I-9 compliance - how employers stay audit-ready with Form I-9
8 mins read | Aug 11, 2026
The immigration medical exam cost is a range rather than a fixed fee, because a private doctor sets the price, not USCIS. If you just learned this exam is required for your green card and you want to know the damage, the honest answer is that most applicants pay somewhere in a few-hundred-dollar band, and where you land depends on the doctor you choose and how many vaccines and tests you still need. This post explains why the price varies, what pushes it up, and how to fold it into your wider green card budget.
The exam is documented on Form I-693, and USCIS charges nothing for the form itself. There's no USCIS medical exam cost to pay, because what you owe goes directly to a civil surgeon, so the number you'll actually see is whatever that provider quotes. Everything below breaks down where that money goes, and the framework here was checked against current USCIS policy before publishing.
This is the medical exam line only. The full adjustment of status bill, from the I-485 filing fee to work and travel permits, is budgeted separately.
What the immigration medical exam is and why it's required
The immigration medical exam is a health check that confirms you're not inadmissible to the United States on health-related grounds, and almost every applicant for a green card and permanent residence has to complete it. It's documented on Form I-693, the Report of Immigration Medical Examination and Vaccination Record, which a USCIS-designated doctor fills out and signs after examining you.
The exam exists to screen for a specific set of public-health concerns, not to give you a general physical. A civil surgeon, which is a doctor USCIS has authorized to perform immigration medical exams, checks for certain communicable diseases, reviews your vaccination history, and screens for conditions that could make you inadmissible. You can look up authorized doctors on the official USCIS Form I-693 page. The results go on Form I-693, which the doctor seals in an envelope that you submit to USCIS unopened, and USCIS won't accept it if the envelope is opened or altered.
Timing matters here because the rules changed recently. Since December 2024, you generally submit Form I-693 together with your Form I-485, the application to adjust status to a green card while you're in the United States. That means the exam is now part of your initial filing rather than something you can send in later, so it's a cost you plan for at the start of the adjustment stage. Our Form I-485 guide explains how the exam fits into the wider application.
If you're going through consular processing abroad rather than adjusting status inside the United States, you see a different doctor. Applicants outside the country use a panel physician, a doctor authorized by the U.S. Department of State, instead of a civil surgeon. The exam serves the same purpose, but the provider and the pricing depend on the country. Our guide comparing consular processing and adjustment of status covers that distinction in more depth.
Immigration medical exam cost: why it's a range, not a fixed fee
The immigration medical exam cost is a range because civil surgeons are private doctors who set their own fees, and USCIS charges nothing for the I-693 form itself. Two applicants across town from each other can get very different quotes, and both are legitimate, because each doctor prices the base exam and any add-ons independently.
What you pay usually breaks into two parts: a base civil surgeon fee and the cost of any vaccines or lab tests you still need. The base fee covers the physical, the paperwork, and the doctor's time to complete and seal Form I-693. On top of that, the price climbs if you're missing required vaccines or need lab work such as a tuberculosis test, since those are billed on top of the base exam. This is why the green card medical exam price is quoted as a band rather than a single figure.
Here's how the pieces of the immigration medical exam cost typically break down.
| Cost piece | Who charges it | Fixed or variable |
|---|---|---|
| Form I-693 form itself | USCIS | No fee |
| Base exam (physical, records, sealed form) | Civil surgeon | Set by provider |
| Missing vaccines | Civil surgeon | Varies by how many you need |
| TB screening and lab work | Civil surgeon | Standard, plus follow-ups if needed |
| Follow-up testing (chest X-ray, specialist) | Civil surgeon or specialist | Only if results require it |
Location and provider type drive a lot of the variation. A civil surgeon in a high-cost metro area often quotes more than one in a smaller city, and a large clinic may price differently from a solo practice. Because the fee is set privately, it's worth calling two or three designated civil surgeons and asking what their quote includes before you book, so you're comparing the base exam plus the same set of vaccines and tests. You can find designated doctors near you through the USCIS civil surgeon locator.
Fees are current as of July 2026. USCIS doesn't set the exam price, and civil surgeons update their own fees over time, so confirm the quote directly with the doctor's office when you book.
How much does your green card cost?Get a personalized price and timeline estimate based on your visa type and nationality.
What can push the price up: vaccines and repeat tests
The two things that most often raise your immigration medical exam cost are missing vaccines and repeat testing. USCIS requires a specific set of vaccinations, and if your records are incomplete, the civil surgeon administers the missing doses and bills you for them on top of the base exam fee.
Vaccines are the most common add-on. The required USCIS list covers shots such as measles, mumps, and rubella, tetanus and diphtheria, hepatitis B, and influenza in season, among others. If you already have documented proof of these, you avoid the extra charge, so bringing a complete vaccination record to your appointment is the single best way to keep the price down. Missing several vaccines can add a meaningful amount, since each dose has its own cost.
Lab work is the other cost driver. Screening for tuberculosis is standard, and if an initial test comes back unclear or positive, follow-up testing such as a chest X-ray or additional blood work gets added. A result that requires a specialist evaluation can push the total higher still. None of this is optional if the doctor determines it's medically necessary, so it's a genuine variable rather than an upsell.
There's a simple way to think about the two ends of the range. An applicant who arrives with a complete vaccination record and a clean TB screen pays close to the base exam fee, while an applicant who needs several catch-up vaccines and follow-up lab work pays noticeably more. Knowing which side you're likely on helps you set a realistic number before you walk in.
Budgeting for the immigration medical exam inside your green card costs
Budget the immigration medical exam as its own line, and treat it as a variable cost that sits inside the larger adjustment of status bill. Because a private doctor sets it and add-ons can move the number, the safest approach is to price the exam separately from the fixed government fees so a higher medical quote doesn't blow up the rest of your plan.
The exam is one line among several in the green card process. The fixed pieces, like the $1,440 Form I-485 filing fee, are published by USCIS and don't move, while the I-693 cost is the line most likely to vary based on your health records. Seeing the whole bill in one place helps you set aside the right amount, which is why we price the full adjustment stage in a separate breakdown that this post links to.
You can keep the exam from becoming a surprise with a few practical steps. Ask each civil surgeon for a quote that spells out the base fee plus vaccines and tests, so you're comparing the same thing. Bring your complete vaccination record to avoid paying for doses you've already had. And if you can, get quotes from two or three designated doctors before booking, since the private pricing means the range is real.
For a personalized view of where the medical exam sits in your total green card spend, our pricing tool estimates the full cost and timeline for your situation, so you can plan the whole stage rather than one line at a time.
Tukki is a U.S. immigration provider that helps skilled professionals through the green card process, including the adjustment of status stage where the Form I-693 medical exam is required, with dedicated attorney support and full case visibility at every step. If you want help mapping out the full cost of your green card, our team can walk you through it.