Carlsmed® Reports First Quarter 2026 Financial Results
Rhea-AI Summary
Carlsmed (NASDAQ: CARL) reported Q1 2026 results: $16.1M revenue (58% YoY), $12.4M gross profit, gross margin 77.1%, and net loss of $8.7M. Adjusted EBITDA was -$7.5M. Cash and equivalents totaled $97.1M. Full-year 2026 revenue guidance raised to $72–$77M from $70–$75M.
Clinical progress includes a published study showing a 74% reduction in reoperations for aprevo and early procedures for corra and aprevo bi-lateral posterior.
AI-generated analysis. Not financial advice.
Positive
- Revenue $16.1M in Q1, +58.2% year-over-year
- Gross margin improved to 77.1% in Q1 2026
- Raised full-year 2026 revenue guidance to $72–$77M
- Cash and short-term investments of $97.1M as of 3/31/26
- Published study showing 74% reduction in reoperations for aprevo
Negative
- Net loss widened to $8.7M in Q1 2026
- Operating expenses increased to $21.7M in Q1 2026
- Adjusted EBITDA was negative $7.5M for Q1 2026
News Market Reaction – CARL
On the day this news was published, CARL gained 10.31%, reflecting a significant positive market reaction. Argus tracked a peak move of +7.6% during that session. Our momentum scanner triggered 9 alerts that day, indicating moderate trading interest and price volatility. This price movement added approximately $26M to the company's valuation, bringing the market cap to $278.18M at that time.
Data tracked by StockTitan Argus on the day of publication.
Key Figures
Market Reality Check
Peers on Argus
Key peers showed mixed but generally positive moves earlier in the day, with NRC up 5.81%, SPOK up 3.16%, and OPRX up 1.5%, while SY slipped 0.33% and TALK gained 0.39%. Momentum scanner only flagged WEAV with a small uptick.
Previous Earnings Reports
| Date | Event | Sentiment | Move | Catalyst |
|---|---|---|---|---|
| Feb 25 | Earnings results | Positive | -3.8% | Reported strong Q4 and 2025 growth with higher 2026 revenue guidance. |
| Nov 06 | Earnings results | Positive | +14.9% | Q3 2025 beat with 98% YoY growth and raised full‑year 2025 guidance. |
| Aug 28 | Earnings results | Positive | -2.9% | Q2 2025 showed 99% revenue growth and strong gross margin but net loss. |
| Aug 28 | Earnings results | Positive | -2.9% | Q2 2025 detailed revenue growth, losses, and IPO proceeds with guidance. |
Earnings reports have highlighted rapid revenue growth and guidance raises, but price reactions have often been negative or muted, with only one clear positive spike.
Over the past few quarters, Carlsmed’s earnings updates have consistently shown rapid growth and expanding gross margins. Q2 and Q3 2025 reported strong revenue increases and raised full‑year 2025 guidance. The Feb 25, 2026 release detailed full‑year 2025 revenue of $50.5M and initial $70–$75M 2026 guidance. Today’s Q1 2026 results, featuring $16.1M revenue and a guidance raise to $72–$77M, extend this pattern of scaling the business while remaining loss‑making.
Historical Comparison
Past 4 earnings releases produced an average move of 1.34% with mostly mixed-to-negative immediate reactions despite strong growth metrics and guidance raises.
Earnings updates show progression from Q2 and Q3 2025 high double‑digit growth and initial 2025 guidance, to full‑year 2025 revenue of $50.5M with 2026 guidance of $70–$75M, and now Q1 2026 revenue of $16.1M alongside a guidance increase to $72–$77M.
Market Pulse Summary
The stock surged +10.3% in the session following this news. A strong positive reaction aligns with the company’s pattern of delivering high growth and raising guidance, as seen with prior updates like Q3 2025’s 98% YoY revenue increase and guidance hikes. However, past earnings often saw mixed price responses, and the business still reports net losses and negative adjusted EBITDA. Investors would need to weigh continued operating losses and spending against the sustained revenue expansion and high gross margins.
Key Terms
adjusted EBITDA financial
GAAP financial
stock-based compensation financial
warrant liabilities financial
retrospective cohort study medical
revision rates medical
AI-generated analysis. Not financial advice.
First quarter 2026 revenue of
Full year 2026 revenue guidance raised to
CARLSBAD, Calif., May 05, 2026 (GLOBE NEWSWIRE) -- Carlsmed, Inc. (Nasdaq: CARL) (“Carlsmed” or the “Company”), a medical technology company pioneering AI-enabled personalized spine surgery solutions, today reported financial results for the first quarter ended March 31, 2026.
“We began 2026 with strong momentum, delivering
Recent Business Highlights
- Study published in Global Spine Journal demonstrated
74% reduction in reoperations in patients treated with aprevo® personalized lumbar implants compared to previously published results for patients treated with traditional implants, reinforcing the durability and clinical differentiation of the aprevo platform. - Performed first procedure using the corra™ personalized cervical plating system in February, marking the debut of the Company’s patient-specific fixation portfolio.
- Completed first procedure utilizing aprevo® bi-lateral posterior in February, expanding the personalized lumbar platform for this additional lumbar fusion technique.
