Surgical Technologist Salary (2026): CST Pay Guide for All 50 States

Certified surgical technologists in the United States earn a national median of $68,141 per year — roughly $32.76/hour. CST pay sits above the U.S. median for allied health roles and continues to climb, driven by chronic operating-room staffing shortages, the rapid expansion of ambulatory surgery centers (ASCs), and growing surgical case volume across orthopedic, cardiac, and outpatient specialties.

The national median is only the middle of the distribution. Three numbers describe the real range of surgical technologist compensation:

• Entry-level surg techs (10th percentile): $48,421/year — typically new CSTs in their first 1–2 years, often as general OR scrubs at community hospitals or ASCs, still rotating across specialties to build case experience.
• Median surg tech (50th percentile): $68,141/year — the working CST with 3–8 years of OR experience, frequently specialty-aligned (general, OB/GYN, orthopedic, ENT, urology) and comfortable as a first scrub on routine cases.
• Top-earning surg techs (90th percentile): $102,175/year — senior CSTs in high-cost metros, cardiovascular OR (CVOR) and neurosurgery scrubs at academic medical centers, surgical first assistants (CSFA/CFA), and lead technologists running daily case scheduling at busy trauma centers.

Geographic location explains the largest share of the gap. Surg techs in Sunnyvale, CA earn a median of $115,254, while colleagues in Arecibo, PR earn around $28,332. State CST credential mandates, the local mix of hospital ORs versus high-volume ASCs, and the strength of specialty subspecialty demand (cardiac, neuro, ortho) all push pay in measurable ways beyond cost of living.

Surgical Technologist Salary vs CST Salary — Are They the Same?

Yes. Surgical Technologist is the occupational title; CST (Certified Surgical Technologist) is the credential awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA) after a candidate completes a program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES) and passes the CST exam. Nine states currently mandate CST certification for new OR hires — Tennessee, Indiana, Massachusetts, Nevada, New Jersey, New York, Oregon, South Carolina, Texas, and Washington — and the Association of Surgical Technologists (AST) recognizes CST as the national professional standard. The same job goes by several names in salary surveys and job ads:

• Surgical technologist salary / surgical tech pay / surg tech salary
• CST salary / certified surgical technologist pay
• Operating room technician salary / OR tech pay
• Scrub tech salary / scrub technologist pay
• Surgical first assistant pay / CSFA salary / CFA pay

All of these reference SOC code 29-2055 in the Bureau of Labor Statistics Occupational Employment and Wage Statistics survey — the data source used throughout this site. Note that surgical assistants — the second-level credential CSFA or CSA — are tracked under the same SOC code group but earn meaningfully more, and that registered nurses in circulating roles (SOC 29-1141) are tracked separately.

Hourly Pay for Surgical Technologists

Surg techs are paid hourly, with rare exceptions for salaried lead-tech and surgical-services-coordinator roles. The national median equivalent of $32.76/hour reflects a full-time 36–40 hour week, but actual paychecks vary widely by region, shift, and specialty:

• West Coast and Northeast metros: commonly $32–48+/hour for experienced CSTs at academic and Level-1 trauma centers; California, Alaska, Washington, Oregon, and Massachusetts consistently lead the surg-tech pay scale.
• Midwest and South: $20–30/hour median range, with metro hospitals and large surgical-hospital chains at the upper end of that band.
• Call coverage and after-hours differentials: trauma centers and 24/7 ORs pay flat call-coverage stipends plus time-and-a-half (or higher) for activated cases; in-house overnight call frequently doubles a regular shift's effective pay on busy nights.
• Travel and per-diem surg techs: 13-week contracts at all-in weekly rates that frequently exceed local staff rates by 30–55%; travel CST demand spiked through the post-pandemic surgical-backlog clearance and remains structurally elevated, especially for CVOR and neuro scrubs.

Total compensation routinely runs 10–25% above headline base wages once shift differentials, NBSTSA recertification reimbursement, AST membership dues, tuition support for surgical-first-assistant programs, and 401(k) or 403(b) match are counted in.

2026 Surgical Technologist Salary Projection

Surgical technologist pay has grown at a compound annual rate of 5.40% over the past five years, driven by persistent OR-staffing shortages, the rapid expansion of physician-owned ASCs, ongoing growth in elective orthopedic and cardiac case volume, and the steady aging of the U.S. patient population. The Bureau of Labor Statistics projects employment for Surgical Technologists to grow 6% through 2033, keeping upward pressure on wages, especially for CVOR-, neuro-, and ortho-specialty CSTs and for first surgical assistants in high-volume practices.

A CVOR-specialty CST at a unionized San Francisco academic medical center can earn nearly double what an entry-level scrub at a rural Mississippi community hospital takes home. Four factors explain almost all of that gap: location and state credential mandates, specialty subspecialization, practice setting, and employment model.

