Question-and-Answer SessionInevitably, typical. Why don't we start big picture. The business originally on the sacropelvic joint space, it's really over the last few years become more of a platform. It might be helpful for you if you could sort of walk through that evolution of that journey and discuss the end markets and products that you're currently exposed to.Laura FrancisCEO & Director Yes. Thanks for the question. And so I've been with the company for over 10 years at this point. So started out with t ...

Question-and-Answer SessionInevitably, typical. Why don't we start big picture. The business originally on the sacropelvic joint space, it's really over the last few years become more of a platform. It might be helpful for you if you could sort of walk through that evolution of that journey and discuss the end markets and products that you're currently exposed to.Laura FrancisCEO & Director Yes. Thanks for the question. And so I've been with the company for over 10 years at this point. So started out with t ...

SI-BONE (NasdaqGM:SIBN) FY Conference September 09, 2025 07:00 AM ET Company ParticipantsAnshul Maheshwari - CFOLaura Francis - CEOMarissa BychAlrighty, morning. Thank you everybody for day two at the MS Healthcare Conference. I appreciate it. The most exciting bit, disclaimers, focusfamily.com forward slash research disclosures. I'm sure you'll all be going there. What is exciting is having Laura and Anshul here, CEO and CFO at SI-BONE respectively. Doing a beautiful morning for us. Thanks so much for join ...

SANTA CLARA, Calif., Aug. 26, 2025 (GLOBE NEWSWIRE) -- SI-BONE, Inc. (Nasdaq: SIBN), a medical device company dedicated to solving sacropelvic disorders, today announced that the company will be participating in the upcoming Morgan Stanley 23rd Annual Global Healthcare Conference in New York, NY. Management will be hosting a fireside chat on Tuesday, September 9, 2025, at 4:00 a.m. Pacific Time/ 07:00 a.m. Eastern Time. Investors interested in listening to the conference call may do so by registering at thi ...

Summary of SI-BONE (SIBN) FY Conference Call - August 12, 2025 Company Overview - **Company**: SI-BONE, a pioneer in sacropelvic solutions with an expanding product portfolio addressing unmet clinical needs [1][2] Key Financial Performance - **Q2 Performance**: - Worldwide growth of 22% and U.S. growth of 23% [3][4] - Procedure volume growth of 25% [4] - Consistent 20% CAGR since IPO, with accelerated growth in the last three years [4][5] - Gross margin expectations raised to 70.5% - 79% for the full year, currently at close to 80% [6] - Achieved positive adjusted EBITDA for three consecutive quarters and cash flow breakeven [6][10] Growth Drivers - **Broad-Based Growth**: - Double-digit growth in procedure volume across all modalities and call points [5][8] - Increase in active physicians to 1,440, indicating strong future growth potential [7] - **Product Adoption**: - Strong adoption of Granite 9.5 and TNT products, with additional capacity planned [7][11] - **Market Opportunities**: - Anticipated strong performance in Q4 and into 2026 due to new product launches and increased surgical capacity [11][17] Market Size and Addressable Market - **Total Addressable Market (TAM)**: - SI joint dysfunction market estimated at $2.5 billion with 300,000 target patients annually [19] - Adult deformity market approximately $400 million and degenerative spine market around $1 billion [20] - Overall market potential close to $4 billion with 5 million target procedures annually [22] Product Pipeline and Innovations - **Upcoming Products**: - NextGen SI joint solution expected to launch in late Q1 2026, targeting interventionalists [31][34] - Second breakthrough device submission planned for the second half of 2026 [35][38] - **R&D Focus**: - Active pipeline with emphasis on addressing unmet clinical needs and maintaining high gross margins [42][43] Reimbursement and Regulatory Environment - **Favorable Reimbursement**: - NTAP for Granite and TPT for outpatient procedures with zero device offset [26][27] - Proposed reimbursement increases for office-based lab procedures and outpatient settings [29][30] - **Impact of Regulatory Changes**: - Potential for increased outpatient procedures due to new APC codes [30] Strategic Outlook - **Growth Strategy**: - Focus on expanding product offerings and leveraging existing physician relationships [23][24] - Emphasis on maintaining differentiation and high gross margins while scaling operations [43][44] - **Market Positioning**: - Strong internal R&D capabilities and a commitment to addressing unmet needs in the market [42][44] Conclusion - **Future Prospects**: - Confidence in sustaining growth through new product launches and market expansion, with a strong focus on profitability and cash flow management [17][45]

PART I - FINANCIAL INFORMATION [Item 1. Financial Statements](index=4&type=section&id=Item%201.%20Financial%20Statements) Presents unaudited condensed consolidated financial statements and detailed notes [Condensed Consolidated Balance Sheets (Unaudited)](index=5&type=section&id=Condensed%20Consolidated%20Balance%20Sheets%20%28Unaudited%29) Presents the company's financial position, detailing assets, liabilities, and equity | Metric | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :-------------------------- | :----------------------------- | :------------------------------- | | Total Assets | $230,921 | $230,437 | | Total Liabilities | $60,578 | $63,473 | | Total Stockholders' Equity | $170,343 | $166,964 | [Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited)](index=6&type=section&id=Condensed%20Consolidated%20Statements%20of%20Operations%20and%20Comprehensive%20Loss%20%28Unaudited%29) Presents the company's financial performance, including revenue, expenses, and net loss | Metric (Three Months Ended June 30,) | 2025 (in