- Initial CSC exam fee is $150 for AACN members and $240 for nonmembers.
- The exam is 90 questions (75 scored, 15 unscored) with a passing cut of 55 of 75 scored items.
- Renewal every 3 years costs $75-$130 via CERPs or $125-$170 via the renewal exam.
- Retesting after a failed attempt means paying the full initial fee again - there's no discounted retake rate.
CSC Exam Fee Breakdown
The Cardiac Surgery (Adult) (CSC) credential from AACN Certification Corporation has a straightforward two-tier pricing structure: $150 for current AACN members and $240 for nonmembers. That $90 gap is the single biggest lever candidates control when budgeting for this exam, and it's worth resolving before you schedule a testing appointment.
The fee covers one attempt at the 90-question closed-book exam, administered either at a PSI test center or via Live Remote Proctoring. Of those 90 questions, 75 are scored and 15 are unscored pretest items used to validate future exam content - you won't know which is which, so every question deserves full attention during the 2-hour testing window.
Because this is a specialty credential layered on top of an existing RN license, there's no bundled "package" pricing the way some multi-part certifications offer. You pay once for the exam attempt itself. For a full walkthrough of how the scoring cut connects to the question format, see CSC Passing Score 2026: Exactly What You Need to Pass.
AACN Membership vs. Nonmember Pricing
Because the member rate saves $90 on the initial exam and further reduces renewal costs, many candidates run the numbers before deciding whether to join AACN ahead of registering. If you already plan to pursue other AACN credentials or want ongoing access to critical-care resources, membership tends to pay for itself quickly given the exam and renewal discounts stack over your certification lifecycle.
If this is a one-time credential you don't plan to renew repeatedly, run a simple comparison: the nonmember exam fee ($240) versus the member fee ($150) plus whatever your membership costs. For most bedside cardiac surgery nurses who intend to keep the credential active through multiple 3-year cycles, membership pricing wins over time because it also lowers renewal fees, covered next.
Renewal Costs Every 3 Years
CSC certification is valid for 3 years, after which you must renew to keep the credential active. Renewal requires maintaining your qualifying RN/APRN license and base certification, plus documenting 432 first-48-hours postoperative adult cardiac-surgery practice hours during the 3-year cycle, including at least 144 hours in the most recent year.
On top of the practice-hour requirement, you choose one of two renewal paths:
- CERP route: Complete 25 relevant Category A Clinical Judgment CERPs. Renewal fee is $75 for members / $130 for nonmembers.
- Exam route: Retake the CSC exam instead of accumulating CERPs. Renewal fee is $125 for members / $170 for nonmembers.
Key Takeaway
The CERP renewal path is cheaper and avoids a second sit-down exam, but it requires ongoing continuing-education tracking throughout the 3-year cycle - start logging CERPs early rather than scrambling in year three.
Over a nursing career, these recurring fees add up more than the initial exam cost. Someone who renews via CERPs every cycle as a member pays $75 per renewal indefinitely, while a nonmember choosing the exam route pays $170 every 3 years. Factoring this into your long-term plan matters if you're evaluating whether the credential is worth maintaining - a question explored in depth in Is the CSC Certification Worth It? Complete ROI Analysis 2026.
Hidden and Indirect Costs
The published exam and renewal fees are only part of the real cost of earning CSC. A few indirect expenses catch candidates off guard:
- Retake fees: There is no discounted retest rate. If you don't pass, you pay the full $150/$240 fee again for another attempt. Reviewing the domain weighting and question style before your first sit reduces this risk considerably - see CSC Exam Domains 2026: Complete Guide to All 4 Content Areas.
- Prep materials: Textbooks, practice question banks, and structured review courses aren't included in the exam fee. Budgeting for quality prep resources upfront is almost always cheaper than paying for a second attempt.
- Time away from unit hours: Meeting eligibility requirements means logging substantial clinical hours in the first-48-hours postoperative population, which can mean seeking out specific unit assignments if your current role doesn't naturally provide that exposure.
- Documentation and audit prep: You'll need to identify a clinical supervisor or RN/physician colleague who can verify your practice hours if your application is audited. Keeping organized records avoids delays that can push back your testing window.
