Key takeaways
- This page is for the owner or administrator of a physician-owned orthopedic practice who is trying to put a real number in the budget line, not for a hospital-employed department whose marketing runs through a health system communications office.
- My published pricing is $800 a month for Starter and $1,500 a month for Core, flat, with no contract. You cancel any month and keep everything I build. Ad spend is separate and goes to Google on your card, never through me.
- The number that matters is not the retainer. It is the retainer plus ad spend plus the one-time project work plus the internal hours your surgeons and front desk have to give it. Most proposals show you the first item and leave the other three for month two.
Who this page is for, and who it is not for
I am Mandeep Singh. I have run Sprout Sage Solutions since 2020 from Chandigarh, India, working with US and international businesses. I lead every account personally, supported by a team of 17. I wrote this because orthopedic groups keep asking me the same question in the first three minutes of a call — what does this cost — and almost nobody publishes an answer.
Looking to hire rather than DIY? I run orthopedic marketing agency services on published pricing with no contract — cancel any month and keep everything I build. Book a free 30-minute call
This is for a physician-owned practice, one surgeon or twenty, that gets most of its patients from referrals and can feel that pipeline narrowing. It is for the administrator who has to defend the line item to a partner meeting where three surgeons think marketing is a waste and one thinks it should have been done five years ago.
It is not for a department inside a health system, where the brand, the domain and the listings belong to the system and the budget is not yours to set. It is not for a group mid-transaction with a private equity buyer, where the decision gets re-made by somebody else in six months. And it is not for anyone shopping for a promised number of surgical cases per month, because that is a claim I will not make about a US medical practice at any price.
The four things you are actually buying
Marketing spend breaks into four categories that behave completely differently, and confusing them is how budgets get blown.
Recurring management. A monthly fee for someone to own the work: profiles, pages, tracking, reviews, reporting. This is the number people mean when they ask what marketing costs, and it is usually the smallest of the four.
Media. Money that goes to a platform, not to an agency. Google Ads, occasionally paid directory placement. It is variable, you control the tap, and it stops producing the day you turn it off.
One-time production. Website rebuilds, photography, video, a new appointment flow. These are projects with a start and an end, and they should be quoted as projects.
Internal time. Surgeon review hours, the administrator who answers questions, the front desk change nobody budgeted. This costs real money and never appears on any proposal, including mine, because it is not mine to invoice.
What I charge: $800 Starter and $1,500 Core
Two tiers, flat monthly, published so you can decide before you speak to me.
Starter — $800 a month. Google Business Profile management for your locations: categories, services written in patient language, photos, posts and Q&A. On-page fixes to your highest-intent pages — top procedures, surgeon bios, insurance, and the appointment request. Review-request setup with visit-type filtering and response templates. Call and form tracking so you can tell where a call came from. A monthly report and a call with me to read it.
Core — $1,500 a month. Everything in Starter, plus four published pieces a month aimed at procedure and second-opinion searches, surgeon-attributed and surgeon-reviewed. Location pages for each office. Practitioner profile buildout for public-facing surgeons. Citation cleanup. Internal linking across the procedure clusters. Schema markup for the practice, the locations, the surgeons and the procedures. Most multi-surgeon groups end up here.
Flat means flat. It does not scale with your revenue, your case volume or your ad spend. If you have a quiet quarter the fee does not go up to cover it, and if a service line takes off I do not send a success invoice.
What is not included, and why I list it
Exclusions are the whole ballgame in agency pricing. A retainer that omits half the work is how a $1,500 line item becomes a much larger invoice in month two.
- Ad spend. Goes to Google on your card. I never hold your media budget.
- Google Ads management. Quoted separately when it makes sense, and often I will tell you it does not.
- Website rebuilds and landing pages. Projects, quoted as projects.
- Photography and video. Not included, though I will give you a precise shot list so you are not paying a videographer to guess.
- Software you already run. Your scheduling system, your EHR, your patient communication platform. I work with what you have.
- Paid directory placements. I do not resell them and I do not take a cut of them.
For market context across health and service verticals I publish the same breakdown for physical therapy practices, chiropractors, plastic surgery practices and dental practices.
How to read a proposal without getting caught
I will not publish other agencies’ rates, because I do not have their books and a made-up range is exactly the kind of invented number I refuse to put on this site. What I can do is tell you what to look for, which is more useful anyway.
Ask for the fee, the term, the notice period and the exclusion list in writing before the second call. Ask whether the person presenting will be on your account in month four, and get the answer in the document rather than in the room. Ask who owns the Google Business Profiles, the tracking numbers, the website files and the content when the relationship ends — if the answer involves porting or losing your numbers, you are looking at a lock-in mechanism dressed as a service. And ask what is measured: a proposal that promises rankings and impressions but cannot say how a phone call gets attributed is selling you a report, not a result.
