I finally have my Surgeon CSR setup the way I want it, all that's left is to acquire a silencer for the rifle. The scope is a prototype NightForce Mil-Spec 4-16x with a Beast elevation knob (this is the only version of this scope known to exist). The thermal is a very rare Voodoo MX with built-in laser range finder. I also just swapped out the RACS 2-piece top rail for an extremely rare Geissele 1-piece top rail.
Here's some photos of Surgeon CSR's with the Geissele top rail. I'd really like to acquire the Geissele LRF mount that goes around the scope's objective lens housing: