As of February 11, 2026, Certified Surgical Services Manager (CSSM) is now Certified Surgical Services Leader (CSSL)!
Certified Surgical Services Leader
As of February 11, 2026, Certified Surgical Services Manager (CSSM) is now Certified Surgical Services Leader (CSSL)
The Certified Surgical Services Leader (CSSL) certification is the only perioperative management credential for perioperative leaders, managers, directors, and nurses who oversee personnel, a budget, business unit, or service line. CSSL certification validates the achievement of the baccalaureate-prepared nurse who demonstrates current proficiency in a perioperative management role. Earning the CSSL is a mark of distinction and recognizes the important role managers play in delivering safe patient care.
Important Notice
SYSTEM UPDATE: Our testing partner, PSI will no longer support Windows 10 or macOS Ventura for online testing after October 14, 2025. Test takers must update their systems in advance to avoid disruptions during their exam sessions.
CSSL Certification
Exam Overview
As of February 11, 2026, Certified Surgical Services Manager (CSSM) is now Certified Surgical Services Leader (CSSL)
3hr. 30min.
To complete the exam
180
Multiple choice questions
COMPUTER-BASED EXAM
Results are pass or no pass
CSSL Certification
Subject Areas
Professionalism
10%
Communication & Relationship Management
18%
Leadership
15%
Strategic Management
12%
Operational Management
18%
Financial Management
15%
Human Resource Management
12%
CSSL Requirements:
Check Your CSSL Eligibility
CSSL Certification
Application Process
Four steps from application to exam day.
Apply
Confirm eligibility and submit your application through your CCI account.
Approval
Receive approval and your 12-month eligibility period begins.
Schedule
Book your exam at any time. You must test within 90 days of approval. For additional testing information, please refer to the CSSL Handbook.
Get Certified
Take your exam and receive your result. Upon successful completion, you will earn your CSSL credential, valid for 3 years.
CSSL Testing Model
Continuous Testing & Retakes
CCI now uses a continuous testing model and no longer utilizes fixed exam windows.
The first exam attempt is included with the application fee and must be completed within 90 days of application approval.
Retakes can be purchased through your CCI account and can be scheduled for 30 days after your last exam, as many times as necessary within the 12-month eligibility period.
TESTING OVERVIEW
Continuous Testing Model
- Scheduling your exam is no longer tied to fixed testing windows
- 12-month eligibility period begins from date of application approval
- First exam attempt is included with the application fee
EXAM RETAKES
Streamlined Retake Process
- Purchase and schedule retakes directly through your CCI account
- No new application required within your 12-month eligibility period
- Retake as many times as needed within the eligibility window
Candidates are strongly encouraged to review eligibility requirements and prepare to test within the initial 90-day window to maximize their testing opportunity.
A percentage of applications will be randomly selected for audit. If you are selected, you will be notified upon submission of your application. Applicants chosen for audit will be required to electronically submit copies of specific documentation, as outlined in the candidate handbook.
For additional How To Videos regarding your CCI account, applications, payment and other information related to your certification, view our YouTube playlist.
CSSL Application Fee
The first exam attempt is included with the application fee. If you need to retake, you can purchase directly through your CCI account. Each retake attempt requires payment of its own fee.
For more information on Continuous Testing, Retakes, and the associated fees, please see the CSSL Handbook.
CCI offers volume discounts for health systems and hospitals seeking to certify multiple nurses through its Facility Purchasing Program.
Administrators can access the facility portal to purchase vouchers, assign them to eligible candidates, and manage bulk registrations.
Application Fee
$425
Includes first exam attempt which must be scheduled and taken within 90 days of application.
AND
$175
Retake Fee
Available within your 12-month eligibility period. Minimum 30 days between attempts.
$425
CSSL Application Fee
$175
CSSL Exam Retake Fee
Making Certification More Affordable
Great news! You can now use tax-advantaged 529 plans to pay for your CCI certification, renewal fees, and continuing education.
This federal expansion makes professional development more accessible than ever.
Material Questions Are Pulled From:
Guidelines for Perioperative Practice
AORN. (current edition). Guidelines for perioperative practice. AORN.
Berry and Kohn’s Operating Room Technique
Hornacky, A., & Phillips, N. (2024). Berry and Kohn’s operating room technique (14th ed.). Elsevier.
Alexander’s Care of the Patient in Surgery
Rothrock, J. C. (Ed.). (2023). Alexander’s care of the patient in surgery (17th ed.). Elsevier.
Penner’s Economics and Financial Management for Nurses and Nurse Leaders
Knighten, M. L., & Waxman, K. T. (Eds.). (2024). Penner’s economics and financial management for nurses and nurse leaders (4th ed.). Springer Publishing Company.
Operating Room Leadership and Management
Kaye, A. D., Urman, R. D., & Fox, C. J. III. (Eds.). (2019). Operating room leadership and management (2nd ed.). Cambridge University Press.
These texts are the primary references for the CSSL exam. Download our CSSL Study Plan for reference material by subject area.
CCI periodically conducts test development activities to develop and maintain the CSSL exam consistent with accreditation standards. A complete list of test development committees is presented in CSSL task and knowledge statements.
Get Prepared
CSSL Exam Resources
Certification Videos
Learn more about exam subject areas and test-taking strategies.
CSSL Exam Study Outline
Develop a personalized study plan with CCI’s free preparation tool.
CSSL Handbook
The complete guide on the CSSL credential.
CSSL Practice Questions
Explore the format and structure of CSSL exam questions.
Get Prepared
CSSL Exam Preparation
Please note: CSSM is still used in these prep materials & will be updated in the next update.
Exam Prep Product Disclaimer: As a certification organization, CCI’s role is developing and administering certification examinations. CCI does not require or endorse any specific study guides, review products, or training courses. Candidates may prepare for certification examinations with any educational materials they choose. The purchase of CCI review materials is not a requirement for testing, nor does the use of any review materials (CCI or otherwise) imply successful performance on the certification examinations. No study resources are prerequisites for the certification examinations.
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