Carlsmed raises 2026 revenue outlook to $80 million after 65% quarterly growth
Key Facts
Carlsmed raised its full-year 2026 revenue outlook after reporting revenue of $21.6 million for the third quarter ended September 30, up 65% year over year from $13.1 million in the same period of 2025. In its earnings release, the company said it now expects annual revenue of $78 million to $80 million, compared with its previous outlook of $74 million to $78 million. That would represent growth of more than 56% at the midpoint of the new range compared with 2025. The higher outlook puts sales growth at the forefront of the results, while profitability figures show the company continues to post losses. The stock closed at $16.05 on November 9, before the results were announced on November 10.
Gross profit improved alongside revenue growth, reaching $16.7 million in the third quarter, compared with $9.9 million a year earlier. Gross margin rose to 77.3% from 75.9% in the third quarter of 2025, reflecting a higher share of gross profit in revenue during the period. But that improvement did not prevent the net loss from widening to $12.2 million, compared with a loss of $8.5 million in the same period. The comparison shows a divergence between sales growth and margin improvement on one hand, and the bottom-line result on the other. Expense levels and losses therefore remain central to assessing the higher revenue outlook.
Adjusted EBITDA loss was $7.3 million in the third quarter, compared with a loss of $8.2 million in the same quarter of 2025, narrowing year over year. Operating expenses, meanwhile, rose to $29.4 million from $19.0 million. The company said those expenses included $2.8 million related to executive transition costs and the anticipated settlement of certain legal matters. That puts the improvement in adjusted EBITDA alongside a higher operating expense base and a larger net loss. The figures indicate that revenue growth has yet to translate into net profitability in the reported quarter.
Chief Executive Mike Cordonnier linked commercial expansion to growth in the base of surgeons using the products, saying the company delivered 65% revenue growth and expanded that surgeon base by more than 60% year over year. He added that the company had “strengthened its leadership position in AI-powered personalized surgery” during the period. The company’s release presents the expansion of its user base as a development accompanying revenue growth, without attributing performance to a single factor. In the results’ broader context, revenue was $18.9 million in the second quarter of 2026, up 57% year over year from $12.1 million in the second quarter of 2025. The company also reported annual revenue of $50.5 million in 2025, compared with $27.2 million in 2024, an annual increase of 85.9%.
Carlsmed ended the third quarter with $80.3 million in cash, restricted cash, short-term investments and marketable securities, according to its financial position as of September 30, 2026. On September 28, the company had announced the appointment of Richard Hebenstrat as chief financial officer, succeeding Leo Greenstein, and reaffirmed its 2026 financial guidance at the time. The subsequent earnings release then raised the revenue range, while operating and net losses remained part of the picture. Cordonnier had described the second-quarter results as reflecting growing momentum in aprevo procedures and progress on the path to profitability. Those earlier results provide context for revenue growth accelerating from 57% in the second quarter to 65% in the third quarter, according to figures reported by the company.
Among developments after the quarter, Carlsmed said a new Medicare payment rate for inpatient aprevo lumbar procedures under the hospital inpatient prospective payment system took effect on October 1, 2026, for fiscal 2027, with higher reimbursement for those procedures. Also in October, the company launched its aprevo posterior bilateral lumbar system, which it estimates targets about 30,000 lumbar fusion procedures annually in the United States. The company presents both developments as part of the business expansion context after the quarter ended. Investors will track their impact as the company delivers on its new annual revenue outlook, alongside changes in its surgeon base and its ability to reduce losses.