CostFlock has no paid relationship with any provider named on this page. How we make money
Key takeaways
- TPLO — the most common repair for dogs over 30 lb — costs $3,500–$6,500 per knee, up to $10,000 at university and big-city specialty hospitals.
- Lateral suture (extracapsular) repair for small dogs costs $1,000–$3,000 and is often done by a general vet.
- All-in, a single TPLO episode runs about $6,500 once pre-op X-rays, bloodwork, medication and rehab are added.
- 40–60% of dogs tear the other knee within two years — budget for a possible second surgery.
Dog ACL surgery cost breakdown
A torn cranial cruciate ligament (the dog equivalent of an ACL) is repaired with one of three techniques. Bone-cutting procedures (TPLO, TTA) use metal implants and a specialist surgeon; the lateral suture uses a strong suture outside the joint and suits smaller, less active dogs. Diagnostics, medication and rehab are billed separately.
| Service | Low | Average | High | Range ($0–$13,500) |
|---|---|---|---|---|
| TPLO — tibial plateau leveling osteotomy (per knee) | $3,500 | $5,000 | $6,500+ | |
| TTA — tibial tuberosity advancement (per knee) | $3,000 | $4,200 | $5,500 | |
| Lateral suture / extracapsular repair | $1,000 | $1,800 | $3,000 | |
| Pre-op exam, X-rays & bloodwork | $200 | $400 | $800 | |
| Post-op pain medication & antibiotics | $100 | $200 | $300 | |
| Rehab / physical therapy (8–12 sessions) | $500 | $1,000 | $1,800 | |
| Follow-up X-rays (6–8 weeks) | $150 | $250 | $400 | |
| Bilateral TPLO (both knees) | $6,000 | $9,000 | $13,000 |
What changes the price
TPLO (per knee) by state
Prices track local labor and rent costs. The figures below are modeled, not surveyed: we apply a regional cost index to the national figure above, so treat them as a guide to how far your state sits from the national average rather than as quotes from local providers.
| State | TPLO (per knee) | Lateral suture | vs. national avg |
|---|---|---|---|
| New York | $7,000 | $2,520 | +40% |
| California | $6,750 | $2,430 | +35% |
| Washington | $6,000 | $2,160 | +20% |
| Florida | $5,500 | $1,980 | +10% |
| Illinois | $5,250 | $1,890 | +5% |
| Arizona | $5,100 | $1,836 | +2% |
| Pennsylvania | $5,100 | $1,836 | +2% |
| Texas | $5,000 | $1,800 | 0% |
| Georgia | $4,500 | $1,620 | −10% |
| Ohio | $4,250 | $1,530 | −15% |
Show all 50 states + D.C.
| State | TPLO (per knee) | Lateral suture | vs. national avg |
|---|---|---|---|
| Hawaii | $7,000 | $2,520 | +40% |
| New York | $7,000 | $2,520 | +40% |
| Washington, D.C. | $6,900 | $2,484 | +38% |
| California | $6,750 | $2,430 | +35% |
| Massachusetts | $6,600 | $2,376 | +32% |
| New Jersey | $6,400 | $2,304 | +28% |
| Connecticut | $6,250 | $2,250 | +25% |
| Alaska | $6,100 | $2,196 | +22% |
| Washington | $6,000 | $2,160 | +20% |
| Maryland | $5,900 | $2,124 | +18% |
| Rhode Island | $5,750 | $2,070 | +15% |
| New Hampshire | $5,600 | $2,016 | +12% |
| Oregon | $5,600 | $2,016 | +12% |
| Colorado | $5,500 | $1,980 | +10% |
| Florida | $5,500 | $1,980 | +10% |
| Vermont | $5,400 | $1,944 | +8% |
| Virginia | $5,400 | $1,944 | +8% |
| Delaware | $5,250 | $1,890 | +5% |
| Illinois | $5,250 | $1,890 | +5% |
| Maine | $5,250 | $1,890 | +5% |
| Nevada | $5,250 | $1,890 | +5% |
