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]

Core Insights - The company achieved its first full year of positive Adjusted EBITDA, with a gross margin of 79% in Q4 and 79.6% for the full year, exceeding its 2025 guidance by approximately 200 basis points [1][7] Financial Performance - For the full year 2025, worldwide revenue reached $200.9 million, marking a 20.2% increase, with U.S. revenue growing by 20.6% to $191.1 million due to a 22% rise in procedure volume [2] - In Q4 2025, the company reported worldwide revenue of $56.3 million, a 15% year-over-year increase, with U.S. revenue at $53.5 million (up 13.9%) and international revenue growing 38.8% to $2.9 million [3][7] - The net loss narrowed to $1.6 million in Q4, compared to a $4.5 million loss in the prior year, and for the full year, the net loss decreased by 38.8% to $18.9 million [8] Operational Highlights - The company reported a significant increase in physician adoption, with a 22% rise in U.S. physicians using its technologies, totaling nearly 22,000 procedures in 2025 [5][11] - In Q4 alone, 1,640 physicians performed procedures using the company's solutions, marking an 18% growth compared to the previous year [12] - The company ended the year with 89 quota-carrying territory managers, achieving an annual revenue per territory of $2.1 million, an 18% increase year-over-year [13] Reimbursement and Product Developments - Management highlighted key reimbursement milestones, including a 17% increase in Medicare reimbursement for office-based lab SI joint fusion, bringing it to nearly $14,000 [6][15] - The company received FDA 510(k) clearance for INTRA Ti and initiated an alpha launch, with expectations for adoption to ramp up through 2026 [16] - iFuse TORQ TNT saw a 50% increase in physician adoption in Q4, with NTAP reimbursement potentially being up to 30% higher in eligible cases [17] Future Guidance - For 2026, the company guided worldwide revenue between $228.5 million and $232.5 million, implying a growth rate of 14% to 16% [19] - The expected gross margin for 2026 is approximately 78%, with operating expenses anticipated to grow due to investments in surgical capacity [20] Strategic Partnerships - The company formed a strategic partnership with Smith+Nephew to enhance its reach in pelvic trauma, particularly in level 1 and level 2 trauma centers [21]

Financial Data and Key Metrics Changes - The company achieved record annual worldwide revenue of nearly $201 million, marking over 20% growth year-over-year [5][21] - Fourth quarter worldwide revenue grew 15% to a record $56.3 million, with U.S. revenue at $53.5 million, representing 13.9% growth [20] - Positive Adjusted EBITDA of $5.1 million in the fourth quarter, a 176.2% improvement over the prior year, with a 9.1% Adjusted EBITDA margin [23][24] - Net loss narrowed to $1.6 million or $0.04 per diluted share in the fourth quarter, compared to a net loss of $4.5 million or $0.11 per diluted share last year [22] Business Line Data and Key Metrics Changes - The company reported a 22% increase in U.S. physicians using its technologies, with nearly 22,000 procedures performed in 2025 [6][20] - INTRA Ti was launched recently, expected to enhance procedural efficiency in SI joint fusion [9][10] - iFuse Bedrock Granite has been one of the fastest-growing platforms, significantly outpacing the overall deformity market growth rate [11] Market Data and Key Metrics Changes - International revenue in the fourth quarter was $2.9 million, growing 38.8%, driven by the reception of iFuse TORQ [20] - The company secured favorable reimbursement positions, including NTAP for iFuse TORQ TNT and TPT for iFuse Bedrock Granite, enhancing access and adoption [6][11] Company Strategy and Development Direction - The company aims to lead the market for patients with compromised bone, focusing on innovation and market development [8] - A strategic partnership with Smith+Nephew was announced to expand reach in the trauma market, allowing trauma surgeons access to breakthrough technologies [16][29] - The next five years are viewed as an innovation super cycle, with plans to launch unique technologies targeting new clinical adjacencies [7][55] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in long-term growth potential, supported by a robust pipeline of innovative products and expanding market opportunities [28] - The company expects worldwide revenue of $228.5 million to $232.5 million in 2026, implying year-over-year growth of 14%-16% [25][26] - Management highlighted the importance of allowing tailwinds to materialize before fully incorporating them into revenue expectations [52][83] Other Important Information - The company exited 2025 with $147.8 million in cash and equivalents, marking a significant improvement in cash consumption compared to the previous year [24] - The company plans to add 10 new territories in 2026 to capture market opportunities [16][66] Q&A Session Summary Question: On the Smith+Nephew partnership, how did it come about and its potential contribution? - Management expressed excitement about the partnership, highlighting its potential to expand access to trauma solutions and allow the sales force to focus on market development [29][30] Question: Regarding clinical data showing similar outcomes for IPM physicians, will this increase engagement? - Management noted the growing interest in interventional business and the launch of INTRA Ti, which aligns with interventional spine physicians' workflows [32][34] Question: Can you clarify the guidance for Adjusted EBITDA in 2026? - Management indicated that while they expect an increase in Adjusted EBITDA, it would be slightly below $20 million [44] Question: What is the expected impact of INTRA Ti on the ASC market? - Management highlighted that INTRA Ti is designed for the ASC market and is expected to drive additional sales due to its simplicity and reimbursement coverage [46][62] Question: Can you discuss the cadence of revenue and the expected tailwinds? - Management noted that they expect more tailwinds than ever before, with a strong physician base and improved reimbursement backdrop [52][53]

