SI-BONE, Inc. — Third Quarter 2026 Earnings Summary

Financial Performance:

• Worldwide revenue reached $55.7 million, a 14.5% increase from $48.7 million in the prior year period.
• U.S. revenue was $52.8 million, up 13.9% from $46.4 million in the prior year period.
• International revenue was $2.9 million, a 27.0% increase from $2.3 million in the prior year period.
• Gross profit was $44.2 million, a 13.7% increase from $38.8 million in the prior year period.
• Gross margin was 79.3%, compared to 79.8% in the prior year period.
• Operating expenses increased 9.7% to $48.5 million from $44.2 million in the prior year period.
• Operating loss improved by 19.2% to $4.4 million from $5.4 million in the prior year period.
• Net loss improved by 20.7% to $3.6 million ($0.08 per diluted share) from $4.6 million ($0.11 per diluted share) in the prior year period.
• Adjusted EBITDA was positive $3.0 million, an improvement of 32.4% from $2.3 million in the prior year period.
• Cash from operations was positive $5.9 million, an improvement of 154.4% from the prior year period.
• Cash and equivalents totaled $146.3 million as of September 30, 2026, compared to $145.9 million as of June 30, 2026.
• Long-term borrowings were $35.7 million as of September 30, 2026, compared to $35.6 million as of December 31, 2025.

Guidance and Future Outlook:

• The company reaffirmed its 2026 worldwide revenue guidance of $231 million to $233 million, representing 15-16% growth.
• The company reaffirmed its 2026 gross margin guidance of approximately 79.0%.
• The company updated its 2026 operating expense growth expectation to 10.5% at the revenue midpoint, down from the previous expectation of 12.0%.
• The company expects positive Adjusted EBITDA for the full year 2026.

Business Segments and Product Lines:

• U.S. procedure volume grew approximately 19.5% in the third quarter.
• The number of active U.S. physicians reached 1,770, representing ~16% growth.
• In September, the company received 510(k) clearance for iFuse Granite Onyx, a FDA breakthrough device targeting failures in spine fusion procedures.
• The estimated total addressable market for iFuse Granite Onyx is ~$1.5 billion annually.
• The alpha launch of iFuse Granite Onyx is expected to expand the company's estimated total addressable market to approximately $5 billion.
• In October, new MS-DRGs took effect for complex spinal fusion procedures incorporating iFuse Bedrock Granite, increasing average hospital inpatient payments by up to ~$50,000 per qualifying procedure.
• International revenue growth reflects increasing adoption of iFuse TORQ and iFuse TORQ TNT.
• U.S. revenue growth was partially offset by lower average selling price due to procedure mix and growing demand for the INTRA platform in office-based and ASC sites of care.

Market and Competitive Landscape:

• The company describes itself as the global leader in developing procedural solutions for compromised bone.
• The company has supported physicians in over 160,000 procedures since 2009.
• The company's technology platform is centered on spinopelvic anatomy.

Risks and Challenges:

• Risks include the ability to introduce and commercialize new products and indications.
• Risks include the ability to maintain favorable reimbursement for procedures using its products.
• Risks include the impact of economic weakness or deterioration in economic conditions, including tariffs and retaliation by U.S. trading partners, on the ability and desire of patients to undergo elective procedures.
• Risks include the ability to manage supply chain risks.
• Risks include future capital requirements driven by new surgical systems requiring instrument tray and implant inventory investment.
• Risks include the pace of the re-normalization of the healthcare operating environment, including the ability and desire of patients and physicians to undergo and perform procedures.

Management Commentary and Tone:

• CEO Laura Francis stated that robust third-quarter growth in procedure volumes and active physicians underscores rising demand for the company's diversified and differentiated platform technologies.
• Management expressed confidence entering the fourth quarter with a record number of active physicians, favorable DRG changes, and exceptional early uptake in the alpha launch of iFuse Granite Onyx.
• Management stated these drivers position the company for an excellent finish to 2026 and to enter 2027 with the strongest foundation for growth acceleration in the company's history.

Other Key Points:

• The company will host a conference call to discuss the results on November 2, 2026, at 4:30 P.M. Eastern Time.
• The company has nearly 200 peer-reviewed publications and four randomized controlled trials supporting its technologies.
• The company's trademarks include SI-BONE, iFuse Bedrock Granite, iFuse TORQ, iFuse TORQ TNT, iFuse Granite Onyx, and iFuse INTRA.