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United StatesMedical equipmentGoogle Ads

47% more store revenue, and cheaper sales from Google.

A US medical equipment retailer came in spending $14K a month on Google Ads at a 2.9x return. Two years in, monthly store revenue was up 47% year over year and Google's cost per purchase was down 27%.

Book a free account review →Common questions

Store numbers from Shopify orders. Ad numbers labeled as platform-reported.

Tal Mor, Medical Equipment Google Ads Case Study

Google ROAS · reported by Google

2.9x → 6.2x → 8.9x

+47%monthly store revenue, 9 months vs a year earlier

$66 → $48Google cost per purchase, same windows

Real account. Client name withheld for privacy.

+47%

Store revenue a month, Nov 2025 to Jul 2026 vs a year earlier

376 → 512

Orders a month, same windows

-27%

Google cost per purchase, same windows

The client

A US medical equipment retailer selling new and certified pre-owned devices, plus the accessories and replacement parts that go with them.

Buyers usually arrive with a specific model in mind, so search intent is high and price comparison is brutal. About a fifth of orders closed offline, by phone or in store, so the ad accounts only saw part of what they drove.

When I started, Google Ads was spending about $14K a month at a 2.9x return, as reported by Google. On high-ticket devices with real cost of goods, that is close to break-even.

Industry	Medical equipment ecommerce
Country	United States
Catalog	About 650 products, new and certified pre-owned
Starting point	$13,592 Google spend, 246 conversions, 2.9x ROAS (Oct 2023, reported by Google)
Channels I run	Google Ads, Microsoft Ads, Meta ads, Klaviyo email, site redesign
Engagement	November 2023 to today

What I found in the audit

One target for every product. A $50 accessory and a $2,000 device were judged on the same cost per sale, so the account either overpaid for cheap items or starved the expensive ones.
Existing customers were left alone. Parts and accessories reorder on a schedule, but nothing brought buyers back. Email was not doing any of the work.
The store was not built to convert ad traffic. Dated design, inconsistent product images, thin category pages and no dedicated home for pre-owned stock.
Part of the picture was invisible. About 20% of orders closed offline, so the ad accounts only saw some of what they drove.

The strategy

A cost-per-sale target for every product tier. Entry devices and accessories run around $40 to $50 per sale. Premium devices are allowed up to $300, because one sale pays for it many times over.
Feed-only Performance Max per category. One campaign per product category carries most of the spend, pointed at Shopping inventory where buyers compare models and prices.
A small display Performance Max at about 10% of spend, for reach and remarketing without letting it eat the budget.
Standard Shopping and Search for best sellers only. Proven winners get their own budget so they never starve inside Performance Max.
A store redesign. New category pages with SEO copy, a certified pre-owned section, better reviews, square product images and a clearer add to cart. Launched December 2025.
Email that brings people back. Automated flows that cross-sell devices to accessory buyers and remind customers when parts are due, plus a newsletter every two weeks.
Microsoft Ads and Meta on top. Same products, extra reach, each judged on its own numbers.
Stability over tinkering. Budgets move on two weeks of data, never on one bad day.

Results

Nine months against the same nine months a year earlier. Store revenue and orders come from the store's Shopify orders (gross, before refunds). Google figures are reported by Google, primary purchase action only.

Monthly average	Nov 2024 to Jul 2025	Nov 2025 to Jul 2026	Change
Store revenue	$166,034	$243,654	+47%
Store orders	376	512	+36%
Google ad spend	$17,124	$26,592	+55%
Google purchases	259	552	+113%
Google cost per purchase	$66	$48	-27%
Google ROAS	6.2x	8.9x	+44%

Store sales stayed up year over year through September 2026 (+13%), though growth slowed after July. Starting point, Oct 2023: $13,592 Google spend, 246 conversions, 2.9x ROAS, as reported by Google.

The screenshots

From the first weeks of the engagement. Store analytics, no names in frame.

shopify · analytics

+34%

Total sales, Dec 20, 2023 to Jan 18, 2024 vs the 30 days before, first weeks of the engagement

shopify · analytics

+22%

Average order value with an upsell setup, same windows

How I work

Free account review

I look at your ads, email and tracking before we talk, so the call starts with real findings.

Audit and plan

In month one you get a ranked list of what to fix first and what it should move.

I run it myself

No juniors and no account managers in between.

One report you can check

Spend sits next to orders and store sales, so you can sanity-check every number.

I have founded and run my own ecommerce brands for 20 years. So I manage your Google account like an owner, judged on store sales, not platform ROAS.

I work with a small number of ecommerce brands at a time on Google Ads, Meta and Klaviyo, on US and Canada hours, and I do the work myself.

20 years operating650 product catalog managedGoogle, Microsoft, Meta, KlaviyoUpwork Top Rated · 100% JSS

Questions about Google Ads for medical equipment stores

Straight answers, from this account.

What is the best Google Ads campaign type for a medical equipment store?

Performance Max per product category, plus Standard Shopping for best sellers. Performance Max finds new buyers, Shopping protects the products that already sell.

Can medical equipment be advertised on Google Shopping?

Most of it, yes. Some products fall under Google's healthcare policies and need certification or careful wording. The audit catches this before ads get disapproved.

How long until Google Ads results show after a restructure?

Usually 4 to 8 weeks, once campaigns exit learning and have enough conversion data.

Why does Google report more sales than my store?

Usually duplicate or overlapping conversion actions, or values that include tax and shipping. Check Google against your store orders every month. On this page, store numbers lead and Google numbers are labeled.

Does Google Ads need daily management?

No. Weekly search term reviews and monthly budget decisions. Daily changes usually hurt performance by resetting learning.

How do you improve Shopping with a large catalog?

Feed first: titles that match real searches, complete attributes, custom labels for margin and sales rank. Then split campaigns so best sellers get a guaranteed budget.