Percentage-of-ad-spend pricing misprices an orthopedic account
A common model charges a percentage of what you spend on ads. It is popular because it scales for the agency, and it has one structural flaw for a surgical practice: it pays the agency more for recommending more spend, at exactly the moment when the right advice is often to spend less and fix the front desk.
Orthopedics has a specific problem with it. Some of your highest-volume searches are ones you should not bid on at all — broad symptom terms against a health system with a brand budget, or clicks from people who will never be candidates. A flat fee lets me tell you to stop. A percentage fee makes that advice expensive to give.
One-time project costs, and when they are worth it
Most practice websites do not need a rebuild. They need rewritten pages, a fixed appointment request and proper structure, and those live inside the monthly work. I say that against my own interest, because a rebuild is a bigger invoice.
A rebuild is warranted when the site cannot be edited without a developer, is not usable on a phone, cannot support separate pages per location and per surgeon, or is slow enough that a patient in pain gives up. Then it is a project with a scope and a fixed price, quoted before it starts, not a surprise three months into a retainer.
The internal cost nobody puts in the budget
This is the line item that kills engagements, and it is not money.
Procedure content has to be reviewed by the surgeon who performs the procedure — roughly an hour a month across your partners, and the difference between a page a referring colleague respects and one a patient’s brother-in-law who is a nurse takes apart in ten seconds. If your surgeons will not give that hour, tell me on the first call and we will scope around it, but it changes what is possible.
Someone in the office also has to own the answers: which plans each location accepts, what changed in the schedule, who is taking new patients. A group where that person does not exist gets less out of any agency, at any price.
How to model the spend against a service line
I will not tell you what an orthopedic case is worth. It depends on your payer mix, your site of service and your case mix, and any figure I published would be invented. So here is the arithmetic with your numbers in it.
Take one service line with room in the schedule. Say, purely as an illustration of the method, your practice decides that a single additional case in that line covers the Core retainer for a month. That is a hypothetical for the shape of the calculation, not a benchmark and not a forecast — you fill in what a case is actually worth to you after your contracted rates and your cost to deliver.
Then ask the harder question: over what period do you expect that, and how will you know it happened? If your intake cannot tell a search-sourced patient from a referred one, the first thing worth paying for is measurement, not marketing. That is much of what the first thirty days buys.
Ambulatory surgery centres and ancillary lines change the maths
An independent group with a stake in a surgery centre, imaging suite, physical therapy line, DME or orthobiologics programme is not evaluating marketing on the professional fee alone. The economics of an additional appropriate case look different when the facility and ancillary sides both participate.
That cuts in a direction people do not expect. The service lines worth marketing are not necessarily the highest-volume ones — they are the ones where you keep the most of the episode. It also means cash-pay lines, orthobiologic and regenerative injections being the usual case, need their own pages with the price stated plainly, because burying a cash price produces an angry phone call instead of a booking.
I am not qualified to advise on ownership structure and will not pretend otherwise. But I need to know which lines you keep the episode in, because it changes what I build first.
What the in-house alternative costs
Some groups should hire rather than retain. A practice with several locations, an active surgery centre and real ancillary lines eventually needs someone internal.
The comparison is not the salary against my fee. It is the salary plus payroll costs plus tools plus recruiting time, plus the fact that one generalist is unlikely to be strong at local search, content, paid media, analytics and design at once, so you buy some of it outside anyway. The honest version is a coordinator who owns execution internally with specialist work bought in. Good structure — just not cheaper than it looks on the offer letter.
Why you cannot outspend the hospital system or the PE-backed group
You are competing against organisations with a brand budget, a media buyer and a directory that frequently outranks your own website for your own surgeon’s name. Matching that spend is not a strategy available to you, and any agency proposing you try is selling you an ad budget.
What is available is specificity. A health system markets service lines to a region. You can be the most complete, most obviously-written-by-the-surgeon answer to a narrow question — a particular procedure, in a particular town, for a particular kind of patient — and that is a fight where budget matters much less than depth. It is also cheap in media terms, which is why my pricing works at $800 and $1,500 rather than at a number built around ad spend.
I have written about the mechanics of that in more detail on orthopedic surgeon SEO and, for the sports and injury side, on sports medicine marketing.
The claims I will not make, and the rules I work inside
In a regulated specialty the constraints are the product. An agency that does not know them writes something cheap that earns you a letter, and that is the most expensive marketing there is.
- No surgical outcome claims. Nothing will say your repairs hold better, your revisions are rarer, or your patients recover faster — not in a headline, a meta description or an ad.
- No patient-volume or case-volume promises. A quantified volume promise made to a US medical practice is a claim somebody may eventually ask you to substantiate.
