The I-693 fee charged by USCIS is $0. The cost you actually pay goes to the civil surgeon who performs the immigration medical exam, and that bill typically runs between $250 and $500 for the physical, lab work, and completed paperwork.1U.S. Citizenship and Immigration Services. G-1055 Fee Schedule Any vaccinations you’re missing add anywhere from $50 to several hundred dollars on top of that. What you pay depends almost entirely on which doctor you choose and how many shots you need.
Why the Price Varies So Much
USCIS does not regulate what civil surgeons charge. The agency’s own guidance encourages applicants to call several local civil surgeons and compare fees before booking.2U.S. Citizenship and Immigration Services. Finding a Medical Doctor Prices swing by region and by clinic, but most applicants land in that $250 to $500 range for a base exam package: the physical evaluation, required blood work, a review of vaccination records, and the sealed I-693 form ready for submission.
Only a physician specifically designated by USCIS as a civil surgeon can perform the exam and sign the I-693. You can look up authorized doctors by ZIP code using the agency’s Find a Civil Surgeon tool.3U.S. Citizenship and Immigration Services. Find a Civil Surgeon When you call to compare prices, ask specifically whether the quoted fee includes vaccinations or bills them separately. Many clinics don’t accept insurance for immigration exams at all, and even when they do, insurance often won’t cover the immigration-specific components.2U.S. Citizenship and Immigration Services. Finding a Medical Doctor
Where the Bill Grows
Vaccinations are the most unpredictable line item. If your records show you’re already immunized against everything on the required list, you won’t pay extra. If you’re missing several vaccines, each dose comes at an additional charge, and some applicants need quite a few. The required vaccines include mumps, measles, rubella, polio, tetanus and diphtheria, pertussis, Haemophilus influenzae type B, hepatitis B, and any others the CDC determines are needed for immigration purposes.4U.S. Citizenship and Immigration Services. Vaccination Requirements If your documentation is incomplete, the civil surgeon administers the missing doses during the appointment at an additional per-shot cost.
Lab results can also inflate the cost. A positive tuberculosis blood test triggers a chest X-ray, which adds roughly $100 to $200. A positive syphilis test triggers a clinical evaluation to stage the infection, and treatment plus documentation of that treatment is typically required before the I-693 can be completed.5Centers for Disease Control and Prevention. Syphilis Technical Instructions for Civil Surgeons If findings suggest active TB, the civil surgeon must refer you to your local health department for further evaluation, including sputum testing.6Centers for Disease Control and Prevention. Tuberculosis Technical Instructions for Civil Surgeons These follow-ups catch people off guard, so budget a cushion above the base price.
How to Keep Your Costs Down
Bring every vaccination record you have to the appointment, even partial ones. The civil surgeon has no way to verify past immunizations without documentation, and arriving empty-handed is one of the most expensive mistakes applicants make: you’ll likely pay for vaccines you’ve already received. Bring a valid government-issued photo ID as well; for a child under 14, a birth certificate showing the child’s name, date and place of birth, and parents’ names works instead.7U.S. Citizenship and Immigration Services. Form I-693 Instructions
Fill out Part 1 of the form before the appointment, but leave the signature block blank. You must sign in front of the civil surgeon, and signing beforehand can result in the doctor rejecting the form entirely, meaning you’d pay again for a redo.7U.S. Citizenship and Immigration Services. Form I-693 Instructions
The bigger cost trap sits in timing. For any I-693 signed by a civil surgeon on or after November 1, 2023, the form is valid only while the application it was submitted with is pending. If your I-485 is denied or withdrawn, that I-693 dies with it, and you’d need to pay for an entirely new medical exam to file again.8U.S. Citizenship and Immigration Services. USCIS Changes Validity Period for Any Form I-693 Signed on or after Nov. 1, 2023 This policy took effect June 11, 2025, reversing an earlier rule that had allowed the I-693 to remain valid indefinitely for future applications. Don’t schedule your medical exam until your I-485 filing strategy is solid. A premature exam attached to a denied or withdrawn application means paying for everything twice.
If you suspect you might test positive for TB or syphilis, schedule your exam well ahead of any filing deadline rather than at the last minute. Waiting compresses the timeline for follow-up testing and can push you into a rushed second appointment.
If You Need a Vaccination Waiver
Applicants opposed to all vaccinations based on religious beliefs or moral convictions can request a waiver under INA 212(g)(2)(C), but this route adds its own costs.9U.S. Citizenship and Immigration Services. USCIS Policy Manual Volume 9, Part D, Chapter 3 – Waiver of Immigrant Vaccination Requirement The waiver requires filing Form I-601 with the applicable USCIS filing fee, along with a sworn statement explaining the nature of your belief and how complying with the vaccination requirement would violate it. The objection must apply to vaccinations across the board; you cannot pick and choose which vaccines to refuse. Between the I-601 fee and the extra processing time, this path is meaningfully more expensive than getting the shots.
Budgeting the Whole Line Item
A realistic plan for the I-693 fee is $250 to $500 for the exam itself, plus a variable amount for any vaccines you still need. Add roughly $100 to $200 if a TB chest X-ray comes into play, and more if syphilis staging and treatment are required. Two phone calls to different civil surgeons in your area, with a direct question about whether vaccines are bundled or billed separately, will tell you more about your likely bill than any published estimate.