- RVS is CCI's one-part, 170-question vascular ultrasound registry exam: 150 scored items, 20 unscored, 170 minutes.
- You need a scaled score of 650 on CCI's 0-900 range; it is not a percentage.
- Arterial (22%), extracranial/intracranial (20%) and venous (19%) domains make up 61% of your score.
- Exam fee is $365 USD, retakes need a new application, new fee and a 45-day wait.
Which RVS This Sheet Covers
"RVS" is an acronym shared by several unrelated credentials. This page is about one thing only: the Registered Vascular Specialist credential awarded by Cardiovascular Credentialing International (CCI). It is a vascular ultrasound certification. It is not the ARDMS RVT, not CCI's own RPhS (phlebology) credential, and not ARRT vascular-interventional radiography. If you are still sorting out the terminology, start with What Is RVS? or What Does RVS Stand For?, then come back here for the compressed review.
Everything below is meant to fit on one printed page in your head: the numbers, the domains, the logistics, and the topics that tend to decide pass-or-fail outcomes. For the full-length treatment of any item, follow the links in each section.
The Exam at a Glance
| Item | RVS Fact |
|---|---|
| Credentialing body | Cardiovascular Credentialing International (CCI) |
| Structure | One-part registry-level exam (no separate physics exam plus specialty exam) |
| Delivery | Pearson VUE test centers, year-round |
| Total questions | 170 (150 scored + 20 unidentified, randomly placed unscored items) |
| Answering time | 170 minutes (2 hours 50 minutes) |
| Appointment length | About 3 hours, including 10 extra minutes for tutorial and survey |
| Passing score | 650 on a 0-900 scaled-score range |
| 2025 first-time pass rate (CCI-reported) | 56% |
| Exam fee | $365 USD, including a $100 nonrefundable application-processing portion |
For a deeper look at what the score means, see RVS Passing Score 2026. A scaled score of 650 is not "65%" and not "650 out of 900 correct." CCI converts raw performance onto its scale, so do not try to back-calculate a number of questions you can miss.
Domain Weights and What Each Tests
The seven domains below are CCI's official examination objectives from the current live RVS Examination Matrix and Task List (reviewed October 14, 2026). The percentages are CCI's published approximate shares of the exam score. They are objectives, not curriculum headings from any prep course.
| Domain | Approx. Share |
|---|---|
| 1. Maintaining Patient Care and Safety | 11% |
| 2. Applying Principles of Physics and Hemodynamics | 15% |
| 3. Performing Abdominal/Visceral Examinations | 10% |
| 4. Performing Extracranial/Intracranial Examinations | 20% |
| 5. Performing Arterial Examinations of the Upper and Lower Extremities | 22% |
| 6. Performing Venous Examinations of the Upper and Lower Extremities | 19% |
| 7. Performing Hemodialysis Examinations | 3% |
The 61% core: Domains 4, 5 and 6
Domain 5: Arterial Examinations of the Upper and Lower Extremities (22%)
The single heaviest domain. Expect questions that ask you to interpret what a waveform or Doppler finding means and to choose the correct next step in an exam protocol.
- Normal triphasic versus abnormal monophasic or dampened waveform patterns and what each implies about disease location
- Stenosis grading concepts tied to velocity changes and waveform changes
- Physiologic testing concepts used alongside duplex imaging
- Bypass graft and post-intervention surveillance logic
Domain 4: Extracranial/Intracranial Examinations (20%)
Carotid and cerebrovascular duplex plus transcranial applications. Candidates often under-prepare the intracranial side because day-to-day work may emphasize the neck vessels.
- Carotid anatomy, vessel identification and flow-direction patterns
- Velocity-based stenosis criteria and the pitfalls that distort them
- Vertebral artery flow interpretation, including reversed flow patterns
- Transcranial windows, vessel identification and flow-direction logic
Domain 6: Venous Examinations of the Upper and Lower Extremities (19%)
Deep vein thrombosis and venous insufficiency dominate this domain.