- No guaranteed rankings. Nobody controls Google’s results, and anyone selling a position is selling a guess and charging you for it.
- No “best surgeon” superlatives. State medical boards treat unsubstantiated superlatives as false or misleading advertising, and the boards, not Google, are the ones who act.
- No before-and-after imagery or patient stories without a written HIPAA marketing authorisation. A consent for surgery is not a consent to publish. That includes imaging, arthroscopy stills, scar photos and range-of-motion video.
- No testimonial describing a clinical result. A patient can say the office was kind and the explanation clear. Once they describe their outcome it is an endorsement of medical efficacy, and the FTC’s endorsement rules apply alongside your board’s advertising rules — including disclosure of any material connection and a bar on cherry-picked or incentivised reviews.
- Credentials stated exactly as the certifying body words them. Board certification and subspecialty certificates are not interchangeable with “specialist” in every state.
- Nothing that pays for, rewards, or is contingent on a referral. Education for referring clinicians is legitimate. Anything resembling compensation for volume is a federal problem, not a marketing one.
- Tracking scoped carefully. Third-party advertising pixels do not go on pages where a visitor’s presence implies a condition.
I am not your attorney or your compliance officer. I write to these constraints by default and flag anything needing your counsel before it publishes rather than after.
What you keep if you cancel
Everything. The website and every page on it. The Google Business Profiles, in your name, with your access — I do not create them under my own account. The practitioner profiles. The tracking setup. The review templates and workflow. Anything I provision is created under your ownership from day one.
No contracts. Cancel any month. Keep everything built. That is the only guarantee I make, because it is the only one I control. I do not build agency-locked stacks where leaving means losing your tracking numbers, because that is a way of keeping clients who want to go.
What I can substantiate about my own track record
I have shipped 450+ websites since starting Sprout Sage Solutions in 2020. There are 17 Google reviews on the business profile.
None of the case studies on this site are orthopedic practices. I am not going to imply otherwise, and I would be careful with any agency showing you a specialty portfolio without naming a single client. The local SEO map pack rescue is the closest in mechanics — a grid audit across a service area, a full profile rebuild, a review system built for continuous velocity. Same levers, different industry, and what happened there happened in that market against that competitive set. The full set is at the case studies hub; read them as evidence of method, not prediction.
Questions surgeons and administrators ask about cost
Is there a setup fee or a minimum term?
No setup fee and no minimum term. First month is first month. If you cancel after it, you keep the work.
Does the price change if we have five locations instead of one?
The published tiers cover the work as scoped. A five-location group needs more location pages and more profiles than a single office, so it usually belongs on Core rather than Starter. If a group is large enough that Core genuinely does not fit, I will say so and quote it rather than quietly under-delivering at the published price.
Should we add Google Ads, and what does that add to the budget?
Sometimes. Paid search earns its keep for acute injury intent, for a new location or associate who needs a schedule filled faster than organic can fill it, and for defending your surgeons’ names when aggregators bid on them. It works badly when you bid broad symptom terms against a health system, or when a third of your calls go to voicemail. Spend goes to Google on your card and management is quoted separately, so you always see the two numbers apart.
How much of this can we do ourselves?
More than most agencies will tell you. Claiming and correcting your Google Business Profiles, asking satisfied patients for reviews consistently, and answering the phone faster are all free and all matter. If that is where you are, do those first and call me in three months. I would rather say that than take $800 for work you could have done.
What happens if we cancel in month two?
You keep the profiles, the pages, the tracking and the templates, and you owe nothing further. The realistic caveat is that two months is not long enough to judge search work, so you would be leaving with the assets and without the answer.
Do you charge extra for surgeon-attributed content review cycles?
No. Review cycles are part of Core. The cost to you is the surgeon’s time, not an invoice.
Will you work with a competing orthopedic group in our market?
No. If I am already working with a practice in your service area I will tell you on the first call and decline. Geographic exclusivity is the only kind that means anything in local search, and it does not cost extra.
Why are you cheaper than the healthcare specialist agencies we have spoken to?
Partly because I run from Chandigarh, India, and my cost base is different — I say it up front because you will find it anyway. Partly because I do not sell brand campaigns, billboards or social media as standalone products to a group whose real problem is an underbooked surgeon. If you need business associate agreements across a health system, a named account team and a firm your board recognises, that is a real product and not mine.
Book a free 30-minute call
The call is free and there is no deck. I look at your profiles, your site and your search data live, and give you three things to fix that week whether or not you hire me. If we are not a fit, I will say so on that call rather than after you have paid me.
Book the free 30-minute call, or call me directly at +91 97297 12388.
If your question is broader than price, start with how I work with orthopedic practices. If it is narrower, I have written separately about orthopedic surgeon SEO and about sports medicine marketing.