1. Location and State Credential Mandates

Metropolitan areas with high costs of living offer the highest nominal surg-tech salaries. After adjusting using BEA Regional Price Parities, the real-dollar gap narrows — but doesn't close. California, Alaska, Washington, Oregon, and Massachusetts lead even on a purchasing-power basis. The drivers include high state minimum-wage floors, strong OR union representation at academic and county-hospital systems, and CMS reimbursement rates that translate directly into OR staffing budgets.

Nine states (Tennessee, Indiana, Massachusetts, Nevada, New Jersey, New York, Oregon, South Carolina, Texas, Washington) currently mandate CST credentialing for new OR hires, raising the entry barrier and supporting higher pay. Additional location-specific factors push pay in measurable ways:

• Trauma-center and academic-medical-center concentration — Level-1 trauma centers in major metros pay above the regional staff median because of call burden, case complexity, and specialty subspecialty rotations.
• ASC market growth — physician-owned ASCs in Texas, Florida, Arizona, and Tennessee pay above local hospital staff rates to recruit scrubs willing to work efficient outpatient case schedules.
• Health professional shortage areas (HPSAs) — rural and underserved markets routinely offer $5,000–$25,000 sign-on bonuses, paid relocation, and tuition support for surg techs willing to anchor a community's OR coverage.

2. Specialty Subspecialization: CVOR, Neuro, Ortho at the Top

Entry-level CSTs working general OR cases start near the 10th percentile at $48,421. Within 2–4 years most CSTs specialize into one or two surgical service lines, which carries a measurable pay differential and opens advanced-credentialing pathways:

• Cardiovascular OR (CVOR) — the highest-paying surgical specialty for CSTs. Open-heart, CABG, valve replacement, and aortic cases require dedicated CVOR scrubs at quaternary hospitals and large cardiac programs. CVOR techs command $4–10/hour premiums above general scrubs.
• Neurosurgery — spine and cranial cases require dedicated neuro scrubs with extensive instrument-tray expertise. Neuro-specialty pay differentials run $3–8/hour above general OR.
• Orthopedic surgery — total joints, sports, and spine cases at high-volume orthopedic hospitals consistently pay above the general OR median, especially in physician-owned specialty hospitals.
• Robotics-trained scrubs — da Vinci-certified CSTs across urology, gynecology, general, and thoracic surgery earn modest premiums and are heavily recruited as robotic case volume grows.
• Surgical First Assistant (CSFA or CSA) — the advanced credential after CST. SFAs participate at the field as second hands, retract tissue, and close. They earn $5,000–$25,000+ above bench CST pay at hospitals that employ them as separate roles, and substantially more in private surgical-group employment.

3. Practice Setting: Hospital vs ASC vs Specialty Hospital vs L&D

Where you scrub matters as much as how long you've scrubbed:

• Academic medical centers and Level-1 trauma centers: the highest-paying single hospital setting for CSTs, with call premiums, complex-case experience, and specialty-rotation pathways.
• Ambulatory surgery centers (ASCs): physician-owned and corporate ASC chains (Surgery Partners, USPI, AmSurg) often pay above local hospital staff rates for predictable Monday–Friday daytime caseloads with no call.
• Specialty hospitals (orthopedic, cardiac, women's): reliable above-median pay for service-aligned scrubs with high case-volume throughput.
• Labor and delivery (L&D scrubs): dedicated C-section scrub roles in hospital L&D suites; pay tracks the general OR median with predictable shift schedules.
• Community hospitals: the broadest CST employer category; pay tracks the regional median with broad case-mix exposure across general, OB/GYN, urology, ortho, and ENT.
• Veterans Affairs (VA) and military treatment facilities: stable pay with strong federal pension eligibility and PSLF.

4. Employment Model: Staff vs Travel vs Per-Diem vs Surgical First Assistant

Staff CSTs receive benefits, retirement contributions, NBSTSA recertification reimbursement, and tuition support on top of base pay. Travel CSTs sign 8–13 week contracts through OR-focused staffing agencies (Aya, Onward Healthcare, Cross Country) at all-in weekly rates that frequently exceed staff annual equivalents by 30–55%, in exchange for variable assignment quality. Per-diem CSTs work shifts as needed for an ASC chain or a hospital float pool at 25–40% above the staff hourly rate. Surgical First Assistants — the advanced CSFA/CSA credential — work as independent contractors in some markets, billing professional fees alongside the surgeon and earning well above the 90th percentile of the bench CST scale.

For a complete city-by-city breakdown of surgical technologist salaries — including BLS percentile data (10th, 25th, 50th/median, 75th, 90th), local cost-of-living adjustments, and 2026 salary projections — browse the 1,677+ metro areas tracked in our dataset below.