- The RPhS exam has 170 questions: 150 scored, 20 unscored, with 2 hours 50 minutes of answering time.
- Passing is 650 on a 0-900 scaled range, not a raw percentage.
- Performance of Diagnostic Testing is the largest domain at 36%; Patient Diagnosis follows at 27%.
- Applicants from August 1-December 31, 2026 test in February 2027 and need the February 2027 matrix.
Identity and Issuer at a Glance
RPhS here means Registered Phlebology Sonographer, a credential issued by Cardiovascular Credentialing International (CCI) and delivered at Pearson VUE test centers. It certifies sonographers who perform and support venous ultrasound and related phlebology work. If you need the basics before diving into numbers, start with What Is RPhS Certification?; for a deeper walk-through of the process, see the RPhS Study Guide 2026: How to Pass on Your First Attempt.
This page is a one-page review sheet. Every number below comes from CCI's published materials as checked on October 15, 2026. CCI's own pages occasionally conflict with each other, and where they do, this sheet says so rather than guessing.
Exam Format and Scoring Numbers
| Item | What to Know |
|---|---|
| Total questions | 170 |
| Scored questions | 150 |
| Unscored (unidentified) items | 20; you cannot tell which ones they are |
| Appointment length | 3 hours total |
| Answering time | 2 hours 50 minutes (170 minutes); the remaining 10 minutes cover the tutorial and post-exam survey |
| Passing score | 650 on a 0-900 scaled-score range |
| Question formats | Single-best-answer multiple choice, multiple response, image hot spots, drag-and-place |
What the scaled score means
A 650 is a scaled score, not "65%" and not a number of questions answered correctly. Because 20 items are unscored and you cannot identify them, treat every question as if it counts. For more on interpreting the number, see RPhS Passing Score 2026: Exactly What You Need to Pass.
Why the formats matter
Expect more than classic four-option items. Multiple-response questions require selecting every correct choice, hot-spot questions ask you to click a location on an image, and drag-and-place items ask you to position elements correctly. For a sonography-based credential, that means practicing image interpretation and sequencing, not just recall. The RPhS practice test mirrors this mix of formats so you are not meeting a hot-spot question for the first time on exam day.
Fees and Registration Mechanics
- Examination fee: USD 365.
- Non-refundable component: USD 100 of that fee is a non-refundable application-processing amount.
- Retakes: a new application and a new examination fee are required each time.
- Documentation: you must supply route-specific education, credential, employment and study verification, depending on your eligibility pathway.
Because retakes mean paying again, one disciplined first attempt is cheaper than a casual one. A full breakdown of costs sits in RPhS Certification Cost 2026: Complete Pricing Breakdown.
Eligibility Routes Compared
Every route starts with a high-school diploma or GED plus one documented pathway. The pathways below are summarized; confirm your exact documentation on CCI's eligibility page and in RPhS Requirements 2026: Eligibility, Prerequisites & How to Qualify.
| Route | Core Requirement | 36 CEUs in Prior 4 Years? |
|---|---|---|
| Credentialed sonographer | Active RVS/RVT plus six months of venous-ultrasound employment | Yes |
| Associate degree route | Relevant associate degree or 62 semester hours, plus one year of experience | Yes |
| Bachelor's degree route | Relevant bachelor's degree plus six months of experience | Yes |
| Physician associate / nurse practitioner | Licensed, with six months of limited or complete venous-ultrasound experience | Not listed as part of this route |
| Physician: certified + 150 studies | Medical license; ABVLM certification or active RVS/RVT/RPVI; 150 studies performed or directly supervised in the preceding two years | Not required |
| Physician: 200 studies | Medical license; 200 such studies in the preceding two years | Not required |
| Physician: residency/fellowship | Medical license; qualifying residency or fellowship with 200 studies during training | Not required |
The 2026 vs. 2027 Matrix Trap
This is the single most important logistics point for current applicants. CCI publishes two Examination Matrix and Task List versions on the same page, both with the same five domain headings but different weights.
| Domain | Current (pre-Feb 1, 2027) Weight | Effective Feb 1, 2027 Weight |
|---|---|---|
| Maintain Information, Facility, and Safety | 9% | 7% |
| Patient Diagnosis | 27% | 25% |
| Performance of Diagnostic Testing | 36% | 38% |
| Conservative Treatment/Therapy of Patients | 9% | 10% |
| Minimally Invasive and Invasive Treatment of Patients | 20% | 20% |
Two quirks deserve a note. First, the current weights sum to 101% even though the issuer's total row says 100%; these are published approximate weights, and this sheet reports them as printed. Second, the current published matrix carries no printed issue year, so rely on the "pre-February 1, 2027" label.
Who needs which version
- Applications received August 1-December 31, 2026 are assigned to the February 1-28, 2027 testing window, so those candidates need the February 2027 matrix, not the current one.
- Earlier-approved candidates follow their Authorization to Test (ATT) dates, capped at the end of February 2027.
- Effective February 1, 2027, testing is offered in February and August only. This transition overrides the generic year-round/90-day authorization language you may see elsewhere.
- The general 45-day minimum retake interval still exists, but the new testing windows constrain it further, so a failed February attempt may mean waiting for August.
