Carlsmed — Third Quarter 2026 Earnings Summary

Financial Performance:

• Third quarter 2026 revenue was $21.6 million, a 65% increase year-over-year compared to $13.1 million in Q3 2025.
• Gross profit for Q3 2026 was $16.7 million, up from $9.9 million in Q3 2025, with gross margin expanding to 77.3% from 75.9%.
• Operating expenses totaled $29.4 million in Q3 2026, compared to $19.0 million in Q3 2025; this included $2.8 million in executive transition costs and legal matter resolutions.
• Research and development expenses were $6.4 million in Q3 2026 versus $4.4 million in Q3 2025.
• Sales and marketing expenses were $13.0 million in Q3 2026 versus $9.6 million in Q3 2025.
• General and administrative expenses were $10.0 million in Q3 2026 versus $4.9 million in Q3 2025.
• Net loss was $12.2 million for Q3 2026, compared to $8.5 million in Q3 2025.
• Adjusted EBITDA was ($7.3) million for Q3 2026, an improvement from ($8.2) million in Q3 2025.
• Cash, cash equivalents, restricted cash, short-term investments, and marketable securities totaled $80.3 million as of September 30, 2026.
• Total assets were $115.3 million as of September 30, 2026, down from $130.1 million as of December 31, 2025.
• Total liabilities were $39.6 million as of September 30, 2026, compared to $31.3 million as of December 31, 2025.
• Long-term debt (term loan, net) was $15.4 million as of September 30, 2026, compared to $15.3 million as of December 31, 2025.

Guidance and Future Outlook:

• Full-year 2026 revenue guidance was raised to a range of $78 million to $80 million, representing over 56% growth at the midpoint versus full-year 2025.
• Prior full-year 2026 revenue guidance was $74 million to $78 million.

Business Segments and Product Lines:

• The aprevo® lumbar spine fusion procedure secured new inpatient CMS reimbursement effective October 1, 2026, under the IPPS rule for fiscal year 2027.
• Launched the aprevo® Lumbar Bi-lateral Posterior System in October 2026, estimated to address approximately 30,000 U.S. lumbar fusion procedures annually.
• The surgeon user base grew by more than 60% compared to the prior year.
• Strengthened leadership team with the promotion of Jeff Bertolini to Chief Operating Officer, appointment of Rich Heppenstall as Chief Financial Officer, and addition of Tony Jarc, Ph.D., as Chief Product and AI Officer.

Market and Competitive Landscape:

• The company positions itself as a pioneer in AI-enabled personalized spine surgery solutions.
• The CMS IPPS rule effective October 1, 2026, includes increased reimbursement for inpatient aprevo® lumbar procedures.

Risks and Challenges:

• Operating expenses included $2.8 million related to executive transition costs and the expected resolution of certain legal matters.
• Forward-looking statements note risks including the ability to achieve profitability, scalability of the business, and market size expectations.
• Actual results may differ from forward-looking statements due to factors outlined in the Company's Form 10-K and subsequent 10-Q filings.

Management Commentary and Tone:

• CEO Mike Cordonnier stated the third quarter represented strong execution against the long-term strategy, delivering 65% revenue growth.
• Management highlighted broadening the personalized surgery platform and strengthening the leadership team as key accomplishments.
• The CEO described the company's differentiated, capital-light model as reinforcing a foundation for sustainable, profitable long-term growth heading into 2027.

Other Key Points:

• A conference call and webcast were hosted on November 10, 2026, at 4:30 pm Eastern Time to review performance.
• The company reported a net loss per share of ($0.45) for Q3 2026, compared to ($0.40) in Q3 2025.
• Weighted-average common shares used to compute basic and diluted net loss per share increased to 27.3 million in Q3 2026 from 21.1 million in Q3 2025.
• Non-GAAP measures including Adjusted EBITDA and Adjusted Net Loss were provided, excluding stock-based compensation, executive transition costs, legal settlements, and changes in fair value of warrant liabilities.