161 Conversions at $4.29 CPA — Independent Ophthalmology Practice on $700/Month

What we were working with.

This practice had a strict $700/month budget — far below what most agencies would consider viable for Google Ads in a competitive specialty. Most campaigns at this budget level get spread too thin, unable to compete on any keyword meaningfully. The practice needed a focused, high-efficiency approach rather than broad coverage.

How we built the campaign.

Budget constraint forced a discipline that actually produced better results than larger budgets sometimes allow. We identified the five highest-intent keywords in the practice's specific geographic market — the searches that most clearly signaled an imminent appointment booking — and allocated all budget exclusively to those terms. Zero spend on broad awareness, zero spend on competitive conquesting. Every dollar went to the highest-probability-to-convert search intent. Bids were capped to ensure visibility during the highest-converting hours of the day (weekday mornings and early afternoons for eye care appointments).

What the numbers say.

161 conversions at $4.29 CPA on $700/month. A 29.9% conversion rate and 10.64% CTR — both among the highest in our portfolio for any specialty. The constraint-driven focus on only the highest-intent searches produced a campaign that converts nearly 1 in 3 clicks into a patient contact. ROI on this account is exceptional.

Specific tactics deployed.

• Hyper-focused keyword strategy limited to 5 highest-intent search terms in the local market
• Dayparting bid adjustments maximizing visibility during peak appointment-booking hours
• Zero budget allocated to broad or informational search intent
• Single landing page with one CTA, minimal friction, and phone number prominently displayed
• Weekly performance review to maintain quality scores and catch any CPC inflation early