thousands) | 2024 (in thousands) | Change ($) | Change (%) | | :----------------------------------- | :------------------ | :------------------ | :--------- | :--------- | | Revenue | $48,630 | $39,969 | $8,661 | 21.7% | | Net Loss | $(6,152) | $(8,939) | $2,787 | -31.2% | | Net Loss per Share | $(0.14) | $(0.22) | $0.08 | -36.4% | | Gross Margin | 79.8% | 79.0% | 0.8% | 1.0% | [Condensed Consolidated Statements of Changes in Stockholders' Equity (Unaudited)](index=7&type=section&id=Condensed%20Consolidated%20Statements%20of%20Changes%20in%20Stockholders%27%20Equity%20%28Unaudited%29) Details changes in the company's equity, including stock-based compensation and accumulated deficit | Metric | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :-------------------------- | :----------------------------- | :------------------------------- | | Total Stockholders' Equity | $170,343 | $166,964 | | Accumulated Deficit | $(444,048) | $(431,354) | | Metric (Six Months Ended June 30,) | 2025 (in thousands) | 2024 (in thousands) | | :--------------------------------- | :------------------ | :------------------ | | Stock-based compensation | $13,321 | $13,428 | [Condensed Consolidated Statements of Cash Flows (Unaudited)](index=9&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows%20%28Unaudited%29) Presents cash flows from operating, investing, and financing activities | Metric (Six Months Ended June 30,) | 2025 (in thousands) | 2024 (in thousands) | Change ($) | | :--------------------------------- | :------------------ | :------------------ | :--------- | | Net cash used in operating activities | $(4,738) | $(13,905) | $9,167 | | Net cash provided by investing activities | $1,159 | $4,517 | $(3,358) | | Net cash provided by financing activities | $2,336 | $1,881 | $455 | | Cash and cash equivalents at end of period | $34,150 | $25,577 | $8,573 | [Notes to Condensed Consolidated Financial Statements (Unaudited)](index=10&type=section&id=Notes%20to%20Condensed%20Consolidated%20Financial%20Statements%20%28Unaudited%29) Provides detailed explanations and disclosures for condensed consolidated financial statements [1. The Company and Nature of Business](index=10&type=section&id=1.%20The%20Company%20and%20Nature%20of%20Business) Describes the company's medical device business, product lines, and regulatory clearances - SI-BONE, Inc. is a medical device company that has pioneered a proprietary minimally invasive surgical implant system to fuse the sacroiliac joint for treatment of musculoskeletal disorders of the sacropelvic anatomy[27](index=27&type=chunk) - The Company has launched multiple implant product lines, including iFuse-3D (2017), iFuse TORQ (2021), iFuse Bedrock Granite (2022), and iFuse INTRA and iFuse TORQ TNT (2024)[27](index=27&type=chunk) - Products have clearances for sacroiliac joint dysfunction, adult spinal deformity, and pelvic trauma in the United States, and sacroiliac fusion, adult spinal deformity, and pelvic fracture fixation in Europe[27](index=27&type=chunk) [2. Summary of Significant Accounting Policies](index=11&type=section&id=2.%20Summary%20of%20Significant%20Accounting%20Policies) Outlines key accounting policies, U.S. GAAP compliance, and segment reporting - The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with U.S. GAAP and SEC rules for interim financial reporting, with certain footnotes condensed or omitted[29](index=29&type=chunk) - There have been **no material changes** to the Company's significant accounting policies as disclosed in the **2024 Annual Report**[32](index=32&type=chunk) - The Company operates as a single operating and reportable segment, with substantially all revenue derived from U.S. customers (international revenue less than **10%**)[33](index=33&type=chunk)[34](index=34&type=chunk) - The Company is evaluating the impacts of new accounting pronouncements: ASU 2023-09 (Income Taxes) effective after December 15, 2024, and ASU 2024-03 (Expense Disaggregation) effective after December 15, 2026[36](index=36&type=chunk)[37](index=37&type=chunk) [3. Marketable Securities](index=12&type=section&id=3.%20Marketable%20Securities) Details marketable securities classification, fair value, and unrealized gains/losses - All of the Company's marketable securities are classified as available-for-sale[38](index=38&type=chunk) | Marketable Securities | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :-------------------- | :--------------------------- | :------------------------------- | | Total Fair Value | $139,215 | $142,420 | - Unrealized losses are generally due to interest rate fluctuations, not credit quality, and are recorded in accumulated other comprehensive income (loss)[39](index=39&type=chunk) [4. Fair Value Measurement](index=13&type=section&id=4.%20Fair%20Value%20Measurement) Explains fair value measurements for financial instruments, including marketable securities - Carrying amounts of cash equivalents, accounts receivable, accounts payable, and accrued liabilities approximate fair value due to their short maturities[41](index=41&type=chunk) | Marketable Securities Fair Value | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :------------------------------- | :--------------------------- | :------------------------------- | | Level 1 | $135,175 | $140,064 | | Level 2 | $4,040 | $2,356 | | Total | $139,215 | $142,420 | [5. Balance Sheet Components](index=14&type=section&id=5.%20Balance%20Sheet%20Components) Provides details on key balance sheet items like inventory, property, and accrued liabilities | Metric | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :-------------------------------- | :--------------------------- | :------------------------------- | | Inventory | $34,245 | $27,074 | | Property and Equipment, net | $21,701 | $20,374 | | Accrued Liabilities and Other | $16,149 | $19,492 | | Allowance for Credit Losses (end of period) | $911 | $588 | - **Inventory increased** primarily in finished goods. **Accrued liabilities decreased** mainly due to lower accrued compensation[43](index=43&type=chunk)[45](index=45&type=chunk) [6. Commitments and Contingencies](index=15&type=section&id=6.%20Commitments%20and%20Contingencies) Discloses lease commitments, purchase commitments, and legal contingencies - The Company extended its Santa Clara office lease to July 31, 2026. **Total operating lease liabilities** as of June 30, 2025, are **$1,424 thousand**[47](index=47&type=chunk)[49](index=49&type=chunk) | Commitment Type | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :---------------- | :--------------------------- | :------------------------------- | | Purchase Commitments | $1,900 | $400 | - The Company received a Civil Investigative Demand from the U.S. Department of Justice in October 2024 related to an investigation under the federal Anti-Kickback Statute and Civil False Claims Act[55](index=55&type=chunk) [7. Borrowings](index=16&type=section&id=7.%20Borrowings) Details the company's term loan, principal outstanding, and effective interest rates | Metric | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :--------------------------------------- | :--------------------------- | :------------------------------- | | Principal outstanding (Term Loan) | $36,000 | $36,000 | | Outstanding debt, net of issuance costs | $35,510 | $35,452 | - The Company entered into a Third Amendment to Loan and Security Agreement with First-Citizens in November 2024, refinancing the existing term loan for **$36.0 million**, with a maturity date of September 1, 2029[61](index=61&type=chunk) | Metric (Effective Interest Rate) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | | :------------------------------- | :------------------------------- | :------------------------------- | | Effective Interest Rate | 7.3% | 9.3% | - The Company was in compliance with all debt covenants as of June 30, 2025[63](index=63&type=chunk) [8. Stock-Based Incentive Compensation Plans](index=18&type=section&id=8.%20Stock-Based%20Incentive%20Compensation%20Plans) Outlines stock options, RSUs, PSUs, and related stock-based compensation expense | Stock Options | June 30, 2025 | | :---------------------------- | :------------ | | Outstanding Shares | 913,617 | | Weighted Average Exercise Price | $11.40 | | Aggregate Intrinsic Value | $7,689 | | Restricted Stock Units (RSUs) and Performance Stock Units (PSUs) | June 30, 2025 | December 31, 2024 | | :------------------------------------------------- | :------------ | :---------------- | | RSUs Outstanding | 2,514,767 | 1,884,640 | | PSUs Outstanding | 785,457 | 610,541 | | Stock-Based Compensation Expense (in thousands) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :---------------------------------------------- | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | Total | $6,658 | $6,398 | $13,321 | $13,428 | [9. Net Loss Per Share of Common Stock](index=20&type=section&id=9.%20Net%20Loss%20Per%20Share%20of%20Common%20Stock) Presents net loss per share calculations and anti-dilutive securities | Metric (Net Loss Per Share, Basic and Diluted) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :--------------------------------------------- | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | Net Loss Per Share | $(0.14) | $(0.22) | $(0.30) | $(0.48) | - Outstanding stock options, restricted stock units, ESPP purchase rights, and common stock warrants were anti-dilutive and excluded from diluted net loss per share computation due to net losses in all periods presented[73](index=73&type=chunk)[74](index=74&type=chunk) [10. Income Taxes](index=21&type=section&id=10.%20Income%20Taxes) Discusses income tax provisions, valuation allowances, and impacts of new tax legislation - The Company did not have a provision for income taxes for the three and six months ended June 30, 2025 and 2024[75](index=75&type=chunk) - A full valuation allowance is maintained against net deferred tax assets due to uncertainty surrounding their realization[75](index=75&type=chunk) - The Company is assessing the impact of the 'One Big Beautiful Bill Act' (OBBBA), signed July 4, 2025, on its financial statements[77](index=77&type=chunk) [Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations](index=22&type=section&id=Item%202.%20Management%27s%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) Management's perspective on financial performance, condition, and future outlook [Overview](index=22&type=section&id=Overview) Provides a high-level overview of the company's medical device business and product portfolio - SI-BONE is a medical device company focused on proprietary minimally invasive surgical implant systems for sacroiliac joint dysfunction and pelvic fixation[79](index=79&type=chunk) - The product portfolio includes iFuse, iFuse-3D, iFuse TORQ, iFuse Bedrock Granite, iFuse INTRA, and iFuse TORQ TNT, with various regulatory clearances[80](index=80&type=chunk) - Over **127,000 procedures** have been performed using the Company's products by over **4,600 physicians** in the United States and **38 other countries** since 2009[81](index=81&type=chunk) [Factors Affecting Results of Operations and Key Performance Indicators](index=22&type=section&id=Factors%20Affecting%20Results%20of%20Operations%20and%20Key%20Performance%20Indicators) Outlines key drivers and metrics influencing financial performance and strategic initiatives [Expand Access to Solutions](index=22&type=section&id=Expand%20Access%20to%20Solutions) Focuses on increasing sales force capacity, productivity, and market penetration - The Company is focused on increasing sales managers' capacity and driving sales force productivity by adding clinical support specialists, implementing hybrid models, and placing instrument trays and implants at select