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SI-BONE, Inc. Reports Record Financial Results for the Fourth Quarter 2025 and Issues 2026 Guidance
Achieves 20% worldwide revenue growth and positive adjusted EBITDA for Fiscal Year 2025
Generates free cash flow in the Fourth Quarter 2025

SANTA CLARA, Calif. February 23, 2026 - SI-BONE, Inc. (Nasdaq: SIBN), the global leader in developing procedural solutions to address clinical challenges associated with compromised bone, today reported financial results for the fourth quarter and full year ended December 31, 2025.

Fourth Quarter 2025 Financial Highlights (all comparisons are to the prior year period)
•Worldwide revenue of $56.3 million, representing growth of 15.0%
•U.S. revenue of $53.5 million, representing growth of 13.9%
•Gross margin of 79.0%
•Net loss of $1.6 million, representing an improvement of 63.3%
•Positive adjusted EBITDA of $5.1 million, representing an improvement of 176.2%
•Positive cashflow from operations of $1.7 million and positive free cash flow of $0.4 million
•Ended the quarter with $147.8 million in cash and equivalents


Fiscal Year 2025 Highlights (all comparisons are to the prior year period)
•Worldwide revenue of $200.9 million, representing growth of 20.2%
•U.S. revenue of $191.1 million, representing growth of 20.6%
•Gross margin of 79.6%
•Net loss of $18.9 million, representing an improvement of 38.8%
•Positive adjusted EBITDA of $8.9 million, representing an improvement of $14.0 million


Recent Operational (all comparisons are to the prior year period)
•~1,640 U.S. physicians performed a procedure in the fourth quarter, representing an increase of 18%
•Entered into a strategic partnership with Smith+Nephew, an orthopedics industry leader, to distribute iFuse TORQ and iFuse TORQ TNT across Level 1 and Level 2 trauma centers nationwide for pelvic trauma
•Expanded INTRA platform with the launch of INTRA Ti in February, our newest SI joint fusion solution that provides physicians procedural flexibility and workflow efficiency in ambulatory surgery centers
•U.S. patent portfolio covering the original iFuse, including the triangular shape, extended to August 2028

Organizational Update
•Anshul Maheshwari promoted to Chief Operating Officer in addition to his role as Chief Financial Officer
•As previously announced, Nikolas Kerr was promoted to the role of Chief Commercial Officer
•Jeff Zigler promoted to Senior Vice President of Market Access and Reimbursement



“In 2025, we demonstrated the strength and scalability of our business model, delivering another year of worldwide revenue growth that exceeded 20% while expanding margins and exiting the year with positive free cash flow. These results reflect disciplined execution, a differentiated platform, and durability of demand across our portfolio.” said Laura Francis, Chief Executive Officer. “As we enter 2026, we have a compelling set of growth catalysts, including favorable reimbursement dynamics, expanding commercial footprint and upcoming product launches designed to deepen physician engagement and expand our reach into a sizable new market. Together, these factors reinforce our confidence in SI-BONE's ability to sustain strong, profitable growth over the long term."

Fourth Quarter 2025 Financial Results

Worldwide revenue was $56.3 million in the fourth quarter 2025, a 15.0% increase from $49.0 million in the corresponding period in 2024. U.S. revenue for the fourth quarter 2025 was $53.5 million, a 13.9% increase from $46.9 million in the corresponding period in 2024. International revenue for the fourth quarter 2025 was $2.9 million, a 38.8% increase from $2.1 million in the corresponding period in 2024.

Gross profit was $44.5 million in the fourth quarter 2025, an increase of 14.8% from $38.8 million in the corresponding period in 2024. Gross margin was stable at 79.0% for the fourth quarter 2025 compared to 79.1% in the corresponding period in 2024.

Operating expenses increased 6.2% to $47.0 million in the fourth quarter 2025, as compared to $44.3 million in the corresponding period in 2024. The change in operating expenses was primarily driven by general commercial activity related to higher revenue and research and development investments related to future products.

Operating loss improved by 55.2% to $2.5 million in the fourth quarter 2025, as compared to an operating loss of $5.5 million in the corresponding period in 2024.

Net loss improved by 63.3%, to $1.6 million, or $0.04 per diluted share in the fourth quarter 2025, as compared to a net loss of $4.5 million, or $0.11 per diluted share in the corresponding period in 2024.

Adjusted EBITDA improved by 176.2% to positive $5.1 million in the fourth quarter 2025, as compared to a positive adjusted EBITDA of $1.9 million in the corresponding period in 2024.

Fiscal Year 2025 Financial Results

Worldwide revenue was $200.9 million for 2025, a 20.2% increase from $167.2 million in 2024. U.S. revenue for 2025 was $191.1 million, a 20.6% increase from $158.4 million in 2024. International revenue was $9.8 million in 2025, a 12.4% increase from $8.8 million in 2024.

Gross profit was $159.9 million in 2025, a 21.0% increase from $132.1 million in 2024. Gross margin was 79.6% in 2025 and 79.0% in 2024.



