Dog ACL Surgery Cost 2026: TPLO vs Lateral Suture Prices

Dog ACL (correctly called CCL, cranial cruciate ligament) rupture is the most common orthopedic injury in dogs. Repair costs $2,000–$6,000 depending on surgical technique and your location. TPLO — the gold standard for medium and large dogs — runs $3,500–$5,500. Lateral suture (extracapsular) repair is less expensive at $1,500–$3,000 and is typically used for small dogs under 30 lbs. California and New York surgeons run 30–40% above those figures.

Cost at a Glance

Dog

$2,000–$6,000

Private vet, national avg

CA / NY

$2,600–$8,100

25–35% above avg

What Affects the Cost

Vet procedure costs vary by pet size, location, and clinic type — specialty practices charge 40–80% more than general practitioners for the same procedure. Urban California and New York run 30–50% above national averages. Teaching hospitals and humane societies perform the same procedures at 30–50% below private vet prices. Select your state above for a location-adjusted estimate.

▸ TPLO (tibial plateau leveling osteotomy) is the most common technique for dogs over 30 lbs. It changes the joint geometry to eliminate the need for the ligament. Long-term outcomes are significantly better than lateral suture.
▸ Lateral suture (extracapsular) repair costs $1,500–$3,000 and is suitable for dogs under 30 lbs or dogs with sedentary lifestyles.
▸ Pre-surgical X-rays ($200–$400) and the initial exam add to the total before you get to the surgery itself.
▸ Physical therapy (hydrotherapy, controlled exercise) is $50–$100/session and significantly improves recovery. Most orthopedic vets recommend 8–12 sessions.
▸ 50–60% of dogs that rupture one CCL will rupture the other within 1–2 years. Budget for both.
▸ Weight is the biggest cost driver — larger dogs need more anesthesia, bigger implants, and longer surgery time.

Cost by State

National average adjusted by state cost-of-living index. Urban areas run ~30% higher than suburban; rural ~25% lower.

State	Dog	vs. Avg
Alabama	$1640–$4920	-18%
Alaska	$2500–$7500	+25%
Arizona	$1900–$5700	-5%
Arkansas	$1600–$4800	-20%
California	$2700–$8100	+35%
Colorado	$2200–$6600	+10%
Connecticut	$2500–$7500	+25%
Delaware	$2100–$6300	+5%
Florida	$2000–$6000	0%
Georgia	$1800–$5400	-10%
Hawaii	$2800–$8400	+40%
Idaho	$1800–$5400	-10%
Illinois	$2100–$6300	+5%
Indiana	$1760–$5280	-12%
Iowa	$1700–$5100	-15%
Kansas	$1700–$5100	-15%
Kentucky	$1700–$5100	-15%
Louisiana	$1700–$5100	-15%
Maine	$2000–$6000	0%
Maryland	$2300–$6900	+15%
Massachusetts	$2600–$7800	+30%
Michigan	$1800–$5400	-10%
Minnesota	$2000–$6000	0%
Mississippi	$1560–$4680	-22%
Missouri	$1700–$5100	-15%
Montana	$1840–$5520	-8%
Nebraska	$1760–$5280	-12%
Nevada	$2100–$6300	+5%
New Hampshire	$2200–$6600	+10%
New Jersey	$2500–$7500	+25%
New Mexico	$1760–$5280	-12%
New York	$2600–$7800	+30%
North Carolina	$1840–$5520	-8%
North Dakota	$1760–$5280	-12%
Ohio	$1800–$5400	-10%
Oklahoma	$1640–$4920	-18%
Oregon	$2200–$6600	+10%
Pennsylvania	$2000–$6000	0%
Rhode Island	$2200–$6600	+10%
South Carolina	$1760–$5280	-12%
South Dakota	$1700–$5100	-15%
Tennessee	$1760–$5280	-12%
Texas	$1840–$5520	-8%
Utah	$1900–$5700	-5%
Vermont	$2100–$6300	+5%
Virginia	$2100–$6300	+5%
Washington	$2300–$6900	+15%
West Virginia	$1600–$4800	-20%
Wisconsin	$1840–$5520	-8%
Wyoming	$1800–$5400	-10%

Data: AVMA fee surveys, BLS cost-of-living data. Ranges reflect typical private practice prices — low-cost clinics and university teaching hospitals charge significantly less.

Dog ACL Surgery Cost by State

ACL/CCL surgery is one of the most location-sensitive procedures — California and New York surgeons run 30–40% above the national range. Pick your state for local TPLO and lateral suture pricing.

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Common Questions

How much does dog ACL surgery cost? ▼

Dog CCL (ACL) surgery costs $2,000–$6,000 depending on technique, dog size, and location. TPLO (tibial plateau leveling osteotomy) runs $3,500–$5,500 and is used for most medium to large dogs. Lateral suture repair is $1,500–$3,000 and used for small dogs. Add X-rays ($200–$400) and physical therapy ($400–$1,200) to the surgery total. California and New York surgeons charge 30–40% more.

What is the difference between TPLO and lateral suture repair? ▼

TPLO changes the geometry of the knee joint so the ligament is no longer needed for stability. It costs $3,500–$5,500 but has better long-term outcomes, especially for active or large dogs. Lateral suture repair ($1,500–$3,000) uses a synthetic material to mimic the ligament but degrades over time — most effective for dogs under 30 lbs with low activity levels. Most board-certified veterinary surgeons recommend TPLO for any dog over 25–30 lbs.

Can a dog heal from a torn ACL without surgery? ▼

Partial tears in very small dogs (under 15 lbs) sometimes stabilize with 6–8 weeks of strict rest. For most dogs, especially those over 25 lbs, surgery is the only reliable path to pain-free function. Without surgery, dogs develop significant arthritis in the affected joint within 1–2 years. The joint continues to degrade with each step. Delaying surgery doesn't avoid the cost — it often makes the surgery more complicated when you do proceed.

Does pet insurance cover dog ACL surgery? ▼

Accident and illness plans cover CCL surgery if the injury wasn't pre-existing — meaning no limping, no diagnosis, and no treatment documented before the policy started. The surgery is categorized as an accident or orthopedic illness depending on the cause. With a typical $500 deductible and 80% reimbursement, pet insurance would cover $2,000–$4,000 of a $3,000–$5,500 TPLO. Breed-specific exclusions (some plans exclude bilateral CCL for Labs and Golden Retrievers) are worth checking before buying.

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