Core Viewpoint - Needham analyst David Saxon has raised the price target for SI-Bone (SIBN) to $27 from $24 while maintaining a Buy rating on the shares, indicating confidence in the company's growth potential [1] Group 1: Price Target and Ratings - The price target for SI-Bone has been increased to $27 from $24 [1] - SI-Bone has been added to Needham's 'Conviction List' and is named as the firm's '2026 Top Pick' [1] Group 2: Growth Potential - Needham believes SI-Bone can deliver potential upside to estimates in the near term, which is expected to enhance profitability [1] - Upcoming product launches are anticipated to drive active surgeon adoption across SI-Bone's portfolio, leading to higher utilization [1]

Core Viewpoint - SiBone (SIBN) is identified as a potential stock pick due to a recent "golden cross" event, indicating a bullish trend from a technical perspective [1]. Technical Analysis - A "golden cross" occurs when a short-term moving average (50-day) crosses above a long-term moving average (200-day), suggesting a potential bullish breakout [2]. - The formation of a golden cross involves three stages: a downtrend that bottoms out, the crossover of moving averages, and subsequent upward momentum [3]. - The golden cross is contrasted with a "death cross," which indicates potential bearish momentum [3]. Performance Metrics - SIBN has experienced a rally of 26.7% over the past four weeks, indicating strong upward momentum [4]. - Currently, SIBN holds a 3 (Hold) rating on the Zacks Rank, suggesting it may be poised for further breakout [4]. - Earnings expectations for SIBN have improved, with five upward revisions and no downward changes in the last 60 days, leading to an increase in the Zacks Consensus Estimate [4]. Investment Consideration - Given the significant technical indicators and positive earnings estimate movements, SIBN is recommended for inclusion on investors' watchlists [6].

Summary of SI-BONE FY Conference Call (December 02, 2025) Company Overview - **Company**: SI-BONE (NasdaqGM:SIBN) - **Industry**: Medical Technology, specifically focused on orthopedic devices and surgical solutions Key Points and Arguments Financial Performance - **Q3 Revenue Growth**: Achieved a total revenue growth of **21%** year-over-year, indicating strong business performance [12] - **Physician Engagement**: Notable **27%** increase in the number of physicians performing procedures, with **330 more surgeons** participating, totaling over **1,500 surgeons** in Q3 2025 [12] - **Profitability**: The company has reported four consecutive quarters of adjusted EBITDA profitability and has reached net cash break-even in recent quarters [12] Product and Market Strategy - **Innovative Products**: The company has established a reputation for innovation, with over **180 peer-reviewed publications** supporting the safety and efficacy of its products [14] - **Sales Strategy**: Utilizes a hybrid sales approach with **88 territory managers** and over **300 third-party agents** to expand market reach [13] - **Diversification**: The company has diversified its product offerings beyond SI Joint Fusion to include pelvic fixation and other breakthrough devices, mitigating risks associated with patent expirations [21][22] Patent and Competitive Landscape - **Patent Expiration Concerns**: Management expressed confidence regarding patent expirations, noting that the majority of sales come from products with patents extending through **2034-2035** [21] - **Competitive Positioning**: The company is focused on developing a robust pipeline of innovative products to maintain competitive advantages [22] Future Growth Opportunities - **Procedure Expansion**: Currently, **25%** of SI joint surgeons are performing multiple procedure types; there is potential to increase this to **50%** [30] - **New Product Launches**: A new product targeting a significant unmet clinical need in spine surgery is expected to launch in the second half of **2026**, which could further enhance growth [31] - **Market Penetration**: The company aims to increase its penetration in the SI Joint Fusion market from **10%** to potentially **15-20%** over time [60] Reimbursement and Regulatory Environment - **Reimbursement Increases**: Recent changes in reimbursement policies are expected to provide tailwinds, including a **30%** higher reimbursement for pelvic ring fracture cases and a **17%** increase for SI Joint Fusion procedures starting January 1, 2026 [52][53] - **Outpatient Opportunities**: The shift of many inpatient procedures to outpatient settings presents additional growth opportunities, particularly for the Granite product [54] Gross Margin and Operational Efficiency - **Gross Margin Performance**: The company reported gross margins exceeding **78%**, driven by better-than-expected average selling prices (ASP) and supply chain efficiencies [80] - **Future Margin Expectations**: Management anticipates maintaining gross margins around **78%** over the next few years, with potential for improvement as new products scale [81] Investment and R&D Focus - **Long-term Growth Strategy**: The company plans to continue investing in R&D to support its pipeline of new products, particularly in the area of compromised bone solutions [91] - **Operating Leverage**: Expected operating leverage of **1.5 times** revenue growth over operating expenses, indicating a focus on maintaining healthy adjusted EBITDA margins [90] Additional Important Insights - **Market Size**: The Granite product targets a **billion-dollar** market, with significant potential for growth as the company expands its offerings [37] - **Sales Force Integration**: New products are expected to be easily integrated into the existing sales force, potentially enhancing overall market attention and sales [47] This summary encapsulates the key insights from the SI-BONE FY Conference Call, highlighting the company's strong performance, innovative strategies, and future growth potential in the medical technology sector.

