Quick Answer — Immigration Medical Exam Cost 2026
$200–$350
Exam only (vaccines up to date)
$350–$600
Exam + a few missing vaccines
$600–$900+
Exam + many vaccines needed
The immigration medical exam (Form I-693) is a required part of the green card application process in the United States. It must be performed by a USCIS-designated civil surgeon — not your regular doctor — and the results are submitted directly to USCIS in a sealed envelope. The cost varies based on your vaccination history and geographic location, but most applicants pay between $200 and $600. This guide explains exactly what the exam includes, how much you should expect to pay, and how to reduce your cost.
Calculate Your Complete Green Card Cost
The medical exam is just one part of your total green card cost. Use our calculator to see all USCIS filing fees.
Open Green Card Fee CalculatorWhat Is the Immigration Medical Exam (Form I-693)?
Form I-693 is the medical examination form required for most green card (Adjustment of Status) applicants. The purpose is to determine whether you have any health conditions that would make you inadmissible to the United States. The exam is performed by a civil surgeon — a licensed physician designated by USCIS — and the completed, sealed form is submitted to USCIS with your I-485 application.
Who needs Form I-693?
- All I-485 Adjustment of Status applicants
- Applicants age 14 and older (required)
- Children under 14 (may be required)
- K-1 fiance visa holders adjusting status
- Asylum applicants adjusting to LPR status
Who does NOT need Form I-693?
- Consular Processing applicants abroad (use panel physician instead)
- Some asylum applicants (certain exemptions apply)
- T and U visa holders in some circumstances
- VAWA self-petitioners (medical exam required separately)
What the Immigration Medical Exam Includes
The civil surgeon will conduct a comprehensive examination covering multiple health areas required by USCIS. Knowing what to expect helps you prepare and reduces appointment time (and cost).
1. Physical Examination
A general physical exam covering height, weight, blood pressure, vision, hearing, and overall physical health. The civil surgeon checks for communicable diseases of public health significance. This portion typically takes 15–20 minutes.
- Height, weight, and BMI
- Blood pressure and pulse
- Vision and hearing screening
- Skin and lymph node exam
- Neurological assessment
- General musculoskeletal review
2. Vaccination Review and Catch-Up Shots
This is the most variable cost component of the exam. The civil surgeon reviews your vaccination history against the CDC required vaccine schedule. Any vaccines you are missing must be administered during the exam.
| Required Vaccine | Est. Cost Per Dose |
|---|---|
| MMR (measles, mumps, rubella) — 2 doses | $50–$80 per dose |
| Varicella (chickenpox) — 2 doses | $75–$120 per dose |
| Tdap (tetanus, diphtheria, pertussis) | $40–$70 |
| Influenza (flu) — seasonal | $20–$40 |
| COVID-19 — primary series + booster | $0–$30 (often free) |
| Hepatitis A — 2 doses | $60–$100 per dose |
| Hepatitis B — 3 doses | $40–$80 per dose |
| Meningococcal | $100–$175 |
If you need all of the above, vaccine costs alone can exceed $1,000. Bringing your vaccination records dramatically reduces this risk.
3. Tuberculosis (TB) Screening
All applicants age 2 and older are required to have TB screening. This is done via a blood test (IGRA/QuantiFERON) or, in some cases, a skin test (TST). If the initial test is positive, the civil surgeon will order a chest X-ray and further evaluation. A positive TB test does not automatically make you inadmissible — active TB is inadmissible, but latent TB is not. TB screening typically costs $50–$100, with additional costs for a chest X-ray if needed ($100–$300).
4. Blood Tests and Additional Screening
Required blood tests include syphilis screening (for applicants age 15+). The civil surgeon may also screen for gonorrhea in some cases, and will review medical history for communicable diseases of public health significance including Hansen disease (leprosy) and Class A/B conditions.
- Syphilis (RPR/VDRL blood test, age 15+)
- TB blood test (QuantiFERON-TB Gold)
- Drug and alcohol assessment (questionnaire + evaluation)
- Mental health screening (mental disorders with harmful behavior)
How to Find a USCIS Civil Surgeon
Only USCIS-designated civil surgeons can complete Form I-693. Using a non-designated physician will result in your application being rejected. You must find a civil surgeon near you using the official USCIS Civil Surgeon Locator.