sites[84](index=84&type=chunk) | Sales Force Component | June 30, 2025 | June 30, 2024 | | :-------------------- | :------------ | :------------ | | U.S. Territory Sales Managers | 85 | 85 | | U.S. Clinical Support Specialists | 75 | 67 | | U.S. Third-Party Sales Agents | 295 | 204 | | International Sales Representatives | 10 | 11 | | International Third-Party Sales Agents and Resellers | 29 | 29 | - Over **30%** of sacroiliac joint dysfunction procedures for the quarter ended June 30, 2025, were performed at ambulatory surgery centers (ASCs) or Office-Based Labs (OBLs)[86](index=86&type=chunk) [Physician Engagement](index=23&type=section&id=Physician%20Engagement) Describes strategies for educating physicians and growing product adoption through training - The Company engages and educates physicians and healthcare professionals on the clinical merits and patient benefits of its solutions to grow physician adoption[87](index=87&type=chunk) - Training methods include hands-on cadaveric and dry-lab training, as well as the SI-BONE SImulator[88](index=88&type=chunk) | Physician Training | June 30, 2025 | June 30, 2024 | | :----------------- | :------------ | :------------ | | U.S. Physicians Trained | >3,600 | >2,900 | | International Physicians Trained | >1,100 | >1,000 | | Surgical Residents and Fellows Trained (since Aug 2018) | ~2,000 | N/A | [Expand Addressable Markets](index=24&type=section&id=Expand%20Addressable%20Markets) Details efforts to expand sacropelvic solutions and clinical trial results for new products - The Company is expanding its platform of sacropelvic solutions to address sacroiliac joint dysfunction, pelvic fixation, and pelvic trauma with a comprehensive product portfolio[91](index=91&type=chunk) - Clinical trial results: SILVIA study showed iFuse-3D **reduced** new-onset SI joint pain; SAFFRON study showed **higher** mobility recovery with iFuse TORQ for sacral fragility fractures; STACI study showed **low** adverse event rate and early pain/function improvement with iFuse TORQ[92](index=92&type=chunk)[93](index=93&type=chunk)[94](index=94&type=chunk) | Research and Development Expenses (in thousands) | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :----------------------------------------------- | :----------------------------- | :----------------------------- | | R&D Expense | $8,843 | $8,697 | | R&D as % of Revenue | 9% | 11% | [Enhance Employee Experience and Engagement](index=25&type=section&id=Enhance%20Employee%20Experience%20and%20Engagement) Focuses on talent recruitment, development, retention, and workplace culture - The Company focuses on recruiting, developing, and retaining highly skilled talent through a diverse and inclusive workplace, competitive compensation, and health and wellness programs[96](index=96&type=chunk) - Strategies include establishing feedback mechanisms, enhancing people manager skills, improving internal communications, and providing ongoing learning and leadership training opportunities[97](index=97&type=chunk)[98](index=98&type=chunk) [Gain Operational Efficiency](index=25&type=section&id=Gain%20Operational%20Efficiency) Aims to improve business processes, sales force productivity, and asset utilization - The Company is evolving business processes to identify, measure, and improve operational efficiency, **increase** sales force productivity, and improve asset utilization[99](index=99&type=chunk) | Metric | June 30, 2025 | June 30, 2024 | | :-------------------------------- | :------------ | :------------ | | Trailing Twelve Month Average Revenue per Territory Sales Manager | ~$2.1 million | ~$1.7 million | - Initiatives include working with suppliers to reduce lead times for implants, optimizing product design for manufacturing, and integrating demand planning and manufacturing systems[101](index=101&type=chunk) [Components of Results of Operations](index=25&type=section&id=Components%20of%20Results%20of%20Operations) Defines key financial components constituting the company's results of operations [Revenue](index=25&type=section&id=Revenue) Describes factors influencing implant sales revenue and seasonal variations - **Revenue** from implant sales fluctuates based on case volume, discounts, U.S./international sales mix, implant pricing, and the number of implants used per patient[102](index=102&type=chunk) - The business is affected by seasonal variations, with lower sales in summer and higher sales in the last quarter of the fiscal year, though seasonality does not materially impact annual financial results[103](index=103&type=chunk) [Cost of Goods Sold, Gross Profit, and Gross Margin](index=26&type=section&id=Cost%20of%20Goods%20Sold%2C%20Gross%20Profit%2C%20and%20Gross%20Margin) Defines cost of goods sold components and their impact on gross profit and margin - Cost of goods sold primarily includes costs of implant components, instruments, instrument tray depreciation, royalties, scrap, inventory obsolescence, and distribution expenses[104](index=104&type=chunk) - Cost of goods sold historically **increases** with case levels and changes in product mix[104](index=104&type=chunk) [Operating Expenses](index=26&type=section&id=Operating%20Expenses) Outlines operating expense categories, including sales, marketing, R&D, and G&A - **Operating expenses** consist of sales and marketing, research and development, and general and administrative expenses, with personnel costs being the most significant component[105](index=105&type=chunk) - The Company anticipates certain **operating expenses** will continue to **increase** to support growth and strategic plans[105](index=105&type=chunk) [Interest Income](index=26&type=section&id=Interest%20Income) Explains interest income sources from cash and marketable securities investments - **Interest income** is primarily related to investments of excess cash in money market funds and marketable