Key Takeaway
Before you open a single study resource, confirm your test window and download the matrix that matches it. A new October 2026 applicant is studying for the February 2027 matrix even though today's published domain lines still reflect the older scope. Details on scheduling live in RPhS Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Domain-by-Domain Review Sheet
These five areas are official examination duty/task domains, not preparation-curriculum chapters. Weights shown are the current published ones; adjust for your matrix version. For a longer treatment, read RPhS Exam Domains 2026: Complete Guide to All 5 Content Areas.
Domain 3: Performance of Diagnostic Testing (36%)
The largest domain and the one that most rewards hands-on scanning fluency. Expect image-driven items here, including hot-spot and drag-and-place formats.
- Venous duplex technique, patient positioning and protocol execution
- Recognizing normal versus abnormal venous flow, compressibility and waveform behavior
- Image optimization, artifact recognition and documentation quality
- Reflux and obstruction assessment as performed in the lab
Domain 2: Patient Diagnosis (27%)
Connecting findings to clinical meaning: what the sonographic picture suggests and what it does not.
- Correlating symptoms, history and risk factors with venous disease patterns
- Distinguishing acute from chronic findings
- Understanding how the sonographer's data supports the diagnostic process
Domain 5: Minimally Invasive and Invasive Treatment of Patients (20%)
Procedural phlebology, often the least familiar domain for candidates from purely diagnostic labs.
- Ultrasound's role before, during and after venous ablation and related procedures
- Procedural guidance, sterile technique and monitoring
- Post-procedure surveillance and complication recognition
Domain 1: Maintain Information, Facility, and Safety (9%)
Smaller, but dependable points for candidates who prepare.
- Documentation, patient information handling and facility standards
- Equipment care, infection control and patient/operator safety
Domain 4: Conservative Treatment/Therapy of Patients (9%)
Non-procedural management of venous disease.
- Compression therapy concepts and patient education
- Lifestyle and conservative measures, and when conservative care is or is not appropriate
Test-Day Rules
- Closed-book: no reference materials.
- Tools provided: an on-screen calculator and an erasable board.
- Navigation: you can mark items, review and revisit them within the time you have remaining.
- ID: bring two acceptable original IDs.
- Rescheduling: CCI's credential page says two full working days while its FAQ says 24 hours. Follow the instructions in your own appointment confirmation.
If you are wondering how demanding this all is in practice, How Hard Is the RPhS Exam? Complete Difficulty Guide 2026 puts the format into context.
Renewal Rules in Brief
| Stage | Requirements |
|---|---|
| Initial certification period | 9-12 months |
| First renewal | USD 165 and Code of Ethics compliance; no CEUs due |
| Every renewal thereafter (three-year cycle) | USD 165, ethics compliance, and 36 CEUs, with at least 30 cardiovascular-related |
Any remaining CEUs beyond the 30 cardiovascular-related credits must be medical-related under CCI's dedicated CE policy. The credential page's broader "any topic" wording conflicts with that more specific rule, so plan to the stricter one. Passing a CCI examination at the full fee is an alternative way to satisfy triennial CE requirements, but it is not an established waiver of other renewal obligations such as the fee and ethics compliance.
Sequencing Your Review by Domain
You do not need a generic study plan here, only a sensible order driven by weight and difficulty. This sample sequence uses the current weights; shift emphasis if the February 2027 matrix applies to you, since Performance of Diagnostic Testing rises to 38% there.
Logistics and Domain 1
- Confirm your test window and matrix version
- Cover safety, documentation and facility topics while the volume of new material is light
Domain 3: Diagnostic Testing
- Work through venous duplex protocols and flow characteristics
- Drill image-based questions daily
Domain 2: Patient Diagnosis
- Link sonographic findings to disease patterns and clinical decisions
Domains 4 and 5
- Conservative therapy first, then procedural phlebology and post-procedure surveillance
Mixed-format review
- Take timed sets in the RPhS practice test and revisit missed hot-spot and multiple-response items
For a fuller approach to preparing across the whole exam, see the RPhS Study Guide 2026.
Why the Credential Matters for Your Career
Employers in vascular labs, vein clinics and phlebology practices look for evidence that a sonographer understands both diagnostic imaging and the treatment context. Compensation varies by region, employer and experience, so weigh it against your own market using RPhS Salary Guide 2026: Complete Earnings Analysis and Is the RPhS Certification Worth It? Complete ROI Analysis 2026. To see how the credential shows up in hiring, browse RPhS Jobs.
FAQ
There are 170 questions: 150 scored and 20 unidentified unscored items. You have 2 hours 50 minutes to answer, inside a 3-hour appointment that also includes a tutorial and post-exam survey.
A scaled score of 650 on a 0-900 range. It is not a raw percentage, so you cannot convert it directly into a number of correct answers.
Performance of Diagnostic Testing at 36% on the current matrix, followed by Patient Diagnosis at 27%. On the matrix effective February 1, 2027, Performance of Diagnostic Testing rises to 38% and Patient Diagnosis is 25%.
Applications received August 1-December 31, 2026 are assigned to the February 1-28, 2027 testing window, so you should use the February 2027 matrix. Testing is offered in February and August only from that date.
The first renewal, after the 9-12 month initial period, costs USD 165, requires Code of Ethics compliance, and has no CEUs due. After that, each three-year renewal requires USD 165, ethics compliance and 36 CEUs, at least 30 of them cardiovascular-related.