Understand Your I-693 Exam Costs Before You Pay

If you’re preparing an adjustment of status case, you probably want to know the exam cost before you book. There isn’t one set price. The clinic that performs the exam sets its own charge, and the final bill can grow with vaccines, lab tests and follow-up visits.

So how much does the I-693 exam cost? Plan around the total on a written, itemized quote, not a general average. This guide explains what the exam covers, what can add to the bill, and how timing affects your case.

What the I-693 is and why it’s part of your case

Form I-693 is the medical exam report that adjustment of status applicants must submit, and it is completed by a civil surgeon. For refugee-based applicants, a medical examination may be required, and family members granted refugee status must submit to a medical examination at the time they seek to adjust. The applicant must have the exam by a designated civil surgeon, and that report becomes part of the record (8 C.F.R. § 245.5).

A civil surgeon is a physician designated by USCIS. A regular doctor visit may not meet this requirement unless that doctor holds the civil surgeon designation (USCIS Policy Manual on civil surgeon exams).

USCIS policy requires the form to be in a sealed envelope, as the form’s instructions detail (USCIS Policy Manual guidance on medical examination results). So the exam is part of your filing, not an optional extra. A mistake with the form can cost you time, and possibly another exam.

Who sets the price of the exam

The clinic sets the price for its own exam. One office may quote a different amount than another, even for the same visit.

Ask for the full price in writing before you book. The amount depends on the clinic and the services included, so ask for the complete price up front.

Before you pay, also confirm the doctor is a civil surgeon. USCIS guidance says applicants should check this with their doctors before the exam (USCIS Policy Manual on the civil surgeon list).

What the base exam usually includes

The base exam usually covers a medical history, a physical exam, and a review of your vaccine records. The civil surgeon records the results on the form.

Vaccine records matter a lot. USCIS treats a failure to show vaccination documentation as a Class A medical condition for aliens who seek admission as immigrants or who seek adjustment of status to lawful permanent residence (USCIS Policy Manual on Class A and B conditions). Class A conditions make an applicant inadmissible and ineligible for adjustment (USCIS Policy Manual on Class A and B conditions). The vaccines include at least those listed in 8 U.S.C. § 1182, such as measles, polio, tetanus, and hepatitis B, along with any other vaccinations recommended by the Advisory Committee for Immunization Practices.

There is one piece of good news. Applicants do not need to submit COVID-19 vaccine documentation for an application pending on or after January 20, 2025 (USCIS vaccination requirement guidance).

The civil surgeon may also order lab tests. Applicants of certain ages must be tested for gonorrhea and syphilis. Under USCIS guidance, an applicant who had not yet reached the age range that requires testing (for example, gonorrhea and syphilis testing) on the date the civil surgeon signed Form I-693 must not be required to obtain those tests before final adjudication, even if the applicant reached that age by the time of final adjudication, unless otherwise specified by the CDC; the same approach applies when the CDC’s Technical Instructions for Civil Surgeons (unless otherwise specified by CDC), USCIS policy, or the edition of Form I-693 has changed, as long as the civil surgeon complied with all procedures and requirements in the CDC’s Technical Instructions for Civil Surgeons and used the edition of the form that was current on the date they signed Form I-693 (USCIS Form I-693 review guidance).

Costs that can be added on top of the exam fee

Extra charges can push the final bill above the exam price, so read the whole quote. Vaccines given at the visit are often priced separately from the exam.

Lab work, follow-up visits, and fees for getting old vaccine records can add up too. Ask the clinic which items are included and which cost extra.

A vaccine the civil surgeon marks as not medically appropriate is generally waived by USCIS, unless that finding is clearly wrong (USCIS vaccination requirement guidance). You do not need a separate waiver application for that finding (USCIS vaccination requirement guidance).

Other gaps work differently. If you object to vaccinations because of a religious belief or moral conviction, that is not a blanket waiver: you must file a waiver request on Form I-601 with the required fee, and you will need to show that you oppose vaccinations in all forms, not just certain vaccinations, so plan for that cost too.

Factors that change the total

Several factors can move the bill up or down. Missing vaccine records can mean more doses or more testing.

Medical conditions can also add work. USCIS calls conditions that are serious in degree or permanent in nature Class B conditions. Class B conditions do not by themselves make you inadmissible, but they can call for more medical work (USCIS Policy Manual on Class A and B conditions).

Your entry history can change whether you need a new exam. If you entered as a K nonimmigrant, such as a fiancé(e) or spouse of a U.S. citizen, you may not need a new exam. That applies when the exam was done before the visa was issued, as a condition of issuing that nonimmigrant visa, and no more than 1 year before you applied (8 C.F.R. § 245.5).

Clinic prices also vary by city and state. The same exam can cost different amounts in different places.

How the I-693 timing affects the adjustment case

The form must match the edition in use when the civil surgeon signs it. In most cases, older editions are not acceptable (USCIS Form I-693 review guidance). Ask the clinic which edition it uses before the visit.

A properly completed form signed by a civil surgeon on or after November 1, 2023 can only be used as evidence to show that you are not inadmissible under the health-related grounds for the entire time your application is pending (USCIS Form I-693 review guidance). That can help you avoid paying for a repeat exam.

Officers should not ask for an updated form to meet a requirement that did not apply when the doctor signed. If you reach an age that requires new tests later, that rule helps you (USCIS Form I-693 review guidance).

Scheduling time differs from clinic to clinic. Ask for the next available appointment so the form is ready for your filing schedule.

Frequently asked questions

Short answers to the questions people ask most about this exam’s cost and timing.

Talk through your I-693 with our team

If you’re arranging this exam for a spouse, child or other relative, you may be juggling cost questions while the green card case is already moving. That’s a stressful spot to be in.

AG Immigration Law P.A. focuses on adjustment of status, family petitions, and other immigration matters. Adriana Gomez is the lawyer responsible for this page.

To talk through where your I-693 and I-485 stand, reach out through our contact form, by phone, or on WhatsApp. You can also ask about a paid consultation.