SI-BONE(SIBN) - 2025 Q3 - Earnings Call Transcript

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]