forgetting the processing fee is non-refundable. $100 of the exam price is kept if you cancel.[nbstsa_faq]
- Letting the credential lapse. Renewal by continuing education costs $40; recertifying by exam costs $540.[nbstsa_renew]
Frequently asked questions
How much does the CST exam cost?
$340 for first-time candidates, or $230 for AST members. Retakes cost $300.
Do you need certification to be a surgical tech?
It depends on the state and employer. Texas requires national certification for employment in licensed facilities, Virginia limits the title to Board-certified people, and Washington requires registration to use the title.
What education do surgical techs need?
A postsecondary surgical technology program; BLS lists a certificate-level award as typical. To sit for the CST, the program must be CAAHEP- or ABHES-accredited.
How much does surgical tech school cost?
It varies by school. Add tuition, fees, books, uniforms and the $340 CST exam, then use the payback calculator to see how long it takes to earn back.
Sources
- Occupational Outlook Handbook: Surgical Assistants and Technologists
- CST Eligibility
- CST and CSFA FAQs (exam price $340; AST members $230; $100 processing fee)
- CST Application Process (retake fee, attempts per year, military rate)
- CST Certification (exam format and passing score)
- CST and CSFA Renewals and Recertification
- Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA)
- Health and Safety Code chapter 259, Surgical Technologists at Health Care Facilities (§259.002)
- Code of Virginia §54.1-2956.12, Surgical technologists; certification
- RCW 18.215, Surgical technologists (registration)
- Local Wages: 29-2055.00 Surgical Technologists (state and metro percentiles)
- OEWS national employment and wage series, May 2025 (BLS Public Data API, series OEUN0000000000000
01 and 13) - Interest Rates for Federal Direct Loans First Disbursed Between July 1, 2026 and June 30, 2027 (undergraduate 6.52%)