Ad ranking is the position in which your pay-per-click ad is displayed in search results. Essentially, ad ranking is what determines whether your ad shows up first or fifth. Not surprisingly, ads that have higher ad rankings may have an edge over the ones displayed below it. You’ll get more visibility, which can directly result in higher click-through rates (CTR). Click to visit website temeculafacialoralsurgery.com for more info.

Relevance of the keywords you’re targeting. If one of your targeted keywords is an exact match to the user’s search query, your ad rank will improve. If, however, it’s an almost-match utilizing the broad-match keyword type, it may be a little lower down.
Relevance of ad text and landing pages. It’s not just about the keywords (though they certainly matter)—Google will also do what they can to make sure your ad text matches the searches, too.
Quality score, which is Google’s evaluation of the quality and relevance of your ad to the audience you’re showing it to. Factors like CTR and past performance are taken into account.
Bid. It’s all about the money, baby. Or at least, all else being equal, the higher ad placement will go to the higher bid. That being said, an ad with a lower bid and a higher quality score can actually outrank an ad with a higher bid.