SI-BONE Reports Quarterly Revenue of $55.7 Million and Raises Adjusted EBITDA to $3 Million
Key Facts
SI-BONE reported results for the third quarter ended September 30, 2026, after the market close on November 2, posting global revenue of $55.7 million, up 14.5% from the same period a year earlier. U.S. revenue rose 13.9% to $52.8 million, while international revenue increased 27.0% to $2.9 million. Net loss narrowed to $3.6 million, or $0.08 per diluted share, from $4.6 million and $0.11 per share a year earlier. Adjusted EBITDA was $3.0 million, compared with $2.3 million in the third quarter of 2025. The company reaffirmed its annual revenue guidance of $231–233 million, while lowering its estimated operating expense growth to about 10.5% at the midpoint of the revenue range, from about 12.0% previously. The stock's close at $21.23 on October 30 preceded the results announcement and does not reflect the market's response to it.
U.S. revenue growth came alongside an increase of about 19.5% in procedure volume, according to the company, though the effect was partially offset by a decline in average selling price. The company attributed the lower price to procedure mix and growing demand for the INTRA platform in clinics and ambulatory surgery centers. International revenue rose from $2.3 million in the year-earlier quarter to $2.9 million, which the company said reflected increased adoption of the iFuse TORQ and iFuse TORQ TNT systems. Gross margin fell to 79.3% from 79.8% a year earlier. The company linked the decline to procedure mix and sites of care, while operating expenses increased 9.7% to $48.5 million. It said the increase was driven mainly by sales and marketing commissions tied to product launches, alongside continued investment in research and development.
Despite the narrower net loss, the company continued to post a quarterly loss, while adjusted EBITDA improved to $3.0 million from $2.3 million a year earlier. A comparison with the second quarter shows continued improvement in the metric: the company posted $2.8 million then, compared with $1 million in the second quarter of 2025. Its net loss in the second quarter also narrowed to $4.1 million, or $0.09 per diluted share, compared with $6.2 million and $0.14 per share a year earlier. Global revenue in that quarter was $56.0 million, up 15.2% year over year, while U.S. revenue was $53.2 million, up 14.7%. In the first quarter, global revenue was $52.6 million, up 11.2%, while adjusted EBITDA was $2.5 million, compared with $0.5 million a year earlier. These quarterly results place revenue growth in the context of year-over-year acceleration from the first quarter, while net loss persisted.
Cash and cash equivalents totaled $146.3 million on September 30, 2026, compared with $145.9 million on June 30. The chief executive said the company was entering the fourth quarter with a record number of active physicians, and that growth in procedures and active physicians reflected demand for its products. She added that the initial limited launch of the iFuse Granite Onyx platform had seen strong interest, and the company estimated the platform's total addressable market at about $5 billion. The system received FDA 510(k) clearance on September 28, making it the company's first product to address poor bone density and intended for use outside the pelvis. In October, MS-DRG changes took effect for complex spinal fusion procedures using iFuse Bedrock Granite. The company said the changes raise inpatient hospital payments for eligible patients by up to about $50,000 per procedure.
The company expects operating expenses to grow about 10.5% at the midpoint of its annual revenue range, compared with a previous estimate of about 12.0%, while reaffirming its 2026 revenue range of $231–233 million. This updates the expense outlook while maintaining the revenue target range. Before the results were released, Investing.com's earnings page showed an estimate of a $0.126 per-share loss and expected revenue of $55.32 million for the third quarter. In trading, the stock closed at $22.41 on October 29 and then at $21.23 on October 30, ahead of the company's announcement after the market close on November 2. Therefore, the October 30 close does not establish a reaction to the quarterly results or guidance announced later. SI-BONE management is scheduled to participate in a fireside chat at the UBS Global Healthcare Conference on November 10, 2026.