| Arizona | $5,100 | $1,836 | +2% |
| Minnesota | $5,100 | $1,836 | +2% |
| Pennsylvania | $5,100 | $1,836 | +2% |
| Texas | $5,000 | $1,800 | 0% |
| Montana | $4,900 | $1,764 | −2% |
| Utah | $4,900 | $1,764 | −2% |
| Idaho | $4,750 | $1,710 | −5% |
| Michigan | $4,750 | $1,710 | −5% |
| North Carolina | $4,750 | $1,710 | −5% |
| Wyoming | $4,750 | $1,710 | −5% |
| Wisconsin | $4,650 | $1,674 | −7% |
| New Mexico | $4,600 | $1,656 | −8% |
| North Dakota | $4,600 | $1,656 | −8% |
| South Carolina | $4,600 | $1,656 | −8% |
| Georgia | $4,500 | $1,620 | −10% |
| Louisiana | $4,500 | $1,620 | −10% |
| Nebraska | $4,500 | $1,620 | −10% |
| South Dakota | $4,500 | $1,620 | −10% |
| Tennessee | $4,500 | $1,620 | −10% |
| Missouri | $4,450 | $1,602 | −11% |
| Alabama | $4,400 | $1,584 | −12% |
| Indiana | $4,400 | $1,584 | −12% |
| Kansas | $4,400 | $1,584 | −12% |
| Iowa | $4,350 | $1,566 | −13% |
| Kentucky | $4,350 | $1,566 | −13% |
| Arkansas | $4,300 | $1,548 | −14% |
| Oklahoma | $4,300 | $1,548 | −14% |
| Ohio | $4,250 | $1,530 | −15% |
| Mississippi | $4,200 | $1,512 | −16% |
| West Virginia | $4,200 | $1,512 | −16% |
How to pay less
Get a second quote from a traveling orthopedic surgeon who operates at your regular vet's clinic. They commonly price $1,000–$2,000 below referral hospitals for the same TPLO.
Ask for a bundled package. Many surgeons include the 6–8-week follow-up X-rays, take-home medication and the first rehab consult in one price — that avoids $400–$800 in add-on billing.
Pet insurance reimburses 70–90% — but only if the policy was active before symptoms and past the orthopedic waiting period (usually 6 months; Nationwide requires 12). CareCredit and Scratchpay financing are accepted at most specialty hospitals.
How we calculated these numbers
Frequently asked questions
How much does TPLO surgery cost for a dog?
Typically $3,500–$6,500 per knee, and up to $10,000 at specialty or university hospitals in major metros. With diagnostics, medication and rehab, most families spend $4,500–$8,000 in total.
Is the cheaper lateral suture repair a good option?
Yes for dogs under about 30 lb and for less active dogs. It's less durable in heavier or athletic dogs, which is why surgeons favor TPLO for dogs over 30 lb.
Will my dog tear the other ACL too?
Statistically, 40–60% of dogs rupture the opposite cruciate ligament within 1–2 years, so many owners plan for a second surgery.
Does pet insurance cover ACL surgery?
Yes, if you enrolled before the injury and the orthopedic waiting period (usually 6 months) has passed. A tear that occurred before enrollment is excluded as pre-existing, and some insurers exclude the second knee if the first tore before coverage.
A note on these figures. Prices are national estimates compiled from the published sources listed below and will differ from what your local provider quotes. CostFlock is not a veterinary practice and nothing here is medical advice — always discuss treatment options and costs with a licensed veterinarian.
- VetCostGuide — Dog torn ACL / TPLO cost (2026)
- RealVetCost — ACL surgery cost data (2026)
- RexVet — Dog ACL/CCL surgery cost, TPLO vs other repairs (2026)
- Lemonade — TPLO surgery cost (2026); MoneyGeek — TPLO coverage and cost (Aug 2026)