First Quarter 2026 Financial Results
- Revenue was
$16.1 million for the first quarter of 2026, a58.2% increase compared to$10.2 million for the first quarter of 2025. - Gross profit for the first quarter of 2026 was
$12.4 million compared to$7.6 million for the first quarter of 2025. Gross margin was77.1% for the first quarter of 2026, compared with74.9% for the first quarter of 2025. - Operating expenses were
$21.7 million for the first quarter of 2026, compared with$13.4 million for the first quarter of 2025, which consisted of:
- Research and development expenses of
$5.2 million for the first quarter of 2026, compared with$3.2 million for the first quarter of 2025. - Sales and marketing expenses of
$10.3 million for the first quarter of 2026, compared with$6.7 million for the first quarter of 2025. - General and administrative expenses of
$6.2 million for the first quarter of 2026, compared with$3.5 million for the first quarter of 2025.
- Research and development expenses of
- Net loss was (
$8.7) million for the first quarter of 2026, compared to a ($5.7) million net loss for the first quarter of 2025. - Adjusted EBITDA was (
$7.5) million for the first quarter of 2026, compared to ($5.5) million for the first quarter of 2025. - Cash and cash equivalents, restricted cash, and short-term investments were
$97.1 million as of March 31, 2026.
2026 Financial Outlook
- Revenue for the full year 2026 is expected to be in the range of
$72 t o$77 million , representing growth of48% at the midpoint of the range over 2025. This compares to prior guidance of$70 t o$75 million .
Webcast & Conference Call Details
Carlsmed will host a conference call and concurrent webcast today at 4:30 pm Eastern Time (1:30 pm Pacific Time), to review the Company’s performance. To access the webcast, please use the following link, which will provide you with dial-in details: https://edge.media-server.com/mmc/p/2j9w2c9m/
Non-GAAP Financial Measures
This press release contains certain financial information that is not presented in conformity with U.S. generally accepted accounting principles (“GAAP”), including adjusted EBITDA. The non-GAAP financial measures are provided as supplemental information to Carlsmed’s financial measures presented in this press release that are calculated and presented in accordance with GAAP.
The Company calculates adjusted EBITDA as net income (loss), as adjusted to exclude, as applicable, (i) net interest income (expense), (ii) income tax expense (benefit), (iii) depreciation expense from property and equipment (iv) amortization expense from long-lived assets, (iv) stock-based compensation expense and (v) change in fair value of warrant liabilities.
This non-GAAP measure is presented because management believes it allows investors to view the Company’s performance in a manner similar to the method used by management to evaluate financial performance for both strategic and annual operating planning. Management believes that to properly understand short-term and long-term financial trends, it is helpful for investors to understand the impact of the items excluded from the calculation of adjusted EBITDA, in addition to considering the Company’s GAAP financial measures. The excluded items vary in frequency and/or impact on our results of operations and management believes that the excluded items are not reflective of the Company’s ongoing core business operations and financial condition. Excluding such items allows investors and analysts to compare our operating performance to other companies in our industry and to compare the Company’s period-over-period results.
The non-GAAP financial measures used by Carlsmed may not be the same or calculated in the same manner as those used and calculated by other companies. Non-GAAP financial measures have limitations as analytical tools and should not be considered in isolation or as a substitute for Carlsmed’s financial results prepared and reported in accordance with GAAP. This non-GAAP measure should not be construed as an inference that the Company’s future results will be unaffected by unusual or non-recurring items. We urge investors to review the reconciliation of these non-GAAP financial measures to the comparable GAAP financial measures included in this press release, and not to rely on any single financial measure to evaluate our business. A reconciliation of adjusted EBITDA reported in this press release to the most comparable GAAP measure for the respective periods appears in the table captioned “Reconciliation of GAAP Net Income (Loss) to Adjusted EBITDA” later in this release. Within the accompanying financial tables presented, certain columns and rows may not add due to the use of rounded numbers.
About Carlsmed
Carlsmed is a medical technology company pioneering AI-enabled personalized spine surgery solutions with a mission to improve outcomes and decrease the cost of healthcare for spine surgery and beyond.
Forward Looking Statement
Any statements in this press release about future expectations, plans and prospects, including statements about Carlsmed’s growth prospects, the potential of its products to improve patient outcomes, anticipated product launch dates, the revenue ranges presented in our 2026 Financial Outlook, and other statements containing the words “anticipate,” “believe,” “estimate,” “expect,” “intend,” “may,” “plan,” “predict,” “project,” “target,” “potential,” “likely,” “will,” “would,” “could,” “should,” “continue,” and similar expressions, constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by such forward-looking statements as a result of various important factors, including such important factors as are set forth under the caption “Risk Factors” in the Carlsmed’s Annual Report on Form 10-K on file with the U.S. Securities and Exchange Commission. The forward-looking statements included in this press release represent Carlsmed’s views as of the date of this press release. Carlsmed anticipates that subsequent events and developments will cause its views to change. However, while Carlsmed may elect to update these forward-looking statements at some point in the future, it specifically disclaims any obligation to do so. These forward-looking statements should not be relied upon as representing Carlsmed’s views as of any date subsequent to the date of this press release.
