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.
Certification Name Update
The Competency & Credentialing Institute (CCI) is updating the name of the Certified Surgical Services Manager (CSSM) credential to Certified Surgical Services Leader (CSSL).
This change reflects feedback from both current and prospective certificants who shared that the word “manager” created unnecessary confusion about eligibility. Surgical services leadership takes many forms — and this update ensures the credential better reflects the breadth of leadership roles across perioperative practice.
As we make this transition, you may still see CSSM being used in various images and documents.
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
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
Confirm your eligibility.
Determine when you would like to take the exam. Your testing window will begin the calendar month after your application is approved. Your exam may be taken at an in-person testing center or via remote proctor from the location of your choice.
You may submit your application online at any time by creating a CCI account or logging into your existing account.
Schedule your exam by clicking on the “PSI Exam Scheduling” button in your CCI account after your application is submitted. For additional testing center information, please refer to the CSSL Handbook.
Month 1
Apply
Month 2
Month 3
Testing Window
Month 4
CSSL Application Fee
The long-term benefits of holding a credential often outweigh the cost of initial certification. Over the three-year CSSL certification cycle, the certification application fee ends up costing less than fifty cents a day.
CCI offers volume discounts for health systems seeking to certify multiple nurses. Download the CSSL Facility Order Forms to enroll.
$425
Application 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
Phillips, N., & Hornacky, A. (Eds.). (2021). 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
CSSL Certification Webinars
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.
Please note: CSSM is still used in this handbook & will be updated in the next version.
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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