Financial Data and Key Metrics Changes - The company generated record annual worldwide revenue of nearly $201 million, marking over 20% growth year-over-year [5][20] - Fourth quarter worldwide revenue grew 15% to a record $56.3 million, with U.S. revenue at $53.5 million, representing 13.9% growth [20] - The company achieved its first full year of positive adjusted EBITDA with a 9% adjusted EBITDA margin in the fourth quarter [7][23] - Net loss narrowed to $1.6 million or $0.04 per diluted share in the fourth quarter, compared to a net loss of $4.5 million or $0.11 per diluted share last year [22] Business Line Data and Key Metrics Changes - The number of U.S. physicians using the company's technologies increased by 22% in 2025, with nearly 22,000 procedures performed [6][20] - The company launched the INTRA Ti product, expected to enhance procedural efficiency in SI joint fusion [9][10] - iFuse Bedrock Granite has been one of the fastest-growing platforms, significantly outpacing the overall deformity market growth rate [11] Market Data and Key Metrics Changes - International revenue in the fourth quarter was $2.9 million, growing 38.8%, driven by the reception of iFuse TORQ [20] - The company expects to commercialize TNT in international markets in late 2026, ahead of the previously planned launch in 2027 [21] Company Strategy and Development Direction - The company is focused on an innovation-led growth strategy, with plans for a series of new product launches targeting new clinical adjacencies [4][8] - The partnership with Smith+Nephew aims to expand access to trauma solutions and enhance market penetration [30][31] - The company is positioned to lead in the sacropelvic space, addressing unmet needs for patients with compromised bone [8][9] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the long-term growth potential of the business, supported by a robust pipeline of innovative products and expanding market opportunities [28] - The company anticipates worldwide revenue of $228.5 million to $232.5 million in 2026, implying year-over-year growth of 14%-16% [25][26] - Management highlighted the importance of allowing tailwinds to materialize before fully incorporating them into revenue expectations [53] Other Important Information - The company ended 2025 with $147.8 million in cash and equivalents, marking a significant improvement in cash consumption compared to 2024 [24] - The company plans to add 10 new territories in 2026 to capture market opportunities [16][66] Q&A Session Summary Question: How did the Smith+Nephew partnership come about and its potential contribution? - Management expressed excitement about the partnership, highlighting its potential to expand access to trauma solutions and enhance productivity [30][31] Question: Will the clinical data showing similar outcomes for IPM physicians help create more engagement? - Management confirmed that the INTRA Ti product is designed to cater to interventional spine physicians, enhancing engagement and procedural efficiency [32][34] Question: Can you clarify the guidance for adjusted EBITDA in 2026? - Management indicated that while they expect an increase in adjusted EBITDA, it would be slightly below $20 million [44] Question: What is the expected impact of the INTRA Ti product on the ASC market? - Management noted that INTRA Ti is expected to drive growth in the ASC market, providing a non-allograft solution that aligns with interventional spine physicians' workflows [46][62] Question: What are the drivers behind the gross margin guidance of 78%? - Management explained that the guidance reflects a mix of factors, including product launches and operational initiatives aimed at maintaining profitability [74][76]

