SI-BONE, Inc. Q4 2025 Earnings Call Summary

Core Insights - The company achieved record revenue of $201 million in 2025, driven by a 22% increase in U.S. physician adoption and expanded utilization across the sacropelvic platform [1] - The company transitioned to a sustainable financial profile, delivering its first full year of positive adjusted EBITDA and reaching positive free cash flow in the fourth quarter [1] - A hybrid sales model was leveraged to drive territory productivity to $2.1 million per manager, marking an 18% year-over-year increase [1] Market Position and Growth - The company strengthened its market leadership in the thoracolumbar space with the iFuse Bedrock Granite, significantly outpacing deformity market growth through new surgeon adoption [1] - Favorable reimbursement shifts were capitalized on, including a 17% increase in Medicare reimbursement for office-based labs, enhancing the economic appeal of minimally invasive SI joint fusion [1] - The trauma footprint was expanded with iFuse TORQ TNT, which saw a 50% increase in physician adoption, addressing procedural gaps in sacral insufficiency fractures [1] - The company maintained a dominant position in the SI joint fusion market while successfully pivoting into high-growth adjacencies like pelvic fixation and trauma [1]