securities[110](index=110&type=chunk) [Interest Expense](index=26&type=section&id=Interest%20Expense) Details interest expense components related to borrowings and debt issuance costs - **Interest expense** is primarily related to borrowings, amortization of debt issuance costs, and accretion of final fees on the First-Citizens Third Amended Loan Agreement[111](index=111&type=chunk) [Other Income (Expense), Net](index=26&type=section&id=Other%20Income%20%28Expense%29%2C%20Net) Covers net foreign exchange gains and losses on international transactions - Other income (expense), net primarily consists of net foreign exchange gains and losses on foreign transactions[112](index=112&type=chunk) [Results of Operations](index=27&type=section&id=Results%20of%20Operations) Detailed comparative analysis of financial performance for reported periods [Comparison of the Three Months Ended June 30, 2025 and 2024](index=27&type=section&id=Comparison%20of%20the%20Three%20Months%20Ended%20June%2030%2C%202025%20and%202024) Compares financial performance for the three months ended June 30, 2025 and 2024 | Metric (Three Months Ended June 30,) | 2025 (in thousands) | 2024 (in thousands) | Change ($) | Change (%) | | :----------------------------------- | :------------------ | :------------------ | :--------- | :--------- | | Revenue | $48,630 | $39,969 | $8,661 | 21.7% | | Gross Profit | $38,807 | $31,576 | $7,231 | 22.9% | | Gross Margin | 79.8% | 79.0% | 0.8% | 1.0% | | Total Operating Expenses | $45,811 | $41,654 | $4,157 | 10.0% | | Interest Income | $1,520 | $2,015 | $(495) | -24.6% | | Interest Expense | $(666) | $(880) | $214 | -24.3% | - **Revenue increase** was primarily driven by a **$8.6 million increase** in U.S. revenue from **increased** case volumes due to an expanded product portfolio[113](index=113&type=chunk) - **Operating expenses increased** due to a **$2.5 million increase** in sales and marketing commissions/personnel costs and a **$1.4 million increase** in general and administrative personnel costs/stock-based compensation, along with a **$0.9 million increase** in legal and consulting fees[115](index=115&type=chunk)[117](index=117&type=chunk) [Comparison of the Six Months Ended June 30, 2025 and 2024](index=29&type=section&id=Comparison%20of%20the%20Six%20Months%20Ended%20June%2030%2C%202025%20and%202024) Compares financial performance for the six months ended June 30, 2025 and 2024 | Metric (Six Months Ended June 30,) | 2025 (in thousands) | 2024 (in thousands) | Change ($) | Change (%) | | :--------------------------------- | :------------------ | :------------------ | :--------- | :--------- | | Revenue | $95,920 | $77,836 | $18,084 | 23.2% | | Gross Profit | $76,502 | $61,441 | $15,061 | 24.5% | | Gross Margin | 79.8% | 78.9% | 0.9% | 1.1% | | Total Operating Expenses | $90,986 | $83,562 | $7,424 | 8.9% | | Interest Income | $3,112 | $4,128 | $(1,016) | -24.6% | | Interest Expense | $(1,328) | $(1,761) | $433 | -24.6% | - **Revenue increase** was primarily driven by a **$18.0 million increase** in U.S. revenue due to **increased** case volumes from an expanded product portfolio[121](index=121&type=chunk) - **Operating expenses increased** due to a **$4.2 million increase** in sales and marketing commissions/personnel costs and a **$2.5 million increase** in general and administrative personnel costs/stock-based compensation, along with a **$1.7 million increase** in legal, consulting, and bad debt expense[124](index=124&type=chunk)[126](index=126&type=chunk) [Liquidity and Capital Resources](index=30&type=section&id=Liquidity%20and%20Capital%20Resources) Discusses financial position, debt, cash flow, and ability to fund future operations | Metric | June 30, 2025 (in millions) | December 31, 2024 (in millions) | | :-------------------------- | :-------------------------- | :------------------------------ | | Cash and Marketable Securities | $145.5 | $150.0 | | Outstanding Debt | $35.5 | $35.5 | | Accumulated Deficit | $(444.0) | $(431.4) | - The Company expects existing cash and marketable securities to fund operating expenses and capital expenditure requirements over the next **12 months**[131](index=131&type=chunk) [Term Loan](index=31&type=section&id=Term%20Loan) Details outstanding debt, refinancing terms, maturity, and future principal payments - The Company's **outstanding debt** is related to a Third Amended Loan Agreement with First-Citizens, which refinanced the existing term loan for **$36.0 million** in November 2024, maturing on September 1, 2029[135](index=135&type=chunk) | Future Principal Payments (in thousands) | | :--------------------------------------- | | 2027: $6,000 | | 2028: $18,000 | | 2029: $12,000 | | Total: $36,000 | | Contractual Obligations | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | | :---------------------- | :--------------------------- | :------------------------------- | | Total | $47,600 | $48,100 | [Cash Flows](index=32&type=section&id=Cash%20Flows) Analyzes cash flow activities from operations, investing, and financing | Cash Flow Activity (Six Months Ended June 30,) | 2025 (in thousands) | 2024 (in thousands) | Change ($) | | :--------------------------------------------- | :------------------ | :------------------ | :--------- | | Net cash used in operating activities | $(4,738) | $(13,905) | $9,167 | | Net cash provided by investing activities | $1,159 | $4,517 | $(3,358) | | Net cash provided by financing activities | $2,336 | $1,881 | $455 | - The **decrease in net cash used in operating activities** was mainly due to **decreased net loss**, net of non-cash items, and improved collections, partially offset by higher inventory build-up and lower accrued liabilities[141](index=141&type=chunk) [Critical Accounting Policies, Significant Judgments, and Use of Estimates](index=33&type=section&id=Critical%20Accounting%20Policies%2C%20Significant%20Judgments%2C%20and%20Use%20of%20Estimates) Highlights