- Compression technique and what a noncompressible segment means
- Acute versus chronic thrombus characteristics
- Reflux testing methods, positioning and valve-closure time concepts
- Phasicity, augmentation and what abnormal responses suggest about proximal obstruction
The supporting domains
Domain 2 (15%) is where physics and hemodynamics live: Doppler shift, angle correction, aliasing, pulse repetition frequency, resistance versus pressure versus flow, and instrument settings. Because it is only 15%, it is tempting to under-study, but physics concepts also surface inside the clinical domains as "why is this image or spectrum wrong?" questions. Domain 1 (11%) covers patient care and safety, including patient identification, communication, infection control, ergonomics and recognizing emergencies. Domain 3 (10%) covers abdominal and visceral vascular exams, and Domain 7 (3%) covers hemodialysis access examinations. Domain 7 is small, but the topic is narrow enough that a few hours of focused review can capture most of those points.
Question Formats and Test-Day Rules
Four item formats
CCI's Question Types section and the Applicant Handbook describe four formats:
- Single-best-answer multiple-choice
- Multiple response (select more than one correct option)
- Image hot spot (click the correct location on an image)
- Drag-and-place (move items into the correct positions)
One paragraph elsewhere on CCI's page describes only four-option multiple-choice questions. Do not rely on that and assume the exam is multiple-choice only. Practice with all four formats, especially hot spot and drag-and-place, which reward image recognition rather than recall of a fact.
At the test center
- The exam is closed book.
- An on-screen calculator and an erasable board are supplied.
- Bring two valid identification documents.
- You may skip questions or mark them for review, so use that to protect your pacing.
Key Takeaway
Because you can mark and return, do a fast first pass: answer what you know, flag image-heavy or multi-select items that need careful reading, and use the remaining time on the flags. Use the erasable board to jot hemodynamic relationships or velocity criteria the moment the tutorial ends, before the clock starts mattering.
If you are wondering how these mechanics translate into difficulty, How Hard Is the RVS Exam? breaks down where candidates typically struggle.
Eligibility Pathways in One Table
Every applicant needs a high school diploma or GED plus one qualifying pathway, backed by typed supporting documentation and the applicable medical or program-director verification letters. The pathways below come from the CCI Applicant Handbook (publication January 2024).
| Pathway | Who It Fits | Core Requirement |
|---|---|---|
| RVS235 | Experienced working sonographers | Health-science diploma, associate or baccalaureate qualification; one year full-time-equivalent vascular ultrasound work; at least 600 vascular studies across work and formal clinical training |
| RVS4 | Graduates of programmatically accredited vascular ultrasound programs | Program graduation; pregraduation testing is possible with documentation, but credential release depends on graduation |
| RVS5 | Graduates of non-programmatically accredited vascular ultrasound programs | At least one year of vascular training and 800 clinical hours completed within the program |
| RVS6 | Already credentialed in ultrasound | Active ultrasound credential; six months full-time-equivalent vascular ultrasound work; participation in at least 100 vascular studies |
Fees, Windows, and Retakes
- Apply to CCI with your pathway documentation and pay the $365 USD exam fee. The fee includes a $100 nonrefundable application-processing portion.
- Receive your Authorization to Test. It opens a 90-day testing window.
- Schedule with Pearson VUE. Testing runs year-round at test centers.
- Test. If you do not pass, a retake requires a new application, the exam fee again, and a 45-day wait.
Because a retake restarts the whole fee cycle, the cost of an unprepared first attempt is real. The full pricing picture, including renewal, is in RVS Certification Cost 2026, and the pass-rate context behind the 56% figure is in RVS Pass Rate 2026: What the Data Shows.
High-Yield Topics to Memorize
Use this as a self-quiz list. If you cannot explain an item out loud in a sentence or two, it belongs in your next study block.
