Credential type: certification examination · verified on the issuer's site September 20, 2026 issuer page
Developed by AAPC, the Certified Orthopedic Surgery Coder (COSC) exam validates professional expertise in coding musculoskeletal procedures, spine and fracture interventions, appropriate modifier use, and global surgery concepts, alongside accurate diagnosis coding for orthopedics. It consists of 100 multiple-choice items presented in a linear format, administered over 340 minutes. Candidates must achieve a 70 percent score to earn the credential, which remains valid for two years before renewal is required.
Medical coders, billing specialists, and health-information professionals who regularly code orthopedic surgeries, spine procedures, or fracture treatments should pursue the COSC credential. Experience with CPT, ICD-10-CM, and modifier application in clinical settings is highly recommended for success.
Study the CPT code range using the official AAPC exam guide, focus on global surgery periods and modifier rules, and review the Medicare NCCI edits. Complete practice exams from AAPC, track your performance, and reinforce weak areas with targeted flashcards. Establish a consistent daily study routine and simulate the linear exam format to build endurance and familiarity with the testing environment before your scheduled test day.
Musculoskeletal Procedure Coding tests the ability to select the most specific CPT code for procedures on bones, joints, muscles and related structures, ensuring compliance with Medicare guidelines and avoiding unbundling during the coding process.
Spine and Fracture Coding covers coding of spinal fusion levels, vertebral instrumentation, fracture fixation, and related imaging, emphasizing correct use of add-on codes and awareness of global surgery periods for all orthopedic surgical interventions.
Modifiers and Global Surgery focuses on applying modifiers such as 57, 25, 59, and 24 correctly, and understanding global periods for major and minor procedures under Medicare rules to ensure accurate billing and compliance.
Diagnosis Coding for Orthopedics requires accurate ICD-10-CM diagnosis assignment that matches the procedure, supporting proper reimbursement and compliance with NCCI edits, while reinforcing the link between clinical documentation and final code selection for orthopedics.
Arrive early at the testing center, bring a valid ID, and have your registration confirmation ready. Bring a pen, stay hydrated, and manage your time carefully throughout the 340 minutes allotted for the 100 questions to ensure you complete every item.
The COSC exam consists of 100 multiple-choice questions presented in a linear format. All items must be answered within the allotted time, and each question contributes to the overall score needed to pass the certification.
Candidates must achieve a score of at least 70 percent to pass the Certified Orthopedic Surgery Coder exam. This threshold applies to the total of 100 questions, meaning at least 70 correct answers are required to earn the credential.
The exam duration is 340 minutes. During this time you will answer 100 multiple-choice questions. It is important to manage your time effectively across the entire session to ensure you have sufficient opportunity to review your answers before finishing.
The non-member price for the COSC exam is $399. AAPC members receive a reduced rate of $299. The fee covers the exam administration and a printed result report provided to the candidate after the testing session is complete.
Verified 2026-09-02
This page was compiled from AAPC’s official exam guide and study documentation, extracting key facts, domain details, and policy excerpts to create concise, actionable content for certification candidates.