Core Insights - SI-BONE, Inc. will participate in the Piper Sandler 37th Annual Healthcare Conference on December 2, 2025, with a management-hosted fireside chat [1] - The company is a leader in developing technologies for surgical treatment of sacropelvic disorders, having supported over 4,900 physicians and performed over 135,000 procedures since 2009 [3] Company Overview - SI-BONE, Inc. specializes in minimally invasive SI joint surgery, having pioneered the iFuse Implant System [3] - The company has a strong clinical foundation with over 180 peer-reviewed publications, including four randomized controlled trials [3] - SI-BONE has expanded its offerings to adjacent markets, including adult deformity and pelvic trauma [3] Conference Participation - Investors can register to listen to the conference call and access a live audio webcast on the company's website [2] - The webcast will be archived for at least 90 days post-event [2]

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Financial Data and Key Metrics Changes - Worldwide revenue reached $48.7 million in Q3 2025, representing approximately 21% growth year-over-year [4][19] - U.S. revenue grew over 21% to $46.4 million, driven by a procedure volume growth of over 22% [4][19] - Positive adjusted EBITDA of $2.3 million for the quarter, translating to an adjusted EBITDA margin of approximately 5% [6][22] - Gross profit was $38.8 million, an increase of 21.8% year-over-year, with a gross margin of 79.8% [20][21] Business Line Data and Key Metrics Changes - The launch of iFuse TORQUE contributed to notable international revenue growth, with international revenue at $2.3 million, representing 10.2% growth [19] - Double-digit volume growth was observed across all modalities, with a record number of physicians added in the quarter [5][6] - The number of physicians performing procedures using the company's solutions increased by 27% year-over-year, with 1,530 active physicians [14][70] Market Data and Key Metrics Changes - The company anticipates that the finalized 17% increase in reimbursement for office-based SI joint procedures will benefit its interventional business [8] - The new technology add-on payment (NTAP) of over $4,100 represents up to a 30% increase in hospital reimbursement for pelvic fracture fixation in Medicare patients [12][88] Company Strategy and Development Direction - The company is focused on innovation, physician engagement, commercial execution, and operational excellence as key priorities [7][17] - Plans to launch new products in 2026, including a next-generation technology aimed at optimizing physician workflow [9][11] - The company aims to expand its addressable market by developing solutions for compromised bone, leveraging its expertise in sacro-pelvic anatomy [14][76] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in sustaining strong top-line growth and expanding margins, driven by substantial adoption of current products and a promising pipeline [25][41] - The company is optimistic about achieving positive free cash flow in 2026, supported by improved profitability and cash flow from operating activities [23][46] Other Important Information - The company achieved its second consecutive quarter of net cash flow breakeven, ending the quarter with $145.7 million in cash and marketable securities [22][23] - The company has a significant pipeline of novel technologies under development, with expectations to launch several solutions over the next five years [14][78] Q&A Session Summary Question: Discussion on physician density and operating leverage - Management highlighted the importance of physician density and the opportunity to increase procedure types among existing surgeons, with a focus on leveraging the expanded product platform [29][30][32] Question: Guidance update and momentum in Q4 - Management raised the full-year revenue guidance to $198 million-$200 million, citing strong performance and physician growth trends as indicators of continued momentum [38][42][44] Question: Cash burn expectations for the rest of the year - Management indicated expectations of some cash usage in Q4 due to investments in surgical capacity and new product preparations, but expressed confidence in achieving free cash flow in 2026 [46][47] Question: Trends in gross margins and ASP - Management noted that gross margins are expected to stabilize around 78%-78.5%, with ASP remaining stable despite some modest impacts from procedure mix [55][56] Question: TNT and NTAP adoption trends - Management expressed excitement about the NTAP's potential to drive TNT adoption, with ongoing interest from national distributors to expand access to the technology [88][90]

