Form I-693 is valid for 2 years from the date of the civil surgeon’s signature. After the 2-year time frame, you must submit a new Form I-693 if USCIS has not adjudicated your Form I-485.

On 9/29/2022, U.S. Citizenship and Immigration Services is extending
temporary waiver of the requirement that civil surgeons must sign Form
I-693, Report of Medical Examination and Vaccination Record, no more than
60 days before an individual applies for the underlying immigration benefit
(including Form I-485, Application to Register Permanent Residence or
Adjust Status).

The waiver was originally effective until Sept. 30, 2022, but USCIS has
extended it to March 31, 2023, to further ease processing delays and
associated difficulties in timely completing the immigration medical
examination. This waiver applies to all Forms I-693 associated with
applications for underlying immigration benefits that have not been
adjudicated, regardless of when the application was submitted to USCIS or
when a civil surgeon signed the Form I-693.