How much does dog ACL (CCL) surgery cost?
Surgery for a torn ACL usually costs about $4,400 per knee, everything included. That is the middle of the prices we collected and checked. The cheapest full price was $2,600 and the highest was $10,000. If you're reading this with a quote in your hand, here is what it should include, why yours may differ, and whether you have to decide today.
A torn ACL in a dog (vets call it the CCL, or cranial cruciate ligament) is the same knee ligament people tear. In dogs, according to the American College of Veterinary Surgeons, it usually frays over months rather than snapping in one jump. The most common repair is a TPLO (tibial plateau leveling osteotomy), where the surgeon cuts and rotates the top of the shin bone so the knee stays stable without the ligament.
is the middle of 30 TPLO prices we collected and checked across 15 states. They come from clinic price pages, university hospitals and prices people shared online. Most of the shared prices are quotes rather than paid bills. The middle price clinics post is $3,900. The middle price people report is $5,250, and the highest, from Seattle and Boston, ran $8,500 to $10,000.
Do I have to do the surgery, and do I have to do it now?
The ligament does not heal on its own. Without surgery the knee stays loose, according to the American College of Veterinary Surgeons, and arthritis sets in faster. The same group reports that 85 to 90 percent of dogs improve a lot after surgery.
That said, this is rarely a same-day decision. Some dogs get by without surgery: strict rest, pain medication, rehab, and sometimes a brace. The American College of Veterinary Surgeons notes that this route leaves the knee loose. We did not collect prices for it.
There is also a cheaper operation, the lateral suture: a strong stitch placed outside the joint to do the ligament’s job, the one owners call the nylon string kind. Colorado State’s veterinary hospital reserves it mainly for small, older or less active dogs. For a big or young dog, most surgeons will recommend a TPLO.
A limp is not always the ligament. The kneecap can slip out of its groove instead, which is a different operation at a different price: our guide to luxating patella surgery puts that at about $2,500 per knee for a dog under 50 pounds.
Getting a second quote, or an opinion from a vet who specializes in rehabilitation (physical therapy for dogs), is a normal step. Ask your vet how long a wait is safe for your dog while you do that.
Embrace runs on a clock of its own, set by when signs appeared rather than by when you operate. If you are weighing a policy for the other knee, read the orthopedic exclusions that do not expire before you read the waiting periods.
How much does a TPLO cost, and is it the same as ACL surgery?
A TPLO costs about $4,400 per knee, which is the figure at the top of this page. TPLO and ACL surgery are not two operations with two prices. “ACL surgery” is what owners call the repair, and the TPLO is its most common version. The number is the same because 30 of the 35 prices on this page are TPLO prices.
The first row of our table is that operation: $2,600 at the low end, $4,400 in the middle and $10,000 at the top, per knee. Those 30 prices come from 15 states. If your quote says TPLO, you are reading the right page.
Why did my vet quote more, or less, than this?
Where the surgery happens moves the number more than anything about your dog. Outside the Seattle and Boston areas, the middle price in our table is $4,000. The four prices people reported from those two metros, all of them quotes, run $5,000 to $10,000.
The type of practice matters too. High-volume surgery-only practices in Texas and Kansas post $2,900 to $3,500 for a TPLO. General practices and university hospitals mostly land between $3,000 and $6,000. Specialty hospitals in big cities, the ones your vet refers you to, sit at the top.
There is also a gap between what clinics post and what people report. The middle posted price is $3,900 and the middle price people report is $5,250, partly because people who post a price online tend to live in expensive cities. Most of those reports are quotes rather than paid bills. A 2025 survey by CareCredit across all 50 states found state averages from about $2,800 to $6,400, which matches what we see.
Your dog’s size moves the price less than you might expect. Two practices in our table charge one flat TPLO price for any weight. Where there are tiers, they are modest: the University of Missouri adds about $1,000 for giant breeds, and an Austin surgery practice’s tiers span roughly $700 from a dog under 60 pounds to one over 130.
What should the quote include?
A complete estimate for a TPLO lists these items. Ask about any that are missing, because that is usually where two quotes differ.
- The consult with the surgeon, often billed separately at $75 to $200 and often not in the first quote.
- X-rays of the knee to plan the cut, sometimes under sedation. Our dog X-ray cost guide says what a series costs on its own.
- Bloodwork before anesthesia.
- Anesthesia and monitoring during the operation.
- The surgery itself, including the metal plate.
- A night in hospital, at some practices.
- Pain medication and antibiotics to take home, plus the cone.
- Follow-up visits, and X-rays at about eight weeks to confirm the bone has healed. One practice in our table bills these separately at about $500; others include them.
- Rehab sessions, if the practice offers them. One Austin practice includes six sessions in its price; most bill them separately, and one Wisconsin practice quotes $400 to $800.
Low-cost options are real but come with conditions. The cheapest full-price TPLO we found, $2,600, is a general practice’s dedicated low-cost program that bills the pre-surgery tests separately. Discount fixed-price surgery centers offer lateral suture at $1,500 to $2,000; some add the consult and bloodwork on top, and some will not operate on dogs over 85 pounds.