Financial Data and Key Metrics Changes - Worldwide revenue reached $48.7 million in Q3 2025, representing approximately 21% growth year-over-year [4][17] - U.S. revenue grew over 21% to $46.4 million, driven by increased adoption of solutions [4][17] - Positive adjusted EBITDA of $2.3 million for the quarter, translating to an adjusted EBITDA margin of approximately 5% [5][19] - Gross profit was $38.8 million, an increase of $6.9 million or 21.8%, with a gross margin of 79.8% [17][18] - Net loss narrowed to $4.6 million, or $0.11 per diluted share, compared to a net loss of $6.6 million, or $0.16 per diluted share [18][19] Business Line Data and Key Metrics Changes - The flagship solutions continue to perform well in a large, under-penetrated market, with double-digit volume growth across all modalities [5][6] - The interventional case volume doubled compared to Q3 2024, indicating strong adoption of clinically validated solutions [7] - The number of procedures using more than two Granite implants per case grew approximately 40% in the quarter [9] Market Data and Key Metrics Changes - International revenue in Q3 was $2.3 million, representing 10.2% growth, with expectations for acceleration in 2026 due to the launch of iFuse TORQUE [17][18] - The company added 330 physicians in the quarter, marking a 27% year-over-year increase in active physicians [12][48] Company Strategy and Development Direction - The company aims to expand its addressable market by adding new applications of technology and expertise, focusing on compromised bone [22][23] - Plans to launch several innovative solutions over the next five years to address poor bone quality [12][54] - The company is focused on operational excellence, with a disciplined pricing strategy and ongoing supply chain optimization initiatives [18][19] Management Comments on Operating Environment and Future Outlook - Management expressed confidence in sustaining strong top-line growth, expanding margins, and achieving positive free cash flow in 2026 [22][34] - The company anticipates continued physician engagement and adoption trends, with a significant opportunity to increase procedure density [12][15] - Management highlighted the importance of favorable reimbursement changes and the potential for new product launches to drive growth [37][61] Other Important Information - The company achieved its second consecutive quarter of net cash flow breakeven, ending the quarter with $145.7 million in cash and marketable securities [20][21] - The company is actively pursuing regulatory clearance to commercialize additional products across several international markets [17][56] Q&A Session Summary Question: Discussion on physician density and operating leverage - Management emphasized the importance of physician density and the opportunity to grow by increasing the use of technology across different procedure types [24][25] - Operating leverage is expected to range between 1.25-1.75 times, with a focus on delivering strong top-line growth [27][28] Question: Guidance update and momentum in Q4 - Management raised the full-year revenue guidance to $198 million-$200 million, reflecting continued outperformance and strong momentum heading into Q4 [30][32] Question: Trends in cash burn expectations - Management expects to use some cash in Q4 for building surgical capacity but remains confident in achieving free cash flow in 2026 [34] Question: Insights on TNT and NTAP adoption - Management expressed excitement about the NTAP, which represents a significant reimbursement improvement, and noted strong interest from national distributors for TNT [57][59] Question: Long-term profitability and operating leverage - Management highlighted the unique business model that allows for high ASP and operating leverage, with expectations for margin expansion as new products contribute to revenue [61][62]

