Here's the arithmetic most orthopedic practices never run. On surgical terms you'll pay $10–$20 a click. If your landing page converts clicks to booked appointments at a healthy 5%, that's 20 clicks per booking, or roughly $200–$400 in ad spend per booked appointment. But not every booked appointment is a surgical case, and not every consult shows up, so factor a show rate and a surgical-conversion rate and your true cost per booked surgical consult often lands around $300–$900. That sounds expensive until you weigh it against case value. Spend $600 to book a consult that converts to a $22,000 total knee at even a 30% surgical conversion, and your effective acquisition cost per surgery is around $2,000 against $22,000 collected. That's a phenomenal return. The practices that lose money aren't paying too much per click. They're paying for clicks that never become anything, because they don't measure past the click, and they can't tell you which keyword produced the last five surgeries.

Not all ortho search intent is equal. Segment your keywords into three buckets and fund them accordingly. High-intent, high-value (fund these hard): "knee replacement surgeon," "hip replacement near me," "spine surgeon [city]," "rotator cuff surgery," "ACL surgeon." These searchers have a diagnosis or a strong suspicion and are shopping for a surgeon. Expensive per click, but they book and they convert. Mid-intent, needs nurturing: "knee pain doctor," "shoulder specialist," "back pain treatment," "sports medicine near me." These convert to consults but skew conservative-care first. Great volume, lower immediate surgical yield, essential for filling clinic and imaging. Budget burners (cap or exclude): broad terms like "orthopedic," "joint pain," "physical therapy," and anything without a body part or a procedure. Add aggressive negatives too: "exercises," "stretches," "home remedy," "jobs," "salary," "school," and payer-specific noise. An untuned ortho account bleeds 20–40% of spend on searches that were never going to book a surgeon.

Four leaks show up in almost every orthopedic account we audit. 1. One landing page for every service line. Sending a spine searcher and an ACL searcher to the same generic homepage tanks Quality Score and conversion. Each buys a higher CPC and a lower booking rate. Joint replacement, sports medicine, spine, and imaging each need their own page with matching headline, surgeon, and one-click booking. 2. No call tracking or offline conversion import. Most orthopedic bookings happen by phone. If you're not tracking calls and importing which calls became consults and surgeries, Google is optimizing toward cheap clicks, not toward revenue. 3. Ads running when nobody answers. Paying $15 a click at 7pm to hit a voicemail is lighting money on fire. Dayparting and after-hours capture matter more in ortho than almost any specialty. 4. Same budget across procedures. A $45,000 knee and a $250 injection visit should not compete for the same dollars. Without procedure-level bidding, your cheapest, lowest-value clicks eat the budget your surgical terms needed.

Before you touch a bid, you should know what a booked orthopedic patient actually costs you today and where the leak is. Drop your URL into the free Surge Report™ and in about sixty seconds you'll see, calibrated to orthopedic case values, the high-intent surgical searches your market is generating, an estimate of the booked consults and revenue you're leaving on the table, and the specific fixes, from landing pages to negative keywords to call tracking, that recover the most. No sales call required, and it's free. Prefer to talk it through? Book a twenty-minute strategy call and we'll walk your specific market, your service lines, and what tuned Google Ads plus a converting site would realistically produce for your practice.