critical accounting policies and significant management estimates - The preparation of financial statements requires management to make estimates and assumptions that affect reported amounts[144](index=144&type=chunk) - There have been **no material changes** to the descriptions of critical accounting policies, judgments, and estimates since the **2024 Annual Report**[145](index=145&type=chunk) [Seasonality](index=33&type=section&id=Seasonality) Discusses historical seasonal sales patterns and their impact on financial results - The Company historically experiences lower sales in the summer months and higher sales in the last quarter of the fiscal year[146](index=146&type=chunk) - Seasonality does not have a material impact on the Company's financial results from year to year[146](index=146&type=chunk) [Item 3. Quantitative and Qualitative Disclosures About Market Risk](index=33&type=section&id=Item%203.%20Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) Describes exposure to market risks, specifically foreign currency and interest rate risk [Foreign Currency Exchange Risk](index=33&type=section&id=Foreign%20Currency%20Exchange%20Risk) Assesses exposure to foreign currency fluctuations and their potential impact - The Company has foreign currency risks related to revenue and operating expenses denominated in currencies other than the U.S. dollar, primarily the Euro[148](index=148&type=chunk) - Changes in exchange rates, particularly a strengthening U.S. dollar, may negatively affect revenue and operating results[148](index=148&type=chunk) - Foreign currency gains or losses were not material, and a hypothetical **100 basis point change** in exchange rates would not have a material impact[149](index=149&type=chunk) [Interest Rate Risk](index=33&type=section&id=Interest%20Rate%20Risk) Evaluates exposure to interest rate changes on investments and floating-rate debt - Exposure to interest rate changes relates to interest earned on cash/investments and interest paid on the floating-rate Third Amendment Term Loan[150](index=150&type=chunk)[151](index=151&type=chunk) - The Company's investment policy focuses on capital preservation and liquidity, not trading or speculative purposes[150](index=150&type=chunk) - A hypothetical **100 basis point change** in market interest rates would not have a material impact due to the low-risk profile of investments and the amount of the term loan[151](index=151&type=chunk) [Item 4. Controls and Procedures](index=34&type=section&id=Item%204.%20Controls%20and%20Procedures) Details disclosure controls and procedures, including effectiveness and internal control changes [Evaluation of Disclosure Controls and Procedures](index=34&type=section&id=Evaluation%20of%20Disclosure%20Controls%20and%20Procedures) Describes the design and effectiveness of disclosure controls and procedures - Disclosure controls and procedures are designed to ensure information required for SEC reports is recorded, processed, summarized, and reported timely[152](index=152&type=chunk) - The CEO and CFO concluded that, as of June 30, 2025, the Company's disclosure controls and procedures were **effective** at the reasonable assurance level[154](index=154&type=chunk) [Changes in internal control over financial reporting](index=34&type=section&id=Changes%20in%20internal%20control%20over%20financial%20reporting) Reports on any material changes in internal controls over financial reporting - During the quarter ended June 30, 2025, there were **no material changes** in the Company's internal controls over financial reporting[155](index=155&type=chunk) PART II - OTHER INFORMATION [Item 1. Legal Proceedings](index=34&type=section&id=Item%201.%20Legal%20Proceedings) Discloses legal proceedings, noting no material adverse effects except for a disclosed investigation - The Company is involved in various claims, complaints, investigations, and legal actions arising in the normal course of business[156](index=156&type=chunk) - Except for the Investigation mentioned in Note 6, **no material legal proceedings** are pending that would have a material adverse effect on the Company[156](index=156&type=chunk) [Item 1A. Risk Factors](index=35&type=section&id=Item%201A.%20Risk%20Factors) Updates significant risks, including supply chain, manufacturing, and stock price volatility - **No material changes** from the risk factors previously disclosed in the **2024 Annual Report**, but additional risks and uncertainties may exist[157](index=157&type=chunk) - Disruptions in the supply of materials and components (e.g., titanium) or sterilization services by third-party suppliers could adversely affect the business[158](index=158&type=chunk)[159](index=159&type=chunk) - Various factors outside direct control, such as sterilization failures, transportation risks, supply chain disruptions (including inflation), and natural disasters, may adversely affect manufacturing and distribution[160](index=160&type=chunk)[162](index=162&type=chunk) - The price of common stock may be volatile due to macroeconomic factors, company performance, industry trends, and potential securities litigation[161](index=161&type=chunk)[163](index=163&type=chunk) - Inadequate funding for the FDA and other government agencies, or disruptions to their workforces, could hinder product development and commercialization[164](index=164&type=chunk)[166](index=166&type=chunk) - Uncertainty in the coverage and reimbursement environment for sacroiliac joint fusion procedures (CPT Codes 27279 and 27278) may **decrease** demand for products and negatively impact the business[168](index=168&type=chunk)[170](index=170&type=chunk)[171](index=171&type=chunk) [Item 2. Unregistered Sales of Equity Securities and Use of Proceeds](index=37&type=section&id=Item%202.