Financial Data and Key Metrics Changes - The company generated record annual worldwide revenue of nearly $201 million, marking over 20% growth year-over-year [5][20] - Fourth quarter worldwide revenue grew 15% to a record $56.3 million, with U.S. revenue at $53.5 million, representing 13.9% growth [19][20] - The company achieved its first full year of positive Adjusted EBITDA, with a margin of 9% in the fourth quarter [6][23] - Net loss narrowed to $1.6 million or $0.04 per diluted share in the fourth quarter, compared to a net loss of $4.5 million or $0.11 per diluted share last year [22][23] - The company exited 2025 with $147.8 million in cash and equivalents, an increase of $2.1 million from the third quarter [24] Business Line Data and Key Metrics Changes - The U.S. physician base grew by 22%, with over 2,400 physicians performing nearly 22,000 procedures in 2025 [5][20] - The company launched the INTRA Ti product, which is expected to enhance procedural efficiency in ambulatory surgery centers [9][10] - iFuse Bedrock Granite has been one of the fastest-growing platforms, significantly outpacing the overall deformity market growth rate [11] Market Data and Key Metrics Changes - International revenue in the fourth quarter was $2.9 million, growing 38.8%, driven by the reception of iFuse TORQ [19][20] - The company secured favorable reimbursement positions, including NTAP for iFuse TORQ TNT and TPT for iFuse Bedrock Granite, enhancing access and adoption [5][11] Company Strategy and Development Direction - The company aims to lead the sacroiliac joint fusion market and expand into new clinical adjacencies, targeting unmet needs for patients with compromised bone [6][8] - The partnership with Smith+Nephew is expected to enhance market penetration in trauma solutions [16][30] - The company anticipates an innovation super cycle over the next five years, with regular product launches targeting new clinical adjacencies [7][57] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the long-term growth potential of the business, supported by a robust pipeline of innovative products and expanding market opportunities [27] - The company expects worldwide revenue of $228.5 million to $232.5 million in 2026, implying year-over-year growth of 14%-16% [25][26] - Management highlighted the importance of allowing tailwinds to materialize before fully incorporating them into revenue expectations [54][86] Other Important Information - The company achieved positive free cash flow in the fourth quarter, generating nearly $500,000, ahead of its previously stated goal [24] - The company plans to add 10 new territories in 2026 to capture market opportunities [16][69] Q&A Session Summary Question: How did the Smith+Nephew partnership come about and its potential contribution? - Management expressed excitement about the partnership, highlighting its potential to expand access to trauma solutions and allow the sales force to focus on spine and interventional markets [30][32] Question: Will the INTRA Ti product create more engagement among interventional physicians? - Management confirmed that the INTRA Ti product is designed to improve procedural efficiency and is expected to drive growth in the interventional business [34][49] Question: What is the rationale behind the high teens growth guidance for 2026? - Management explained that the guidance considers the impact of new products and reimbursement coverage, with a focus on prudent expectations early in the year [86] Question: What is the expected ramp-up for the Smith+Nephew partnership in 2026? - Management indicated that activity is expected to start in March, with a ramp-up in Q2 and Q3 in preparation for Q4 [74][75]

SI-BONE Corporate Overview Recent Highlights – Record Performance Fourth Quarter 2025 Fiscal Year 2025 Note: Financial As of February 18, 2026 February 2026 Forward-Looking Statements 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 signific ...