If a quote is far below the local market, ask what is excluded and who does the surgery. If it is far above, you are usually paying for a board-certified surgeon at a specialty hospital, which is exactly what some cases need.
Cost by procedure type
Where these numbers come from. 35 prices, collected in September 2026 and re-checked at each source. 21 are posted by clinics, surgery centers and university hospitals in 10 states, from Missouri and Texas to California and Florida. 14 are bills or written quotes that people shared online, from Washington, Colorado, Massachusetts, Minnesota and Tennessee. Most posted TPLO prices cover bloodwork, anesthesia, the surgery with its metal plate, and at least one follow-up visit; a few bill the consult or the pre-surgery tests separately, and we say so where it matters. The consult, when separate, is usually $75 to $200.
| Procedure | Low | Typical | High |
|---|---|---|---|
| TPLO · most dogs, and what surgeons prefer for large or active dogs | $2,600 | $4,400 | $10,000 |
| Lateral suture · small to medium dogs, or older, quieter dogs | $1,500 | $2,200 | $3,500 |
The lateral suture (vets also call it extracapsular repair) is the stitch-outside-the-joint operation described above. Its range rests on fewer collected prices than TPLO. A third operation, TTA (tibial tuberosity advancement, which moves the front of the shin bone forward to the same end), exists; we found no published US prices for it.
How we collect these estimates: where each price comes from, and which ones we leave out and why.
Would insurance have covered this?
If your dog's ACL is already torn, a new Embrace policy will not pay for it. Embrace counts a condition as pre-existing when a vet advised on it, your dog was treated, or signs showed, before the policy starts or during a waiting period. So this is a question about the other knee, or your next dog. Embrace has its own rule for cruciate ligament disease, one of four orthopedic conditions, meaning bones and joints.
If the condition appears in the first 180 days in most states, or as few as 30 days in others, it is excluded for the life of the policy. It is not a clock you wait out: past that window the rule does not apply to your dog. A few states work differently, with a six-month orthopedic waiting period, not an exclusion. You can apply to shorten it: a vet examines your dog at your cost and fills in Embrace's Orthopedic Report Card.
A clean report can shorten that waiting period: to the end of the 14-day illness wait for an exam in the first 14 days, otherwise to the exam date. The exam can also work against you: anything your vet notes on the form may be treated as pre-existing. That 14-day illness wait is separate and real, and other illnesses are covered after it. Which applies depends on your state, and Embrace publishes a state-by-state list worth checking before you buy.
Embrace's policy terms add a two-knee rule: a tear in one knee in the first 180 days, or earlier, can make a later tear in the other knee pre-existing. The figures below are for a knee the policy covers, with the whole $4,400 eligible and the $500 annual deductible unmet. The policy pays $3,510 and you pay $890. Once earlier claims have met the deductible, 90 percent of $4,400 comes back, $3,960, and you pay $440.
The wider question, answered across every bill we have priced: Is pet insurance worth it for a dog?
Questions owners ask
Will the other knee go too?
Often, yes. Because the ligament wears out rather than snapping, the other knee is usually wearing too. The American College of Veterinary Surgeons estimates that 40 to 60 percent of dogs that tear one ACL will tear the other.
What if I can't afford the quote?
Three things that came up repeatedly in the price pages and owner threads we read. Ask the same practice what the quote leaves out and whether it offers a payment plan or takes a financing card such as CareCredit or Scratchpay, and read the interest terms before you sign. Get a second quote: the same operation ran $3,000 to $5,000 around Denver and $4,000 to $6,000 around the Twin Cities in our table. And for a small or older dog, ask whether a lateral suture is a reasonable option at roughly half the price.
What is recovery like?
About eight weeks of strict rest with short leash walks only, then a gradual return. The University of Missouri's veterinary hospital tells you to expect full normal function by about a year. It puts all complications under 10 percent and serious ones under 5. Colorado State's hospital says physical therapy improves the result; it is usually billed separately, and one Wisconsin practice in our table quotes $400 to $800 for it.
Does the price include the metal plate?
Usually yes. Most of the 30 TPLO prices on this page cover bloodwork, anesthesia, the surgery with its metal plate, and at least one follow-up visit. A few add the consult or the pre-surgery tests on top, and a separate consult runs $75 to $200. If your quote is one number, it is worth asking which of those four things it covers.
Sources
American College of Veterinary Surgeons, cranial cruciate ligament disease · Colorado State University Veterinary Health, canine cruciate ligament injury · University of Missouri Veterinary Health Center, TPLO client handout (2023) · Price data: 59 prices collected from published fee schedules, clinic price pages and owner reports online (25 quotes, 3 paid bills), every one re-verified at its source, 35 used after exclusions, September 2026 · Embrace Pet Insurance state terms (version 6), its state-by-state list of orthopedic rules and the rule pages that list points to, the waiting period and coverage pages, and the Help Center article on orthopedic conditions, checked September 2026