%20Unregistered%20Sales%20of%20Equity%20Securities%20and%20Use%20of%20Proceeds) States no unregistered sales of equity securities or use of proceeds to report - **None**[172](index=172&type=chunk) [Item 3. Defaults Upon Senior Securities](index=37&type=section&id=Item%203.%20Defaults%20Upon%20Senior%20Securities) Indicates no defaults upon senior securities during the reported period - **None**[173](index=173&type=chunk) [Item 4. Mine Safety Disclosures](index=39&type=section&id=Item%204.%20Mine%20Safety%20Disclosures) States that mine safety disclosures are not applicable to the company - **Not Applicable**[174](index=174&type=chunk) [Item 5. Other Information](index=39&type=section&id=Item%205.%20Other%20Information) Discloses Rule 10b5-1 trading arrangements by certain Section 16 officers and directors - Michael Pisetsky (Chief Business & Legal Affairs Officer) adopted a Rule 10b5-1 trading arrangement on June 13, 2025, for up to **238,985 shares**[176](index=176&type=chunk) - Jeffrey W. Dunn (Chairman of the Board of Directors) adopted a Rule 10b5-1 trading arrangement on May 8, 2025, for up to **240,000 shares**[176](index=176&type=chunk) - **No other directors** or executive officers adopted Rule 10b5-1 trading arrangements during the three-month period ended June 30, 2025[177](index=177&type=chunk) [Item 6. Exhibits](index=40&type=section&id=Item%206.%20Exhibits) Lists all exhibits filed with the Form 10-Q, including corporate documents and certifications - Exhibits include Amended and Restated Certificate of Incorporation, Second Amended and Restated Bylaws, and various agreements[178](index=178&type=chunk) - Certifications of Principal Executive Officer and Principal Financial Officer (**31.1***, **31.2***, **32.1***) are filed or furnished[178](index=178&type=chunk)[179](index=179&type=chunk) - Inline XBRL Instance Document and Taxonomy Extension Documents are included[178](index=178&type=chunk) [SIGNATURES](index=41&type=section&id=SIGNATURES) Contains official signatures of CEO and CFO certifying the Form 10-Q filing - The Report was signed by Laura A. Francis (Chief Executive Officer) and Anshul Maheshwari (Chief Financial Officer) on August 5, 2025[184](index=184&type=chunk)[185](index=185&type=chunk)

Financial Performance - Si-Bone reported a quarterly loss of $0.14 per share, better than the Zacks Consensus Estimate of a loss of $0.19, and an improvement from a loss of $0.22 per share a year ago, representing an earnings surprise of +26.32% [1] - The company posted revenues of $48.63 million for the quarter ended June 2025, surpassing the Zacks Consensus Estimate by 0.80%, and showing an increase from $39.97 million in the same quarter last year [2] - Over the last four quarters, Si-Bone has exceeded consensus EPS estimates four times and topped consensus revenue estimates three times [2] Stock Performance - Si-Bone shares have increased approximately 24% since the beginning of the year, significantly outperforming the S&P 500's gain of 6.1% [3] - The current consensus EPS estimate for the upcoming quarter is -$0.17 on revenues of $46.68 million, and for the current fiscal year, it is -$0.62 on revenues of $196.13 million [7] Industry Outlook - The Medical - Instruments industry, to which Si-Bone belongs, is currently ranked in the bottom 37% of over 250 Zacks industries, indicating potential challenges ahead [8] - The performance of Si-Bone's stock may be influenced by the overall outlook for the industry, as research indicates that the top 50% of Zacks-ranked industries outperform the bottom 50% by more than 2 to 1 [8]

Financial Data and Key Metrics Changes - The company reported worldwide revenue of $48.6 million for Q2 2025, representing a growth of 21.7% year-over-year [30] - U.S. revenue was $46.4 million, reflecting a growth of 22.8% [31] - The net loss narrowed to $6.2 million or $0.14 per diluted share compared to a net loss of $8.9 million or $0.22 per diluted share in the prior year [34] - Positive adjusted EBITDA of $1 million was achieved, compared to an adjusted EBITDA loss of $2.7 million in the prior year [34] - Cash and marketable securities increased to $145.5 million, marking the first quarter of cash flow breakeven [35] Business Line Data and Key Metrics Changes - U.S. procedure volume increased by 25%, with double-digit growth across all modalities [32][9] - The physician base grew by 25%, reaching a record of 1,440 U.S. physicians performing procedures [21] - The average territory productivity reached $2.1 million, representing a 23% growth year-over-year [24] Market Data and Key Metrics Changes - International revenue was $2.2 million, impacted by delayed regulatory clearance for the iFuse Torque product [32] - The company expects the iFuse Torque to boost revenue growth in Europe in 2026 and beyond [32] Company Strategy and Development Direction - The company aims to build a platform of solutions targeting challenging procedures, improving surgical outcomes with lower failure rates [5][6] - Focus on innovation, physician engagement, commercial execution, and operational excellence as key priorities [11] - The company plans to expand its product offerings and enhance its market presence, particularly in the outpatient setting [88] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the demand across the portfolio and highlighted the strong growth momentum [44] - The company is optimistic about achieving positive adjusted EBITDA for the full year of 2025 and beyond [36] - Management noted that the regulatory changes proposed by CMS could provide additional tailwinds for the business [17] Other Important Information - The company announced the retirement of Tony Recoupero, President of Commercial Operations, effective February 2026, with Nicholas Kerr set to take over [26][27] - The company is preparing to launch a new SI joint product in 2026, which is expected to simplify workflow and expand engagement with interventionalists [20][88] Q&A