Financial Performance - Revenue for Q3 2025 reached $48.656 million, a 20.5% increase from $40.340 million in Q3 2024[17] - Gross profit for Q3 2025 was $38.846 million, compared to $31.903 million in Q3 2024, reflecting a gross margin improvement[17] - Operating expenses increased to $44.229 million in Q3 2025 from $39.536 million in Q3 2024, primarily driven by higher sales and marketing costs[17] - Net loss for Q3 2025 was $4.566 million, an improvement from a net loss of $6.575 million in Q3 2024[17] - Revenue for the three months ended September 30, 2025, was $48,656, an increase from $40,340 in the same period of 2024, representing a growth of 8.1%[34] - For the nine months ended September 30, 2025, the net loss was $17,260, compared to a net loss of $26,418 for the same period in 2024[25] - For the three months ended September 30, 2025, the net loss was $4,566,000, compared to a net loss of $6,575,000 for the same period in 2024, representing a 30.6% improvement[80] - The basic and diluted net loss per share for the three months ended September 30, 2025, was $(0.11), an improvement from $(0.16) in the same period of 2024[80] - For the nine months ended September 30, 2025, the net loss was $17,260,000, down from $26,418,000 in the same period of 2024, indicating a 34.7% reduction[80] - The basic and diluted net loss per share for the nine months ended September 30, 2025, was $(0.40), compared to $(0.64) for the same period in 2024[80] Assets and Liabilities - Total current assets as of September 30, 2025, were $210.784 million, up from $207.779 million at the end of 2024[16] - Total liabilities decreased to $62.147 million as of September 30, 2025, compared to $63.473 million at the end of 2024[16] - Stockholders' equity increased to $172.126 million as of September 30, 2025, from $166.964 million at the end of 2024[16] - As of September 30, 2024, the total stockholders' equity was $164,974, with a net loss of $6,575 for the quarter[22] - The company reported cash and cash equivalents of $26,487 as of September 30, 2025, down from $30,225 at the end of the same period in 2024[25] - As of September 30, 2025, total marketable securities amounted to $140.660 million, with unrealized gains of $75, and unrealized losses of $2[42] - The allowance for credit losses increased to $985,000 as of September 30, 2025, from $588,000 at the end of 2024, with write-offs of $140,000 during the period[51] - The company reported accrued liabilities of $17.587 million as of September 30, 2025, a decrease from $19.492 million as of December 31, 2024[50] - The company had purchase commitments related to inventory management amounting to $3.5 million as of September 30, 2025, up from $0.4 million at the end of 2024[56] Inventory and Expenses - The company experienced a decrease in inventory of $10,334 for the nine months ended September 30, 2025, compared to a decrease of $5,922 in 2024[25] - Inventory as of September 30, 2025, consisted of finished goods valued at $31.2 million and work-in-progress and components valued at $4.5 million, compared to $24.0 million and $3.1 million respectively as of December 31, 2024[48] - Depreciation expense for the three months ended September 30, 2025, was $1.5 million, compared to $1.1 million for the same period in 2024[49] - Stock-based compensation for the nine months ended September 30, 2025, was $19,547, slightly down from $19,734 in 2024[25] - Stock-based compensation expense for the three months ended September 30, 2025 totaled $6.226 million, slightly down from $6.306 million in the same period of 2024[78] Future Outlook and Strategy - The company expects to derive a significant portion of revenue from products addressing sacropelvic anatomy in the future[12] - The company is focused on developing additional revenue opportunities, including new indications for use and new products[12] - The company anticipates challenges related to supply chain factors, including tariffs and availability of raw materials[12] - The company launched new products including iFuse INTRA and iFuse TORQ TNT in 2024, expanding its product line for sacroiliac joint treatment[27] - International revenue accounted for less than 10% of total revenue during the periods presented, indicating a strong reliance on the U.S. market[34] Debt and Financing - As