Spine Center of Louisiana is a spine surgery practice with 5 locations across Louisiana, and in five weeks its Google Ads cost per lead fell from $14.17 to $6.66 in the peak week. We took over a stalled campaign and fixed it without a budget increase, working with one ad group and a website still in the middle of a rebuild.
April 3 to 9, the peak week: 71 conversions at a 79.8% conversion rate
BaselineSpine Center of Louisiana specializes in minimally invasive spinal fusion surgery. The practice needed a Google Ads campaign to produce qualified patient leads in the Baton Rouge market right away, even though its website was in the middle of a rebuild.
The campaign had already launched, with structural problems that choked it from day one. This is what we found on intake.
A $12 max CPC bid cap was losing 27.65% of impression share to rank, per the Google Ads report. The campaign showed an “Eligible (Limited)” status.
Only 12 keywords, all variations of “minimally invasive.” Three exact match keywords were dead on arrival with no local volume.
No sitelinks, no callouts, no call extension, no structured snippets. The ads ran bare with no supporting assets.
Form submission tracking was broken at launch and there was no GHL call import. The only signal was a GA4 phone click event.
All traffic pointed to a single existing page on a site two months from launching its new design. No custom landing page.
A $67 a day budget was spending only $9.11 a day on average. The campaign was crawling when it should have been sprinting.
One ad group, one responsive search ad, one landing page. Every change was deliberate and dated, so each one can be read against the numbers that followed it.
The $12 max CPC bid cap was strangling the campaign, which was spending $9.11 a day of a $67 daily budget. Three keywords were dead, no ad extensions were running, and expected CTR was scoring “Below average.” The fix list started with the bid cap, because a budget the campaign cannot spend is not the constraint.
The keyword set grew beyond “minimally invasive” into “spine surgery,” “back surgery,” “spinal fusion” and surgeon-intent terms. Negative keyword blocks went in across two waves to keep the broader terms clean.
On the responsive search ad, headline #1 was pinned and three keyword-relevant headlines were added.
Sitelinks for “Our Spine Surgeons” (12.44% CTR), “Patient Reviews” (13.13%), “5 Louisiana Locations” (11.58%) and “Request an Appointment.” The call extension alone generated 36 clicks at a 13.19% CTR.
An 11.59% CTR, a $6.66 cost per conversion and a 79.8% conversion rate, with no visible competitors in auction insights. Each optimization compounded on the last.
Over five days of the peak week, the practice took 190 phone calls, 118 of them from first-time callers, and did not miss one.
Drag the slider or pick a week to see click-through rate, cost per lead, conversions and impression share for that stretch of the campaign.
Week 5, April 3 to 9: the peak week. 71 conversions at $6.66 each and a 79.8% conversion rate. Rank loss fell to 9.9%; the remaining limit was budget.
Case study data covers March 6 to April 9, 2026, verified in Google Ads and GHL reporting. Week 1-2 is the baseline across the first two weeks. *Campaign paused during week 4.
Every metric moved the right way. These are the numbers at peak performance in week 5 against the baseline of weeks 1 and 2, as reported, not averaged across the five weeks.
| Metric | Weeks 1-2 | Week 5 | Change |
|---|---|---|---|
| Click-through rate | 3.15% | 11.59% | +268% |
| Average CPC | $8.50 | $5.31 | -38% |
| Cost per lead | $14.17 | $6.66 | -53% |
| Conversion rate | 60% | 79.78% | +33% |
| Weekly conversions | ~4.5 | 71 | +1,478% |
| Impression share lost to rank | 27.65% | 9.89% | -64% |
This keyword was not in the original campaign. It went in as a phrase match term during the March 20 expansion. By week 5 it was responsible for 79% of all conversions, pulling 72 clicks from 518 impressions at a 13.90% click-through rate.
The original build targeted how the procedure is described. Patients were searching for who does it.
Most conversions came from mobile devices, the largest share came from Baton Rouge, and the cheapest leads came from smaller towns around it. Every ad extension beat the baseline.
Mobile carried the campaign. Desktop converted at the lower cost.
Baton Rouge drove 24 conversions at $6.83. Plaquemine came in lowest at $4.00.
Added March 27. The dark line on each bar marks the 3.15% baseline CTR.
The budget stayed at $67 a day throughout. These lessons apply to any account where leads cost too much or the phone is quieter than the ad spend suggests.
This campaign had a $67 daily budget and spent $9.11 of it, because a $12 bid cap kept the ads out of auctions they could have won. Impression share lost to rank against lost to budget tells you which one is holding you back. Raising a budget that is not being spent changes nothing.
At launch the only signal was a GA4 phone click, with broken form tracking and no call import. You cannot lower a cost per lead you cannot measure. Call tracking and a CRM that logs every inquiry are part of our lead generation setup for exactly this reason.
Every extension added on March 27 beat the campaign's 3.15% baseline CTR, and the call extension alone brought 36 clicks. Sitelinks and callouts give a searcher more reasons to pick you and more ways to reach you.
“Back surgeon” was not in the original campaign. Added as a phrase match term in the March 20 expansion, it drove 79% of conversions by week 5. The best keyword is often one the original build did not include.
The whole result came from one ad group, one ad and one existing page on a site that was mid-rebuild. A good Google Ads management program can produce leads now and improve again when the new landing page is ready.
Call 631-612-6976, email john@designmemarketing.com or ask for a free Google Ads audit, and we'll show you where your campaign is losing auctions and money.