For a realistic sense of how challenging the exam content itself is - which directly affects how much you'll spend on prep and potential retakes - read How Hard Is the CSC Exam? Complete Difficulty Guide 2026.
What the Fee Actually Covers
It helps to understand exactly what content your exam fee is buying access to. CSC tests four domains, currently weighted as follows through November 18, 2026:
Domain 1: Procedures (11%)
Covers the surgical and perioperative procedural knowledge relevant to the first 48 hours after adult cardiac surgery.
- Smallest current domain by weight, but still tested every exam administration
Domain 2: Complications (33%)
Focuses on recognizing and managing the complications that arise in the immediate postoperative window.
- Combined with Therapeutic Interventions, accounts for 76% of the current exam
Domain 3: Therapeutic Interventions (43%)
The largest domain by a wide margin - mastery here has the biggest impact on your score.
- Deserves the most study hours per point of exam weight
Domain 4: Monitoring and Diagnostics (13%)
Covers hemodynamic monitoring, lab interpretation, and diagnostic data specific to postoperative cardiac surgery patients.
- Smaller weight, but frequently intersects with Complications questions
Eligibility Routes and Their Cost Trade-Offs
Before you even pay the exam fee, you need to meet eligibility: an unencumbered U.S. RN/APRN license and a current nationally accredited clinical nursing specialty certification. From there, AACN offers two practice-hour pathways, and which one you qualify under can affect how much time (and indirect cost) you invest before testing.
| Requirement | Two-Year Route | Five-Year Route |
|---|---|---|
| Total qualifying hours | 1,750 hours | 2,000 hours |
| Hours in most recent year | 875 hours | 144 hours |
| Hours specific to first-48-hours postop cardiac surgery | 875 hours | 1,000 hours |
| Best fit for | Nurses currently working heavily in cardiac surgery recovery | Nurses building specialty hours over a longer career stretch |
Neither route carries an additional application fee beyond the exam cost itself, but the route you're on affects how quickly you can realistically sit for the exam - and therefore how soon you start incurring renewal costs down the line. Full eligibility mechanics are broken down in CSC Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Budgeting Your Prep Timeline
Once you've paid the exam fee, the smartest way to protect that investment is to allocate study time in proportion to domain weight rather than spreading effort evenly across all four areas.
Therapeutic Interventions
- Spend the most hours here since it's 43% of the exam - the single highest-leverage domain for your fee
Complications
- Build recognition and management scenarios; this domain plus Therapeutic Interventions covers 76% of scored questions
Monitoring and Diagnostics
- Review hemodynamic data interpretation tied to the postoperative population
Procedures + Timed Review
- Cover the smallest domain, then run full-length timed practice sets under the 2-hour limit
This weighted approach is far more cost-efficient than treating all four domains equally, since a passing score of 55 of 75 scored questions is most reliably reached by locking down the two domains that make up three-quarters of the exam first. For a complete study system built around this exact structure, see CSC Study Guide 2026: How to Pass on Your First Attempt. Running realistic practice questions on the CSC practice test platform before your test date is one of the more affordable ways to reduce your risk of paying for a retake.
Key Takeaway
Every dollar spent on quality practice questions ahead of test day is cheaper than the $150-$240 cost of a second attempt - treat prep spending as retake insurance.
Frequently Asked Questions
The initial exam fee is $150 for AACN members and $240 for nonmembers. This covers one attempt at the 90-question closed-book exam administered at a PSI test center or via Live Remote Proctoring.
No. If you don't pass on your first attempt, you pay the full initial exam fee again to retest. There is no reduced retake rate, which is why thorough preparation before your first attempt matters financially, not just academically.
Renewal fees are $75 for members / $130 for nonmembers if you choose the CERP route (25 Category A Clinical Judgment CERPs), or $125 for members / $170 for nonmembers if you choose to retake the renewal exam instead.
Yes. Members pay $150 versus $240 for nonmembers on the initial exam, and members also pay lower fees on both renewal paths every 3-year cycle. Over multiple renewal cycles, membership pricing typically produces meaningful savings.
The published fees don't include prep materials, practice exams, or the time investment required to accumulate qualifying practice hours. Candidates should also budget for potential retake costs if they don't pass on the first attempt.