Investor Relations
Stephanie Zhadkevich
Vice President, Head of Investor Relations
IR@Carlsmed.com
Media
LeAnn Burton
Senior Director, Brand Marketing
LBurton@Carlsmed.com
| CARLSMED, INC. CONDENSED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS (in thousands, except share and per share amounts) (unaudited) | ||||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Revenue | $ | 16,116 | $ | 10,189 | ||||
| Cost of sales | 3,691 | 2,553 | ||||||
| Gross profit | 12,425 | 7,636 | ||||||
| Operating expenses: | ||||||||
| Research and development | 5,178 | 3,150 | ||||||
| Sales and marketing | 10,297 | 6,739 | ||||||
| General and administrative | 6,226 | 3,466 | ||||||
| Total operating expenses | 21,701 | 13,355 | ||||||
| Loss from operations | (9,276 | ) | (5,719 | ) | ||||
| Other income (expense): | ||||||||
| Interest expense | (311 | ) | (357 | ) | ||||
| Interest income | 891 | 380 | ||||||
| Change in fair value of warrant liabilities | — | (33 | ) | |||||
| Total other income (expense), net | 580 | (10 | ) | |||||
| Net loss and comprehensive loss | (8,696 | ) | (5,729 | ) | ||||
| Deemed dividend to preferred stockholders | — | (584 | ) | |||||
| Net loss attributable to common stockholders | $ | (8,696 | ) | $ | (6,313 | ) | ||
| Net loss per share attributable to common stockholders, basic and diluted | $ | (0.32 | ) | $ | (1.47 | ) | ||
| Weighted-average number of common shares used to compute basic and diluted net loss per share | 26,835,841 | 4,299,492 | ||||||
| CARLSMED, INC. CONDENSED BALANCE SHEETS (in thousands, except for share and par value amounts) (unaudited) | ||||||||
| March 31, 2026 | December 31, 2025 | |||||||
| Assets | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 73,016 | $ | 85,793 | ||||
| Restricted cash | 100 | 100 | ||||||
| Short-term investments | 24,000 | 24,000 | ||||||
| Accounts receivable, net of allowances of | 12,268 | 11,362 | ||||||
| Inventory | 2,063 | 1,845 | ||||||
| Prepaid expenses and other current assets | 3,959 | 3,573 | ||||||
| Total current assets | 115,406 | 126,673 | ||||||
| Property and equipment, net | 1,597 | 1,487 | ||||||
| Operating lease right-of-use assets | 1,663 | 1,826 | ||||||
| Other assets | 103 | 134 | ||||||
| Total assets | $ | 118,769 | $ | 130,120 | ||||
| Liabilities and Stockholders’ Equity | ||||||||
| Current liabilities: | ||||||||
| Accounts payable | $ | 2,952 | $ | 4,481 | ||||
| Accrued liabilities | 3,202 | 3,287 | ||||||
| Accrued compensation | 2,785 | 5,760 | ||||||
| Short-term operating lease liabilities | 776 | 752 | ||||||
| Total current liabilities | 9,715 | 14,280 | ||||||
| Long-term portion of term loan, net | 15,364 | 15,346 | ||||||
| Long-term operating lease liabilities | 1,115 | 1,316 | ||||||
| Other long-term liabilities | 327 | 309 | ||||||
| Total liabilities | 26,521 | 31,251 | ||||||
| Commitments and contingencies | ||||||||
| Stockholders’ equity: | ||||||||
| Preferred stock, | — | — | ||||||
| Common stock, | — | — | ||||||
| Additional paid-in capital | 201,749 | 199,674 | ||||||
| Accumulated deficit | (109,501 | ) | (100,805 | ) | ||||
| Total stockholders’ equity | 92,248 | 98,869 | ||||||
| Total liabilities and stockholders’ equity | $ | 118,769 | $ | 130,120 | ||||
| RECONCILIATION OF GAAP NET LOSS TO ADJUSTED EBITDA (unaudited) | ||||||||||||||||
| Three Months Ended March 31, | $ | % | ||||||||||||||
| 2026 | 2025 | Change | Change | |||||||||||||
| (in thousands, except percentages) | ||||||||||||||||
| Net loss | $ | (8,696 | ) | $ | (5,729 | ) | $ | (2,967 | ) | 51.8 | % | |||||
| Interest (income) expense | (580 | ) | (23 | ) | (557 | ) | 2,421.7 | % | ||||||||
| Income taxes | — | — | — | — | ||||||||||||
| Depreciation and amortization | 99 | 40 | 59 | 147.5 | % | |||||||||||
| EBITDA | (9,177 | ) | (5,712 | ) | (3,465 | ) | 60.7 | % | ||||||||
| Stock-based compensation | 1,629 | 175 | 1,454 | 830.9 | % | |||||||||||
| Change in fair value of warrant liabilities | — | 33 | (33 | ) | (100.0 | ) | % | |||||||||
| Adjusted EBITDA | $ | (7,548 | ) | $ | (5,504 | ) | $ | (2,044 | ) | 37.1 | % | |||||
