The Civil Surgeon Exam is the required medical screening for individuals applying for permanent residency in the United States. U.S. Citizenship and Immigration Services (USCIS) mandates this examination to ensure applicants are not inadmissible on health-related grounds. The results of this medical assessment are documented on USCIS Form I-693, Report of Immigration Medical Examination and Vaccination Record, which is sealed by the physician. The government does not set a standard price for this procedure, meaning the total cost varies widely across the country.
Base Fees and Cost Variability
The initial fee charged by a civil surgeon covers the consultation, physical assessment, medical history review, and the administrative completion and sealing of the Form I-693. This base price for the service component typically falls within a range of $100 to $500, though the national average is often cited around $400. Some clinics may charge $800 or more, depending on the services included in their initial quote.
A primary driver of this financial variability is the geographic location of the surgeon’s practice. Clinics operating in major metropolitan areas with high costs of living, such as New York or Los Angeles, generally charge higher base fees. USCIS does not regulate the rates for the examination service itself, allowing surgeons to set individual fee structures. A low advertised base price often indicates that mandatory laboratory tests and vaccines will be billed separately.
Mandatory Add-Ons and Supplemental Testing
The total expenditure for the medical exam is often significantly higher than the quoted base fee due to mandatory add-on costs for laboratory work and vaccinations. All applicants aged two years and older are required to be screened for tuberculosis using a blood test, such as the Quantiferon-TB Gold, as the traditional skin test is no longer accepted. Applicants aged 15 and older must also undergo blood screening for Syphilis (RPR test) and a urine test for Gonorrhea.
These required laboratory tests are generally billed separately from the surgeon’s fee and can add between $100 and $300 to the total cost. If the tuberculosis screening is positive, the applicant must obtain a follow-up chest X-ray, which can add an additional $100 to $150. Applicants must also provide proof of having received a complete set of age-appropriate vaccinations, such as those for Measles, Mumps, Rubella (MMR), Polio, and Tetanus-Diphtheria-Pertussis (Tdap).
If an applicant lacks proper documentation or is missing any required immunizations, they must either receive the necessary vaccines or submit to a titer test (a blood test to prove immunity). Paying for multiple missing vaccinations or titer tests can inflate the final bill substantially, sometimes adding $50 to $500 depending on the specific vaccines needed. Applicants should confirm whether the surgeon’s office provides these services directly or requires the applicant to use an outside lab or pharmacy, as this will affect how the charges are applied.
Finding a Civil Surgeon and Payment Options
Applicants must find a physician authorized by USCIS to perform the examination using the myUSCIS “Find a Civil Surgeon” tool on the agency’s official website. Since fees are not standardized, applicants should contact multiple designated surgeons in their area to compare the total estimated cost. When price shopping, ask for a breakdown that includes the physical exam, the Form I-693 processing fee, and the cost of all required labs and potential vaccinations.
The immigration medical examination is considered an administrative requirement and is typically not covered by standard private or government health insurance plans. Applicants should prepare to pay for the civil surgeon’s physical exam and the I-693 completion fee entirely out-of-pocket. It is worthwhile to check with your insurance provider, however, as some plans may cover the cost of required vaccinations and certain laboratory tests.