Physics and hemodynamics (Domain 2)
- How the Doppler angle affects measured velocity, and why angle correction has limits
- Aliasing: what causes it and the main ways to eliminate it (scale, baseline, PRF, lower frequency)
- Relationship among pressure, flow and resistance, and what changes distal to a hemodynamically significant stenosis
- Gain, wall filter and color settings, and the artifacts that result when they are wrong
- Laminar versus turbulent flow, and spectral broadening
Arterial and cerebrovascular patterns (Domains 4 and 5)
- Waveform changes proximal to, at and distal to a stenosis or occlusion
- Peak systolic velocity changes and velocity ratios as stenosis indicators
- Subclavian steal physiology and vertebral flow reversal
- Graft surveillance concepts and what elevated velocities within a graft may signal
Venous patterns (Domain 6)
- Full compressibility as the key finding that rules out thrombus in a segment
- Spontaneity, phasicity and augmentation: what each normal pattern looks like and what loss of it suggests
- Superficial versus deep system anatomy and why the distinction matters clinically
- Reflux evaluation positioning and technique
Safety, visceral and dialysis topics (Domains 1, 3 and 7)
- Patient identification, privacy, infection control and safe scanning ergonomics
- Core visceral vessel anatomy and the flow patterns expected in fasting versus postprandial states
- Hemodialysis access basics: what a mature, functioning access looks like on duplex and what flow or stenosis findings warrant attention
For a structured plan to cover all of this, RVS Study Guide 2026: How to Pass on Your First Attempt goes much deeper.
A Domain-Ordered Review Schedule
Rather than generic advice, order your review by exam weight and by how much each domain borrows from the others. Physics comes first because it powers every clinical question.
Physics and Hemodynamics (Domain 2) plus Patient Safety (Domain 1)
- Doppler angle, aliasing, instrument settings, flow dynamics
- Safety and patient-care scenarios, which are quick wins at 11%
Arterial Extremity Exams (Domain 5, 22%)
- Waveform interpretation drills
- Stenosis and occlusion patterns, grafts, physiologic testing concepts
Extracranial/Intracranial (Domain 4, 20%)
- Carotid and vertebral criteria and pitfalls
- Transcranial windows and flow-direction logic
Venous Exams (Domain 6, 19%)
- DVT technique and thrombus characterization
- Reflux and chronic venous disease
Visceral and Dialysis (Domains 3 and 7), then full mixed review
- Abdominal vessel patterns and dialysis access evaluation
- Timed practice sets using all four question formats
This is a template, not a rule. If you work daily in vascular labs, you may need less time on arterial and venous basics and more on the intracranial and dialysis material. If you are a recent graduate, the opposite is often true. Timed practice in the real format is available at the RVS Exam Prep practice test site.
Staying Credentialed: Renewal Cheat Sheet
| Stage | Requirement |
|---|---|
| Initial credential period | 9-12 months |
| First renewal | $165, Code of Ethics attestation, no CEUs |
| Ongoing renewal cycle | Every three years, $165, Code of Ethics attestation, 36 CEUs |
| CEU split | At least 30 cardiovascular-related; remaining CEUs must be medical-related |
Quick FAQ
650 is the passing scaled score on CCI's 0-900 range. It is not a percentage of questions answered correctly, so you cannot convert it directly into a number of allowable misses.
The exam has 170 questions, of which 150 are scored and 20 are unscored items randomly distributed and not identified to you. Treat every question as if it counts.
Performing Arterial Examinations of the Upper and Lower Extremities carries the largest share at about 22%, followed by Extracranial/Intracranial at 20% and Venous Examinations at 19%.
A retake requires a new application, the exam fee and a 45-day wait. CCI reported a 56% first-time pass rate for 2025, so it is worth preparing thoroughly the first time. See the ROI analysis if you are weighing the investment.
Our guides on RVS jobs and the RVS salary guide cover employer types and earnings context in more depth than this cheat sheet can.
Print the tables above, quiz yourself on the high-yield list weekly, and test your recall under timed conditions with the RVS Exam Prep practice questions before you book your Pearson VUE appointment.