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A single joint replacement bills at $20,000 to $50,000+ — which means an insurance-driven specialty can afford acquisition economics that look expensive on a spreadsheet and are bargains in the OR schedule. There is no published CPC benchmark for orthopedics, so we anchor honestly on the closest verified LocaliQ median (physical therapy: $4.95 CPC / 15.35% CVR / $32.79 CPL) plus a surgical-specialty uplift — then manage to the only number that matters: cost per booked surgery.
Orthopedics is the highest-value insurance-driven specialty in this practice: the patient arrives with coverage and usually a referral, and the surgical case — a knee or hip replacement, a rotator cuff repair, an ACL reconstruction — bills at $20,000 to $50,000 or more. That case value changes the acquisition math completely. A cost per lead that would bankrupt a primary-care practice is trivially affordable when one converted case repays months of ad spend. The discipline is refusing to report leads and reporting kept surgical evaluations instead.
Benchmark honesty first: no public dataset publishes an orthopedic CPC. The anchor we use is the verified LocaliQ healthcare dataset (3,542 US campaigns, Oct 2024–Sep 2025): physical therapy — the closest PT-adjacent specialty — runs a $4.95 median CPC, a 15.35% conversion rate, and a $32.79 CPL, the best lead economics in specialty care. Add the surgical uplift (hospital systems bid head terms; the Physicians & Surgeons category sits at $4.76) and a realistic planning band lands at $5–8 per click, 6–10% conversion, $70–130 per lead. We label it an estimate because it is one — and then we replace it with your market's real auction data in week one.
The structural risk is referral dependence. Insurance-driven orthopedics lives on PCP referrals and PT overflow — and one hospital-system employment wave can cut that flow overnight. Direct-to-patient capture is the hedge: patients increasingly search “knee replacement surgeon [city]” and “orthopedic doctor accepting [plan]” before they ever ask their PCP. Practices that own those searches own a referral channel no employment contract can revoke.
Where the money leaks is the funnel, not the auction. Practice Growth Co's verified framework: cost per new surgical patient runs 3–6× the CPL once lead-to-show and surgical-conversion rates apply. A $90 lead that never becomes a kept evaluation is expensive; a $180 lead that books a $32,000 knee replacement is cheap. Speed-to-evaluation, show-rate tracking, and consult-to-surgery follow-up are where we earn the multiple.
High-intent orthopedic searches we target — procedure, condition, and plan-fit terms — and the budget-drainers we strike before they cost you a dollar.
| Search term | Est. CPC band | Intent |
|---|---|---|
| orthopedic doctor near me | $5–8 | Access intent · the head term |
| orthopedic surgeon accepting [insurance] | $5–8 | Plan-fit · books fastest |
| knee replacement surgeon [city] | $6–9 | Surgical intent · $20K+ case |
| hip replacement cost | $4–7 | Cost intent · insurance fork |
| shoulder surgeon near me | $5–8 | Procedure + geo intent |
| acl reconstruction surgeon | $6–9 | Surgical intent · younger demo |
| sports medicine doctor [city] | $5–8 | Athlete segment · cash-adjacent |
| carpal tunnel surgery [city] | $5–8 | Procedure intent · high volume |
| spine surgeon [city] | $6–10 | Highest-acuity surgical intent |
| joint replacement cost with insurance | $4–6 | Coverage research · pre-surgical |
| orthopedic urgent care near me | $4–6 | Walk-in fork · injury intent |
| rotator cuff repair surgeon | $5–9 | Procedure intent · older demo |
Just as important as the searches we buy are the ones we block. Negative keywords tell Google to never show your ad for these searches — so job-seekers, students, and researchers never spend a dollar of your budget:
Surgical demand is insurance-mediated: a torn ACL hurts at every income level, and the plan card matters more than the ZIP code. Here is where affluence filters still earn their keep — and where they would only shrink the surgical pipeline.
Joint replacement, fracture care, and sports-injury demand run insurance-mediated at every bracket. Excluding lower-income ZIPs here would only shrink a pipeline where coverage — not affluence — is the gate. We run surgical campaigns demographically wide and let plan-fit messaging do the filtering.
PRP and regenerative injections, sports-performance programs, and concierge surgical packages are cash-pay. Those campaigns get the full cash-economy treatment: top-bracket bid layering, affluent-ZIP lists from Census ACS and IRS data, and financing-first landing pages.
