RRA Certification Cost 2026: Complete Pricing Breakdown

The Official Fee Schedule at a Glance

Reconstructive Rearfoot/Ankle Surgery (RRA) certification is issued by the American Board of Foot and Ankle Surgery (ABFAS). Unlike a single-sitting credential, it is a multi-stage pathway, so the true cost is a sum of several separately billed pieces rather than one exam fee. The published figures from the issuer are below.

The authoritative schedule lives on the issuer's annual fees page, and you should confirm it before paying anything, since fee tables are revised periodically. For a broader look at who qualifies to pay these fees in the first place, see our guide to RRA requirements, eligibility and prerequisites.

How the Fees Stack Across the Pathway

Adding the listed items for a candidate who passes every component on the first attempt gives a straightforward total: $225 + $475 + $475 + $550 = $1,725 in core RRA examination and application fees. That figure excludes status fees, Foot prerequisites, travel, and preparation materials, so treat it as a floor, not a budget.

Part I: two separately priced components

Part I is not one exam. The RRA Didactic ($475) and the NEW RRA CBPS ($475) are separate components, each with its own scaled-score requirement of 500 on a 200-800 scale. Because they are billed separately, failing one component does not automatically mean repaying the other. That distinction matters for retake planning, covered below.

Part II: Case Review is priced once but front-loaded with work

The $550 Case Review fee is modest next to the effort it represents. You are not attending a timed sitting; instead, eight selected surgical cases are evaluated through PLS. For the 2027 Case Review, at least 30 logged cases must contain an RRA-eligible procedure, including eight selectable RRA core-procedure cases from unique patients. The real cost here is surgeon time spent logging, so log all required post-residency surgeon-of-record cases rather than only the minimum. Note that 2027 changes should not be backdated to Spring 2026 cycles.

The Prerequisite Foot Costs You Must Budget Separately

This is the line item candidates most often miss. Foot qualification is required for RRA qualification, and Foot certification is required for RRA certification. The Foot examinations and their associated fees are additional to everything in the table above. The issuer's fee page lists them, and none of the Foot-side figures are folded into the RRA numbers in this article.

Candidates who are already Foot-certified benefit in one specific way: the issuer applies an RRA-only logging exception for case logging, which can reduce the documentation burden even though it does not reduce the fees.

In-training examination conversion

Eligible passed final-year in-training examination components may be converted for a fee. This can shorten the path, but it does not change the scope of RRA, and the conversion fee should be added to your budget if you use it. Verify current eligibility and pricing with the issuer rather than assuming a component will convert.

Recurring Costs After You Qualify

Credentialing is not a one-time purchase. Once you hold status, annual fees continue: $205 per year as Board Qualified and $440 per year as Board Certified. The jump of $235 per year at certification is the price of the higher status, and it continues for as long as you maintain it.

The qualification clock

Certification is normally required within seven years of qualification, with exceptions for certain pre-2014 residency cohorts. Staying Board Qualified for the full window means paying the $205 annual fee each year, so delaying Part II has a quantifiable carrying cost. Seven years at $205 is $1,435 in status fees alone, which is why many candidates move to certification as soon as their case logs are sufficient.

Maintenance after certification

Initial certification lasts ten years. Maintenance includes the annual fee, unrestricted licensure, privileges, a recent-surgery attestation, 100 Category 1 and/or CPME-approved CME hours per five-year period, and LEAD. New time-limited cohorts complete at least 12 LEAD quarters in each five-year period and meet the applicable performance standard. RRA requires its own MDT standard but no participation quarters beyond Foot. Older cohorts follow transition schedules documented on the issuer's LEAD requirements page. The CME hours carry their own costs, which depend on the courses you choose and are not set by the board.

Hidden and Indirect Costs

The issuer's fee table captures only what is paid to the issuer. Real budgets also include several items that vary by candidate.

Because no books or study materials are allowed in the testing room, your preparation spending is all front-loaded. Nothing you buy comes with you into the sitting.

Retake Math: Why Passing the First Time Saves Money

The historical cumulative pass rates through Spring 2025 show why a contingency line belongs in the budget. For the 2025 residency class, cumulative RRA Didactic performance is 54% (211/394), CBPS is 89% (353/398), and for the 2023 residency class, RRA Case Review is 79% (19/24). These are cumulative figures, not first-attempt or 2026 rates, and the issuer publishes them on its exam pass rates page. For a deeper read, see our analysis of the RRA pass rate.

The practical takeaway: the Didactic is the component where a retake is most plausible. Since the RRA Didactic is $475 and is billed separately from the CBPS, a Didactic retake adds that component fee and potentially a new application fee if you cross into another examination calendar year. A retake can therefore cost far more than the sticker price suggests once delay and a possible second $225 application are included.

Scoring context for budgeting

Each Part I component requires a scaled score of 500 on a 200-800 scale. This is not 62.5% correct, so you cannot calculate a safe raw-score cushion. Our guide to the RRA passing score explains why. The practical consequence for cost: do not schedule on a hunch that you are probably close.

Where Prep Spending Pays Off, Domain by Domain

The Didactic is built from five weighted Topics with official target weights, and their allowable ranges are 10-20%, 15-25%, 20-30%, 15-25% and 15-25% respectively. Spending should follow the weighting, because every dollar of prep should buy coverage of high-yield material.

The Didactic is computer-adaptive, and completed items cannot be revisited, so there is no opportunity to circle back. Some items may be unscored field-test items, but no fixed scored/unscored split is assigned, so treat every question as if it counts. The official subject areas page is the objective source. Our RRA exam domains guide walks through all 19 serialized source headings.

Do not add percentages across classifications

One caution on reading the blueprint: Domains 1-5 are the Didactic Topics. Domains 6-9 are separate CBPS Case Management Areas (Physical Examination 20-40%, Diagnostic procedures/labs/imaging 15-35%, Diagnosis 10-30%, Treatment 15-35%). Domains 10-19 are overlapping, unweighted CBPS Content Areas. Nineteen is the number of serialized headings, not a single 19-domain blueprint, and percentages must not be summed across these groups. The CBPS Content Areas cover Complications/Revision, congenital disorders in pediatrics and adults, deformities, perioperative management, neoplastic disorders, neurovascular disorders, trauma, wound/infection, and metabolic, rheumatologic and inflammatory disorders.

A Cost-Aware Preparation Timeline

Preparation should be sequenced so you pay for exam components only when ready. This is the one place we use a schedule, tied to the weighting above.

For a fuller plan, our RRA study guide expands on sequencing, and you can pressure-test your readiness with the RRA practice tests before committing $475 to a sitting. Check RRA exam dates and deadlines as well, since a missed window can push you into a new calendar year and a second application fee.

Weighing the Spend Against the Career Return

Over the whole pathway, the issuer-collected costs are modest relative to the surgical practice they support: roughly $1,725 in core fees on a clean first pass, plus annual status fees and Foot prerequisites. Whether that spend pays back depends on your practice setting, your hospital privileging requirements, and your referral base, and we do not quote salary figures here. For that side of the equation, see the ROI analysis of RRA certification and the RRA salary guide.

In practice, many candidates treat certification as a credentialing requirement for privileges and hiring rather than a discretionary purchase. If you want to understand the credential itself before paying for it, start with what RRA certification is.

Frequently Asked Questions