Session Summary Question: Guidance on top line growth and assumptions for the second half - Management highlighted strong first half performance and discussed the potential for continued growth, with a sequential decline expected in Q3 due to seasonality [40][46] Question: Gross margin guidance and pricing pressure - Management provided insights on gross margin expectations, indicating a potential decline due to ASP pressure but also noted sticky improvements from supply chain efficiencies [50][56] Question: Growth of interventional doctors using products - Management confirmed strong growth in interventional doctors and noted that many are using multiple products, enhancing overall engagement [60][62] Question: Outpatient procedure opportunities - Management discussed the shift towards outpatient settings for certain procedures and the potential for increased adoption of their products in this market [66] Question: Expansion of territories and agents - Management confirmed plans to expand to approximately 100 territories over the next 15 months, while also increasing the number of agents to support growth [75][76] Question: Momentum across the product portfolio - Management reported strong demand for existing solutions and rapid adoption of new products, with a focus on maximizing physician potential [81][84] Question: Cash flow and capital deployment priorities - Management indicated a balanced approach to capital deployment, focusing on continued investment in R&D and commercial initiatives while maintaining strong cash flow [103]

Financial Data and Key Metrics Changes - Worldwide revenue for Q2 2025 was $48.6 million, representing a growth of 21.7% year-over-year [30] - U.S. revenue was $46.4 million, reflecting a growth of 22.8% [31] - Adjusted EBITDA was positive at $1 million, compared to an adjusted EBITDA loss of $2.7 million in the prior year [34] - Net loss narrowed to $6.2 million or $0.14 per diluted share, compared to a net loss of $8.9 million or $0.22 per diluted share in the prior year [34] - Cash and marketable securities increased to $145.5 million, marking the first quarter of cash flow breakeven [35] Business Line Data and Key Metrics Changes - U.S. procedure volume increased by 25%, with double-digit growth across all modalities [10][32] - The physician base grew by 25%, reaching a record of 1,440 U.S. physicians performing procedures [22] - Average territory productivity reached $2.1 million, representing a 23% increase year-over-year [25] Market Data and Key Metrics Changes - International revenue was $2.2 million, impacted by delayed regulatory clearance for iFuse Torque in Europe [32] - The company expects iFuse Torque to boost revenue growth in Europe starting in 2026 [32] Company Strategy and Development Direction - The company aims to expand its platform of solutions targeting challenging procedures, improving surgical outcomes with lower failure rates [6][8] - Focus on innovation, physician engagement, commercial execution, and operational excellence as key priorities [12] - Plans to launch new products targeting outpatient settings and expand into new addressable markets [21][86] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the demand across the portfolio and the effectiveness of their strategy [44] - The company anticipates continued growth driven by strong physician engagement and product adoption [80] - Guidance for full-year revenue was updated to $195 million to $198 million, implying year-over-year growth of approximately 17% to 18% [36] Other Important Information - The company achieved cash flow breakeven ahead of schedule, indicating potential for consistent positive free cash flow [35] - Leadership changes were announced, with Tony Recoupero retiring and Nicholas Kerr promoted to Chief Commercial Officer [27][28] Q&A Session Summary Question: Guidance on top line growth and assumptions for the second half - Management highlighted strong first-half performance and confidence in continued demand, with a sequential decline expected in Q3 due to seasonality [40][46] Question: Gross margin guidance and pricing pressure - Management discussed maintaining gross margin guidance at 78.5% to 79%, embedding assumptions for ASP pressure while acknowledging potential for better-than-expected outcomes [51][56] Question: Growth of interventional doctors using products - Management noted strong growth from interventional doctors and the potential for further engagement with new product launches [60][62] Question: International market contribution and torque rollout in Europe - Management expressed optimism about the torque product's impact in Europe, with expectations for growth in 2026 [95] Question: Capital deployment priorities - Management indicated a focus on continued investment in R&D and commercial initiatives while maintaining a strong cash position [98]

Financial Performance - SI-BONE achieved 21.7% worldwide revenue growth, reaching $48.6 million in the second quarter of 2025[8] - U S revenue grew by 22.8% to $46.4 million in the second quarter of 2025[8] - The company reported a gross margin of 79.8%, an improvement of 80 basis points[8] - Adjusted EBITDA was positive at $1.0 million, marking the third consecutive quarter of positive AEBITDA[8, 16] - The company generated $1.1 million in net cash[8] - SI-BONE has $145.5 million in cash and equivalents[17] Market and Physician Engagement - U S active physicians increased by 25%[8, 10] - The company has experienced 18 consecutive quarters of double-digit U S active physician growth[13] Guidance and Future Opportunity - SI-BONE updated its 2025 worldwide revenue guidance to $195 - $198 million, implying a growth of approximately 17%-18% year-over-year[21] - The company estimates a total U S addressable market opportunity of over $3.5 billion[23, 31] - iFuse TORQ TNT received NTAP with payment of $4,136[8, 59]