SI-BONE Inc (SIBN) Q4 2025 Earnings Call Highlights: Record Revenue and Strategic Partnerships …

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Tue, February 24, 2026 at 2:02 PM GMT+9 4 min read

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**Worldwide Revenue:** $56.3 million in Q4, 15% growth; $200.9 million for full year 2025, 20.2% growth.

**US Revenue:** $53.5 million in Q4, 13.9% growth; $191.1 million for full year 2025, 20.6% growth.

**International Revenue:** $2.9 million in Q4, 38.8% growth; $9.8 million for full year 2025.

**Gross Margin:** 79% in Q4; 79.6% for full year 2025.

**Operating Expenses:** $47 million in Q4, 6.2% growth; $182.2 million for full year 2025, 8.9% growth.

**Net Loss:** $1.6 million in Q4; $18.9 million for full year 2025, 38.8% improvement.

**Adjusted EBITDA:** $5.1 million in Q4, 176.2% improvement; $8.9 million for full year 2025.

**Cash and Equivalents:** $147.8 million at end of 2025.

**Free Cash Flow:** Nearly $0.5 million in Q4.

**2026 Revenue Guidance:** $228.5 million to $232.5 million, 14% to 16% growth.

**2026 Gross Margin Guidance:** Approximately 78%.

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Release Date: February 23, 2026

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

SI-BONE Inc (NASDAQ:SIBN) achieved record annual worldwide revenue of nearly $201 million, marking over 20% growth.

The company delivered its first full year of positive adjusted EBITDA and achieved a 9% adjusted EBITDA margin in the fourth quarter.

SI-BONE Inc (NASDAQ:SIBN) secured favorable reimbursement, including NTAP for iFuse TORQ TNT and TPT for iFuse Bedrock Granite, enhancing access and adoption.

The company launched INTRA Ti, a new product expected to improve procedural efficiency in ambulatory surgery centers.

SI-BONE Inc (NASDAQ:SIBN) formed a strategic partnership with Smith & Nephew to expand reach and penetration into the trauma market.

Negative Points

Operating expenses grew by 6.2% in the fourth quarter and 8.9% for the full year, driven by higher sales commissions and increased R&D investment.

Net loss narrowed but still amounted to $1.6 million in the fourth quarter and $18.9 million for the full year.

Gross margin guidance for 2026 is set at 78%, indicating a potential compression from the previous year's 79.6%.

The company anticipates revenue growth to be weighted towards the second half of 2026, suggesting potential short-term challenges.

Despite the positive outlook, the guidance for 2026 implies a sequential slowdown in growth compared to 2025.

Q & A Highlights

Q: How did the partnership with Smith & Nephew come about, and is it factored into the guidance? A: Laura Francis, CEO, explained that the partnership builds on SI-BONE’s hybrid sales model, leveraging Smith & Nephew’s significant trauma footprint. This collaboration allows trauma surgeons access to SI-BONE’s solutions for sacral insufficiency fractures. Although the partnership is expected to be beneficial, its impact is not yet fully factored into the guidance as it is too early to determine its full effect.

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Q: Does the clinical data showing similar outcomes for IPM physicians and direct surgeons help increase engagement? A: Laura Francis, CEO, highlighted that the STACI study demonstrated the efficacy of SI-BONE’s TORQ product used by interventionalists, showing similar outcomes to other studies. The company is focusing on interventionalists, with significant growth in this area, and the INTRA Ti product is expected to enhance procedural efficiency in ambulatory surgery centers.

Q: Is the guidance for adjusted EBITDA in 2026 around $20 million? A: Anshul Maheshwari, CFO, clarified that while the company expects an increase in adjusted EBITDA compared to the prior year, it will be slightly less than $20 million. The focus is on commercializing new products and expanding commercial infrastructure, which will drive growth.

Q: How should we think about the potential halo effect of INTRA Ti in ASCs? A: Laura Francis, CEO, noted that INTRA Ti is designed for ambulatory surgery centers and aligns with interventional spine physicians’ workflows. It is expected to expand the market by providing a solution in states where allograft solutions are not reimbursed and for physicians preferring non-allograft solutions.

Q: Can you provide more color on the revenue cadence and tailwinds for 2026? A: Anshul Maheshwari, CFO, mentioned that 2026 has more tailwinds than ever, including a strong physician base, improved reimbursement, new product launches, and commercial expansion. Revenue growth is expected to be back-half weighted as these tailwinds materialize.

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

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