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.

Financial Data and Key Metrics Changes - The company achieved record revenue of $1.2 million in Q3 2025, a 32% increase compared to $0.9 million in the same period last year [3][12] - Gross profit for Q3 2025 was $0.8 million, or 66% of revenue, compared to $0.4 million, or 47% in the prior year quarter [13] - The net loss for Q3 2025 was $3.3 million, or $0.40 per share, compared to a net loss of $3.2 million, or $3.63 per share, in Q3 2024 [15] Business Line Data and Key Metrics Changes - The increase in revenue was primarily driven by a rise in Cadmium procedure volumes and the addition of sales from the newly acquired Symmetry SI Joint Fusion System [12] - The company reported over 1,000 Cadmium devices implanted to date, demonstrating strong clinical performance across various indications [6] Market Data and Key Metrics Changes - The demand for both Cadmium and Symmetry products increased throughout Q3 2025 and has continued into Q4 2025 [12] - The company hosted 26 physicians in various workshops to enhance physician education and engagement [10] Company Strategy and Development Direction - The strategic asset acquisition of CyVantage's Symmetry technologies marks a pivotal milestone, transforming the company into a multi-product entity capable of addressing a broader spectrum of sacral pelvic fixation and fusion needs [4] - The company is focused on expanding its product portfolio and leveraging recent regulatory and clinical milestones to support commercial growth [10] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the ability to drive long-term value for patients, providers, and shareholders, citing strong execution across strategic priorities [18] - The company is actively onboarding sales professionals and expanding its commercial footprint, which is expected to build momentum into Q4 2025 [11] Other Important Information - The company ended Q3 2025 with $3.4 million in cash and no debt, and subsequently raised an additional $2.85 million through pipe financing [10][16] - The FDA granted 510(k) clearance for the Symmetry Plus SI joint fusion system, expanding the company's portfolio and competitive position [8] Q&A Session Summary Question: How much of the $1.2 million in product revenues was from base Cyvanage revenues? - The company had two months of Cyvanage product contribution, with approximately $1.1 million in Cadmium revenue and the rest from early Symmetry activity [20] Question: Will Cadmium grow sequentially from Q3 to Q4 2025? - The company expects Cadmium activity to continue growing, driven by positive data from the Mainsail study and the additional month of CyVantage activity in Q4 [21] Question: How will the Symmetry Plus alpha launch evolve over the next 6 to 12 months? - The alpha launch will start with a small group of physicians for feedback before expanding to a broader audience [23] Question: What are the expectations for G&A expenses moving forward? - G&A expenses in Q3 included some one-time integration costs, but future expenses are expected to be closer to the Q3 figure [24] Question: How is the integration of Cyvanage progressing? - The integration is largely complete, with a focus on launching Symmetry Plus and integrating customer bases [30] Question: What is the strategy for adding commercial sales professionals? - The company is committed to a hybrid commercial structure, with salespeople trained across all products to provide comprehensive solutions to physicians [35]

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]