of September 30, 2025, the outstanding principal of the term loan is $36.0 million, with net outstanding debt of $35.540 million after deducting unamortized debt issuance costs[62] - The effective interest rate for the three and nine months ended September 30, 2025 was 7.3%, down from 9.2% and 9.3% for the same periods in 2024[69] - The future principal payments under the Fourth Amended Loan Agreement total $36.0 million, with $6.0 million due in 2027, $18.0 million in 2028, and $12.0 million in 2029[69] - The Company has a secured revolving credit facility of up to $15.0 million as part of its financing arrangements[64] - The Third Amendment to the Loan and Security Agreement sets the maturity date for the term loan as September 1, 2029, with the first principal repayment due on October 1, 2027[66] - The Company was in compliance with all debt covenants as of September 30, 2025[69] Compliance and Risks - The company is cooperating with an investigation by the U.S. Department of Justice regarding compliance with the federal Anti-Kickback Statute, which may have a material impact on its financial condition[60] - The company has foreign currency risks primarily related to revenue and operating expenses denominated in currencies other than the U.S. dollar, particularly the Euro[156] - A hypothetical 100 basis point change in foreign exchange rates during the periods presented would not have had a material impact on the condensed consolidated financial statements[157] - The company’s exposure to interest rate risk is considered low, with a floating annual interest rate on the Third Amendment Term Loan set at the greater of the prime rate minus 0.5% or 4.25%[159] - The company has not entered into derivatives or other financial instruments to hedge foreign currency exchange risk but may consider this in the future[157] Employee Stock Purchase Plan - The total accumulated employee payroll deductions related to the Employee Stock Purchase Plan (ESPP) amounted to $0.6 million as of September 30, 2025[76] - Proceeds from the issuance of common stock under the employee stock purchase plan were $1,568 for the nine months ended September 30, 2025, compared to $1,472 in 2024[25] - The Company granted 1,305,384 Restricted Stock Units (RSUs) with an average grant date fair value of $16.79 during the nine months ended September 30, 2025[74] - As of September 30, 2025, there are 910,018 stock options outstanding with a weighted average exercise price of $11.41[70]

The statements in this presentation regarding expectations of future events or results, including SI-BONE's expectations of continued revenue and procedure growth and financial outlook, are "forward-looking" statements. These forward-looking statements are based on SI-BONE's current expectations and inherently involve significant risks and uncertainties. These risks include SI-BONE's ability to introduce and commercialize new products and indications, SI-BONE's ability to maintain favorable reimbursement fo ...

Revenue Growth - Worldwide revenue for Q3 2025 was $48.7 million, a 20.6% increase from $40.3 million in Q3 2024[7] - U.S. revenue for Q3 2025 was $46.4 million, reflecting a 21.2% growth from $38.3 million in Q3 2024[7] - The company expects 2025 worldwide revenue to be in the range of $198 million to $200 million, implying year-over-year growth of approximately 18% to 20%[12] Profitability Metrics - Gross margin improved to 79.8% in Q3 2025, up from 79.1% in Q3 2024, representing an improvement of 75 basis points[8] - Adjusted EBITDA was positive at $2.3 million in Q3 2025, compared to an adjusted EBITDA loss of $0.2 million in Q3 2024[10] - Net loss improved by 30.6% to $4.6 million, or $0.11 per diluted share, in Q3 2025, compared to a net loss of $6.6 million, or $0.16 per diluted share, in Q3 2024[10] Operational Highlights - The number of active U.S. physicians increased by 27% to 1,530 in Q3 2025[6] - New Technology Add-on Payment (NTAP) for procedures involving iFuse TORQ TNT is over $4,100 effective October 1, 2025[6] - Operating expenses increased by 11.9% to $44.2 million in Q3 2025, driven by higher revenue and new product rollout[9] Cash Position - Cash and equivalents as of September 30, 2025, were $145.7 million, compared to $145.5 million as of June 30, 2025[11]