Operating expenses increased 8.9% to $182.2 million in 2025, as compared to $167.4 million in 2024. The change in operating expenses was primarily driven by general commercial activity related to higher revenue and research and development investments related to future products.

Operating loss improved by 36.6% to $22.3 million in 2025, as compared to an operating loss of $35.2 million in 2024.

Net loss improved by 38.8%, to $18.9 million, or $0.44 per diluted share in 2025, as compared to a net loss of $30.9 million, or $0.75 per diluted share in 2024.

Adjusted EBITDA improved to positive $8.9 million in 2025, as compared to a loss of $5.1 million in 2024, representing and improvement of $14.0 million.

Cash and equivalents were $147.8 million, representing a sequential improvement of $2.1 million, and borrowings were $35.6 million as of December 31, 2025.

2026 Financial Guidance

SI-BONE expects 2026 worldwide revenue to be in the range of $228.5 million to $232.5 million, implying year-over-year growth of ~14% to ~16%. SI-BONE estimates fiscal year 2026 gross margin to be approximately 78%, and operating expenses growth to be ~12.5% at the mid-point of the revenue guidance. Based on these assumptions, SI-BONE expects to deliver increased positive adjusted EBITDA for the full year 2026.

Webcast Information
SI-BONE will host a conference call to discuss the fourth quarter 2025 financial results after market close on Monday, February 23, 2026 at 4:30 P.M. Eastern Time. The conference call can be accessed live over webcast at https://edge.media-server.com/mmc/p/zfxy6yox. Live audio of the webcast will be available on the “Investors” section of the company’s website at: www.si-bone.com. The webcast will be archived and available for replay for at least 90 days after the event.

About SI-BONE, Inc.

SI-BONE (NASDAQ: SIBN) is a global leader in developing procedural solutions to address clinical challenges associated with compromised bone. With expertise in biomechanical design and anatomy specific innovation, SI-BONE has built a technology platform with market-leading applications centered on the spinopelvic anatomy. SI-BONE continues to leverage the deep experience in addressing the challenges of low-density bone in the sacrum to develop unique technologies that are targeting new clinical adjacencies to help improve outcomes for patients with compromised bone. Since 2009, SI-BONE has supported physicians in performing a total of over 140,000 procedures. A unique body of clinical evidence supports the use of SI-BONE's technologies, including four randomized controlled trials and over 180 peer reviewed publications.


SI-BONE® is a registered trademark of SI-BONE, Inc. ©2026 SI-BONE, Inc. All Rights Reserved.





Forward Looking Statements

The statements in this press release regarding expectations of future events or results, including SI-BONE’s expectations of continued revenue and procedure growth and financial outlook, contained in this press release are "forward-looking" statements. These forward-looking statements are based on SI-BONE's current expectations and inherently involve significant risks and uncertainties. These risks include SI-BONE's ability to introduce and commercialize new products and indications, SI-BONE's ability to maintain favorable reimbursement for procedures using its products, the impact of any future economic weakness on the ability and desire of patients to undergo elective procedures including those using SI-BONE's devices, SI-BONE's ability to manage risks to its supply chain, future capital requirements driven by new surgical systems requiring instrument tray and implant inventory investment, and the pace of the re-normalization of the healthcare operating environment including the ability and desire of patients and physicians to undergo and perform procedures using SI-BONE's devices. Actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these and other risks and uncertainties, many of which are described in the company's most recent filing on Form 10-K, and the company’s other filings with the Securities and Exchange Commission (SEC) available at the SEC's Internet site (www.sec.gov), especially under the caption "Risk Factors." SI-BONE does not undertake any obligation to update forward-looking statements and expressly disclaims any obligations or undertaking to release publicly any updates or revisions to any forward-looking statements contained herein, except as required by law.

Use of Non-GAAP Financial Measures

To supplement our condensed consolidated financial statements, which are prepared and presented in accordance with generally accepted accounting principles in the United States ("GAAP"), SI-BONE uses two non-GAAP financial measures: Adjusted EBITDA and free cash flow. Non-GAAP measures should be considered supplemental to, and not a substitute for, financial information prepared in accordance with GAAP. Adjusted EBITDA excludes the effect of items that increase or decrease SI-BONE’s reported results of operations. Free cash flow is not intended to represent our residual cash flow available for discretionary expenditures. Management strongly encourages investors to review, when they become available, the company's consolidated financial statements and publicly filed reports in their entirety. The company's definition of adjusted EBITDA and free cash flow may differ from similarly titled measures used by others.

Adjusted EBITDA excludes from net loss the effects of interest income, interest expense, depreciation and amortization, and stock-based compensation. Free cash flow is defined as net cash provided by operating activities less purchases of property and equipment. SI-BONE believes the presentation of these financial measures is useful to management because it allows management to more consistently analyze period-to-period financial performance and provides meaningful supplemental information with respect to core operational activities used to evaluate management's performance. SI-BONE also believes the presentation of non-GAAP financial measures is useful to investors and other interested persons as it enables these persons to use this additional information to assess the company’s performance in using this additional metric that management uses to assess the company’s performance.