Official USCIS Civil Surgeon Locator
Go to uscis.gov/civil-surgeons and enter your ZIP code to find designated civil surgeons near you. Always verify the civil surgeon is currently designated before making an appointment.
Tips for choosing a civil surgeon:
- Compare prices — civil surgeons are private practices and fees vary widely
- Ask if they charge the same fee regardless of vaccination status, or extra for catch-up shots
- Ask how long wait times are for appointments (typically 1–4 weeks)
- Check if they accept payment plans for large vaccine costs
- Confirm they will complete Form I-693 in a sealed envelope per USCIS requirements
- Ask about their experience with the specific category of your application
How to Reduce Your Immigration Medical Exam Cost
Gather all vaccination records before the appointment
This is the single most important cost-saving step. Every vaccine you can prove you already have saves $20–$175 in catch-up costs. Collect records from your childhood doctor, school records, employer health records, and your home country health authorities. Have them translated into English if needed.
Get the flu shot and COVID-19 booster from a pharmacy first
Influenza and COVID-19 vaccines are often free or low-cost at pharmacies (CVS, Walgreens, Rite Aid) through insurance or free community programs. Getting these before your civil surgeon appointment eliminates those costs from the exam bill.
Check multiple civil surgeons for pricing
Civil surgeons are private practices and prices vary significantly — sometimes by 50–100% for the same geographic area. Call several offices to compare their base exam fee and how they charge for vaccines (some charge per vaccine, others have flat rates).
Look for community health centers
Some Federally Qualified Health Centers (FQHCs) and nonprofit community health organizations have designated civil surgeons who offer reduced-fee immigration exams on a sliding scale for low-income patients. Search HRSA.gov for health centers near you.
Time your exam carefully
Form I-693 is valid for 2 years from the civil surgeon signature date. If you plan to file I-485 soon, schedule the exam close to your filing date to maximize the validity period. Also, schedule the exam after April each year for the seasonal flu vaccine — you can get the flu shot for free before your appointment.
Medical Conditions That Can Affect Your Green Card
The immigration medical exam screens for health-related grounds of inadmissibility. Most applicants pass without issue, but it is important to understand what conditions can cause problems.
Conditions that CAN cause inadmissibility:
- Active tuberculosis (TB) — latent TB is NOT inadmissible
- Infectious syphilis (secondary stage)
- Gonorrhea (infectious)
- Hansen disease (leprosy) — infectious stage
- Class A and Class B communicable diseases
- Failure to complete required vaccinations
- Physical/mental disorder with associated harmful behavior
Conditions that are NOT grounds for inadmissibility:
- HIV (removed from inadmissibility list in 2010)
- Latent (inactive) tuberculosis
- Non-communicable conditions (diabetes, heart disease, etc.)
- Mental health conditions without associated harmful behavior
- Obesity or BMI
- Most chronic conditions
Frequently Asked Questions
How much does the immigration medical exam cost in 2026?
The immigration medical exam costs $200–$350 for the exam itself when vaccinations are up to date. Add $100–$400 for catch-up vaccines if needed. Total cost ranges from $200 to $800+ depending on your vaccination history and geographic location. Always call ahead to compare prices between civil surgeons in your area.
How long does the immigration medical exam take?
The civil surgeon appointment typically takes 1–2 hours if all vaccinations are up to date. If catch-up vaccines are needed, the appointment may take longer. Some vaccines require observation periods. If blood work or a TB blood test is ordered, results can take 1–3 days, requiring a follow-up appointment to complete Form I-693.
What documents should I bring to my civil surgeon appointment?
Bring: government-issued photo ID (passport, driver license), vaccination records (complete history in any language — bring translations), any relevant medical records (history of TB, psychiatric conditions, prior medical issues), your USCIS receipt number or I-485 application documents, and payment for the exam fee.
Do I need to repeat the medical exam if my green card is delayed?
Form I-693 is valid for 2 years from the civil surgeon signature date. If USCIS does not decide your I-485 within 2 years and there is a concern about the validity of the medical exam, USCIS may request a new Form I-693. In practice, USCIS often accepts exams that are slightly beyond 2 years if the applicant's health status has not changed, but a new exam may be requested.
My medical exam is done — what do I do with Form I-693?
The civil surgeon seals Form I-693 in an envelope. Do not open it. Submit the sealed envelope to USCIS with your I-485 application, or give it to your attorney if they are filing on your behalf. If the envelope is opened or tampered with, USCIS will reject it and you will need a new exam.