Core Insights - Smith+Nephew has entered into a distribution agreement with SI-BONE to enhance its offerings in percutaneous pelvic fracture fixation procedures, particularly through the iFuse TORQ portfolio [1][3] - The partnership aims to leverage both companies' strengths to improve patient outcomes and expand access to innovative solutions in trauma procedures [3][4] Company Overview - Smith+Nephew is a global medical technology company focused on the repair, regeneration, and replacement of soft and hard tissue, with annual sales of $5.8 billion in 2024 [7] - The company operates in over 100 countries and is a constituent of the FTSE100 [7] Product Details - The iFuse TORQ portfolio includes iFuse TORQ TNT and iFuse TORQ implants, designed for pelvic fracture fixation and sacroiliac joint fusion, providing a competitive edge in the market [4][5] - iFuse TORQ TNT has received FDA Breakthrough Device Designation, indicating its potential for more effective treatment compared to traditional methods [5] Financial Implications - The iFuse TORQ TNT is eligible for a Medicare New Technology Add-on Payment, which could provide hospitals with up to $4,136 in additional reimbursement per procedure [5] Strategic Goals - The collaboration with SI-BONE reflects a commitment to innovation and clinical excellence, aiming to deepen surgeon engagement and drive sustainable growth in the trauma sector [3][4] - The partnership is expected to enhance Smith+Nephew's ability to serve surgeons and patients in high-need areas, thereby expanding its market presence [4]

Core Insights - SI-BONE, Inc. achieved a 20% worldwide revenue growth and positive adjusted EBITDA for Fiscal Year 2025, indicating strong business performance and operational efficiency [1][4][10] - The company generated free cash flow in the Fourth Quarter of 2025, reflecting improved financial health [1][7] Financial Highlights - Fourth Quarter 2025 worldwide revenue was $56.3 million, a 15.0% increase from $49.0 million in the same period of 2024 [5][7] - U.S. revenue for the fourth quarter was $53.5 million, up 13.9% from $46.9 million in the prior year [5][7] - International revenue for the fourth quarter reached $2.9 million, a significant increase of 38.8% from $2.1 million in the previous year [5][7] - Gross profit for the fourth quarter was $44.5 million, a 14.8% increase from $38.8 million in the corresponding period in 2024, with a stable gross margin of 79.0% [6][7] Annual Performance - For Fiscal Year 2025, worldwide revenue totaled $200.9 million, representing a 20.2% increase from $167.2 million in 2024 [10][12] - U.S. revenue for the year was $191.1 million, a 20.6% increase from $158.4 million in 2024 [10][12] - International revenue was $9.8 million, a 12.4% increase from $8.8 million in the previous year [10] Profitability Metrics - The company reported a net loss of $1.6 million in the fourth quarter, an improvement of 63.3% compared to a net loss of $4.5 million in the same period in 2024 [9][12] - Adjusted EBITDA for the fourth quarter was positive at $5.1 million, representing a 176.2% improvement from $1.9 million in the prior year [9][12] - For the full year, the net loss improved by 38.8% to $18.9 million, or $0.44 per diluted share, compared to a net loss of $30.9 million, or $0.75 per diluted share in 2024 [12] Operational Developments - Approximately 1,640 U.S. physicians performed procedures using SI-BONE's products in the fourth quarter, marking an 18% increase [7] - The company entered into a strategic partnership with Smith+Nephew to distribute its products across trauma centers nationwide [7] - SI-BONE expanded its INTRA platform with the launch of INTRA Ti, enhancing procedural flexibility for physicians [7] Future Outlook - For 2026, SI-BONE expects worldwide revenue to be between $228.5 million and $232.5 million, indicating a year-over-year growth of approximately 14% to 16% [13] - The company anticipates a gross margin of around 78% and operating expenses growth of approximately 12.5% at the midpoint of the revenue guidance [13]

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]