Investor Contact
Saqib Iqbal
VP, FP&A and Investor Relations


investors@SI-BONE.com


SI-BONE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(In thousands, except share and per share amounts)
(Unaudited)
Three Months Ended December 31
Twelve Months Ended December 31
2025202420252024
Revenue
$56,350 $49,002 $200,925 $167,178 
Cost of goods sold
11,818 10,225 41,046 35,057 
Gross profit44,531 38,777 159,879 132,121 
Operating expenses:
Sales and marketing32,806 31,249 124,224 117,054 
Research and development4,363 3,870 17,448 16,560 
General and administrative9,825 9,152 40,537 33,755 
Total operating expenses
46,994 44,271 182,209 167,369 
Loss from operations
(2,463)(5,494)(22,330)(35,248)
Interest and other income (expense), net:
Interest income1,446 1,784 6,074 7,848 
Interest expense(629)(795)(2,628)(3,440)
Other income (expense), net(2)10 (20)(73)
Net loss
$(1,648)$(4,495)$(18,904)$(30,913)
Net loss per share, basic and diluted
$(0.04)$(0.11)$(0.44)$(0.75)
Weighted-average number of common shares used to compute basic and diluted net loss per share
43,507,786 41,994,284 42,959,856 41,466,564 





SI-BONE, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands)
(unaudited)
December 31, 2025December 31, 2024
ASSETS
Current assets:
Cash and cash equivalents$42,240 $34,948 
Short-term investments105,583 115,094 
Accounts receivable, net 29,915 27,459 
Inventory33,897 27,074 
Prepaid expenses and other current assets4,480 3,204 
Total current assets216,115 207,779 
Property and equipment, net21,298 20,374 
Operating lease right-of-use assets1,087 1,984 
Other non-current assets55 300 
TOTAL ASSETS $238,555 $230,437 
LIABILITIES AND STOCKHOLDERS' EQUITY
Current liabilities:
Accounts payable$4,631 $6,488 
Accrued liabilities and other19,704 19,492 
Operating lease liabilities, current portion944 1,152 
Total current liabilities25,279 27,132 
Long-term borrowings35,569 35,452 
Operating lease liabilities, net of current portion175 879 
Other long-term liabilities— 10 
TOTAL LIABILITIES61,023 63,473 
Stockholders' Equity:
Common stock and additional paid-in capital626,974 598,074 
Accumulated other comprehensive income816 244 
Accumulated deficit(450,258)(431,354)
TOTAL STOCKHOLDERS’ EQUITY177,532 166,964 
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY$238,555 $230,437 



SI-BONE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)
(unaudited)
Twelve Months Ended December 31,
20252024
Cash flows from operating activities
Net loss$(18,904)$(30,913)
Adjustments to reconcile net loss to net cash used in operating activities
Stock-based compensation25,524 25,869 
 Depreciation and amortization5,770 4,379 
 Accounts receivable credit losses570 470 
Inventory reserve1,997 1,300 
Amortization of discount and premium on marketable securities(3,051)(5,440)
Amortization of debt issuance costs117 153 
Loss on disposal of property and equipment1,627 1,877 
Changes in operating assets and liabilities
Accounts receivable(3,027)(5,840)
Inventory(8,684)(8,047)
Prepaid expenses and other assets(1,030)(2)
Accounts payable(1,763)1,861 
Accrued liabilities and other179 1,908 
Net cash used in operating activities(675)(12,425)
Cash flows from investing activities
Maturities of marketable securities205,100 228,500 
Purchases of marketable securities(192,526)(205,380)
Purchases of property and equipment(8,414)(10,497)
Net cash provided by (used in) investing activities4,160 12,623 
Cash flows from financing activities
Proceeds from debt financing, net of debt issuance cost— 35,954 
Repayments of debt financing— (36,000)
Final payment fee related to debt— (720)
Proceeds from the exercise of common stock options1,169 570 
Proceeds from issuance of common stock under employee stock purchase plan2,207 2,154 
Net cash provided by financing activities3,376 1,958 
Effect of exchange rate changes on cash and cash equivalents431 (479)
Net increase in cash and cash equivalents7,292 1,677 
Cash and cash equivalents at
Beginning of year34,948 33,271 
End of year$42,240 $34,948 





SI-BONE, INC.
RECONCILIATION OF NET LOSS TO NON-GAAP ADJUSTED EBITDA
(In thousands)
(unaudited)

Three Months Ended December 31,
Twelve Months Ended December 31,
2025202420252024
Net loss$(1,648)$(4,495)$(18,904)$(30,913)
Interest income(1,446)(1,784)(6,074)(7,848)
Interest expense629 795 2,628 3,440 
Depreciation and amortization1,638 1,213 5,770 4,379 
Stock-based compensation5,976 6,135 25,524 25,868 
Adjusted EBITDA$5,150 $1,864 $8,944 $(5,074)


SI-BONE, INC.
RECONCILIATION OF FREE CASH FLOW
(In thousands)
(unaudited)



Twelve Months Ended December 31,
20252024
Net cash used in operating activities
$(675)$(12,425)
Less:
Purchases of property and equipment
(8,414)(10,497)
Free cash flow
$(9,089)$(22,922)