Joint-replacement demographics skew Medicare-age. Messaging leads with access and plan fit — “accepting Medicare,” “most major plans” — and the 2025 fee-schedule cut (−2.83%, fifth straight year per MGMA) makes every kept evaluation count more, not less.
Performance Max gained household-income exclusions in 2025–2026. Where we run it, the exclusion set mirrors the posture: open on surgical campaigns, layered only on the cash-service fork.
Three channels fill an orthopedic surgical schedule, sequenced so cases book this quarter while referral independence builds underneath.
“Knee replacement surgeon [city]” and “orthopedic surgeon accepting [plan]” are patients weeks from an evaluation. Tightly matched Search campaigns — one per service line, disciplined negatives, broad demographics — capture surgical demand within days of launch.
Surgical patients cross-check everything: map-pack reviews, surgeon credentials, outcomes language. With 82–89% of patients researching online before booking and roughly half avoiding incomplete profiles, the business profile is a surgical-funnel asset — categories, services, photos, Q&A, and review velocity all managed.
Condition and recovery pages (“ACL tear treatment [city],” “knee replacement recovery timeline”) capture patients before they ever ask their PCP for a referral — a direct channel no hospital employment wave can cut, compounding underneath the paid engine.
PCP referrals and PT overflow are structural — and structurally fragile. One hospital-system employment wave can redirect the flow overnight. Direct-to-patient search capture builds a self-sourced pipeline that no contract can revoke, measured as a growing share of new surgical evaluations.
“Orthopedic urgent care” and “sports injury clinic” searches are the top of the surgical funnel — today's sprain evaluation is next quarter's ACL reconstruction. We build the walk-in fork as its own campaign and landing architecture, feeding the surgical schedule downstream.
At 3–6× CPL cost per new patient, the funnel decides profitability: five-minute response workflows, call tracking, show-rate management, and consult-to-surgery follow-up. A kept-evaluation pipeline beats a bigger ad budget every time.
We lead with the channels that produce kept surgical evaluations — and we report cost per booked case, not cost per lead.
Surgical advertising touches Google healthcare policy, state medical-board rules, and privacy law at once. Here is how we build it.
Server-side tracking and first-party data, architected so evaluation forms and call recordings never leak patient information into Google or Meta. AHA v. Becerra (June 2024) vacated part of the HHS pixel guidance, but the $12.2M Advocate Aurora and $6.6M Novant settlements prove liability is lawsuit-driven — so we build as if the strictest reading applies.
Google's personalized-ads policy prohibits remarketing on health conditions, symptoms, and treatments — knee pain, arthritis, and injury pages included. We work around it compliantly: first-party audiences from your own scheduling data, on-platform lead forms, and Smart Bidding signals — no PHI, no policy risk.
No “guaranteed outcomes,” no unverifiable success rates. Surgical-volume and outcomes statistics run only when they are your real numbers, current, and sourced. “Board-certified orthopedic surgeon” runs only when the certification is real and current — state medical-board advertising rules are treated as a per-state checklist, not a footnote.
Implant-brand and device names sit in a restricted-policy zone, and speculative or experimental treatment terms are restricted outright. We write high-performing procedure ads without restricted terminology — technique, credentials, and access language — and flag any category that needs certification review before launch, never after a disapproval.
An illustrative model at anchored estimates: a $6.50 CPC and an 8.0% conversion rate on a $7,500 monthly budget. Every stage below is a lever we actively manage.
Illustrative model — not client data. CPC and conversion rate are estimates anchored on the verified LocaliQ physical-therapy median ($4.95 CPC / 15.35% CVR / $32.79 CPL) plus surgical uplift; booking, show, and surgical-conversion rates are planning assumptions. Real numbers vary by market, competition, and intake discipline.
At $20,000–$50,000+ billed per joint replacement, one booked case repays a $7,500 monthly budget roughly three times over — which is why the modeled month below shows seven cases producing $175,000 in billed surgical revenue. The leverage is not in the click price; it is in the intake funnel: show rate, surgical conversion, and speed to evaluation decide whether the model holds.
A 30-minute practice-strategy call: your service lines, your payer mix, your referral exposure — and exactly where the next kept surgical evaluations come from. No obligation.
Matched ad credit for new Google Ads accounts through our Premier Partner program.