TPLO surgery cost and pet insurance

The most common big orthopedic bill. Published costs, and the clauses that decide whether insurance pays.

Labrador Retriever
On this page
  1. The short answer
  2. By insurer
  3. What this means for your dog
  4. Before you buy
  5. Questions owners ask

Updated October 6, 2026. Plan facts come from each insurer's published documents; each insurer's policy documents control.

The short answer

TPLO surgery for a torn cruciate ligament typically costs several thousand dollars per knee: the University of Missouri's veterinary hospital estimates $4,000 to $4,500, or $4,500 to $5,000 for giant breeds[10], and insurers' published figures run from about $2,000 to $10,000[11][13].

Insurance pays if the knee problem started after coverage and its orthopedic waiting period, and many policies exclude the second knee if the first was pre-existing.

What will it cost for your dog?

Pick your breed, age and ZIP code to see the estimated monthly price from the insurers we compare.

Model updated Sep 2026 · No phone calls · Independent

Orthopedic and bilateral rules, by insurer

InsurerOrthopedic and bilateral rulesNotes
Embrace180-day exclusion for CCL, IVDD, hips, patella[1]Dogs: these conditions appearing in the first 180 days are excluded for the life of the policy. If one side shows signs before coverage or in first 180 days, the other side is excluded.
Fetch180 days; knee waiver with vet exam[2]Orthopedic conditions in first 180 days excluded for life; knees covered if vet exam within 180 days notes no knee issues. If one side showed signs before coverage or during waiting period, the other side is excluded (e.g. cruciate tears).
Healthy PawsHip dysplasia 12 months; others 15 days[3]15-day accident/illness wait; hip dysplasia covered only if enrolled under age 6; no separate cruciate waiting period stated. If either knee showed cruciate lameness or tear before enrollment or in waiting period, the other side is excluded too.
LemonadeOrtho 30 days; CCL 6 months (some states)[4][5]Waiting periods vary by state: 2 days accidents, 14 days illness, 30 days orthopedic, 6 months cruciate. If one side shows signs of a bilateral condition before the policy starts, the other side is not covered.
OdieCruciate 6 months; injury 3, illness 14 days[6][7]Standard waiting periods; the cruciate ligament wait is shorter in some states. No separate hip dysplasia wait stated. Bilateral condition (e.g. cruciate, luxating patella, hip dysplasia) pre-existing on either side at any time is excluded.
Pets BestCruciate 6 months; may be waived[8]Illness 14 days, injury 3 days, cruciate 6 months; may be reduced or waived if a participating vet certifies pet health.
Spot14 days, incl. ligament/knee[9]Same 14-day wait for accidents, illnesses and ligament/knee conditions; no waiver option stated in sample policy. Bilateral conditions of pre-existing conditions are excluded; a knee/ligament issue on one side counts for both sides.
TrupanionNot verified yetTrupanion's website blocks automated requests, so we could not check this against its policy yet. Ask Trupanion directly.

From each insurer's own sample policy, terms or FAQ, checked October 2, 2026. Terms vary by state and plan, and the policy you buy controls.

Check how this applies to your breed

What this means for your dog

Published costs vary with the clinic and the dog's size. Embrace puts TPLO at about $2,000 to $3,000 per knee[15]; MetLife at $2,000 to $5,000, with total ACL treatment reaching $8,000[12]; Lemonade at $6,000 to $10,000 per knee. Claims data gives real bills: Spot's average ACL surgery claim was $4,600.85, with $2,811.64 reimbursed on average[16], and Pumpkin's claims put ACL or TPLO repair at $5,200 to $10,700[17].

Breeds with cruciate ligament disease on their list, like the Labrador Retriever, Rottweiler, Newfoundland and Bernese Mountain Dog, are where this bill comes up most. For them, the orthopedic waiting period in the table and the bilateral clause matter more than the monthly price: a knee problem in the first six months can be excluded for life at some insurers. Orthopedic waiting periods in detail.

Choose an annual limit that covers the surgery plus rehab, and read the bilateral clause: if the first knee showed signs before coverage started, several insurers exclude the second knee too. The bilateral exclusion, by insurer.

Before you buy

  • Check the orthopedic or cruciate waiting period and whether a vet exam can shorten it.
  • Read the bilateral clause for the second knee.
  • Pick an annual limit above the surgery plus rehab cost.
  • Ask whether rehab or physical therapy after surgery is covered.

Questions owners ask

How much does TPLO surgery cost?

The University of Missouri veterinary hospital estimates $4,000 to $4,500 per knee, or $4,500 to $5,000 for giant breeds. Insurers publish figures from about $2,000 to $10,000 per knee.

Does pet insurance cover TPLO surgery?

Yes, if the cruciate problem began after coverage and any orthopedic waiting period. Lemonade, Odie and Pets Best apply six months for cruciate events, Embrace and Fetch 180 days for orthopedic conditions, and Spot 14 days.

How much does insurance pay toward TPLO?

It depends on your deductible and reimbursement rate. Spot reports an average ACL surgery claim of $4,600.85 with $2,811.64 reimbursed.

Will insurance cover surgery on the second knee?

Embrace, Fetch, Lemonade, Odie and Spot apply a bilateral exclusion: if the first knee showed signs before coverage, the second knee is excluded too. Healthy Paws applies it to the cruciate ligament.

Sources

  1. Embrace Pet Insurance Sample Policy Terms & Conditions (v6, most states). Embrace Pet Insurance.
  2. Pet Health Insurance Policy Terms and Conditions (sample, GPTM 050 0326 A). Fetch, 2026.
  3. Frequently Asked Questions | Healthy Paws. Healthy Paws.
  4. Lemonade FAQ (Pet Health Insurance section). Lemonade.
  5. How Does Pet Insurance Work? (Lemonade coverage guide). Lemonade.
  6. Insurance Terms - Odie Pet Insurance. Odie Pet Insurance.
  7. Sample Illness & Injury Insurance Policy (Trisura Insurance Company, TRSA-OPI-PC101-ILL). Odie Pet Insurance, 2026.
  8. Accident and Illness Policy Form, Arizona sample (IAIC-PB10001-ILL). Pets Best Insurance Services.
  9. Accident & Illness Sample Policy (Arizona, form PET-P-20000-1024, Independence American Insurance Company). Spot Pet Insurance.
  10. Cranial Cruciate Ligament Disease and the Tibial Plateau Leveling Osteotomy (TPLO). University of Missouri Veterinary Health Center, 2021.
  11. TPLO Surgery for Dogs. MetLife Pet Insurance.
  12. How Much Does Dog ACL/CCL Surgery Cost?. MetLife Pet Insurance, 2026.
  13. TPLO Surgery for Dogs Cost. Lemonade, 2026.
  14. How Much Does Dog Surgery Cost?. Lemonade, 2025.
  15. Cruciate Ligament Injury in Dogs. Embrace Pet Insurance, 2025.
  16. How Much is Dog ACL Surgery? With Pet Insurance Reimbursement. Spot Pet Insurance.
  17. Does Pet Insurance Cover Surgery?. Pumpkin, 2025.

How we choose and check sources: Sources we use.

Orthopedic waiting period. A longer waiting period some insurers apply specifically to joint and ligament conditions, such as cruciate ligament tears, often around six months. More in the glossaryPre-existing condition. Anything diagnosed or showing symptoms before coverage starts or during the waiting period. No insurer we list covers it. More in the glossaryAnnual limit. The most the policy pays in one policy year. "Unlimited" means there is no yearly cap. More in the glossary