Carlsmed® Reports Fourth Quarter and Full Year 2025 Financial Results 

Rhea-AI Summary

Carlsmed (Nasdaq: CARL) reported strong revenue growth with Q4 2025 revenue $15.2M (+61% YoY) and full-year 2025 revenue $50.5M (+86% YoY). Gross margin expanded to 75.3% for 2025 and cash resources were $109.9M at year-end. Management provided 2026 revenue guidance of $70–$75M.

Company highlighted published 2-year aprevo lumbar outcomes showing a 74% reduction in revision rates and multiple product and first-in-human procedural milestones in February 2026.

Positive

• Full-year revenue +86% to $50.5M
• Q4 revenue +61% to $15.2M
• Gross margin ~75% for 2025
• Cash and short-term investments $109.9M
• 2026 revenue guidance $70–$75M (midpoint +44%)

Negative

• Operating expenses rose to $68.6M in 2025
• Net loss widened to $29.6M in 2025
• Adjusted EBITDA negative $28.4M for 2025

News Market Reaction – CARL

-3.83% 6.8x vol

18 alerts

-3.83% News Effect

+22.1% Peak Tracked

-2.2% Trough Tracked

-$16M Valuation Impact

$402M Market Cap

6.8x Rel. Volume

On the day this news was published, CARL declined 3.83%, reflecting a moderate negative market reaction. Argus tracked a peak move of +22.1% during that session. Argus tracked a trough of -2.2% from its starting point during tracking. Our momentum scanner triggered 18 alerts that day, indicating notable trading interest and price volatility. This price movement removed approximately $16M from the company's valuation, bringing the market cap to $402M at that time. Trading volume was exceptionally heavy at 6.8x the daily average, suggesting significant selling pressure.

Data tracked by StockTitan Argus on the day of publication.

Key Figures

Q4 2025 revenue: $15.2M Full-year 2025 revenue: $50.5M Q4 2025 gross margin: 76.5% +5 more

8 metrics

Q4 2025 revenue $15.2M Fourth quarter 2025, 61.2% YoY growth vs. $9.4M in Q4 2024

Full-year 2025 revenue $50.5M 2025, 86% YoY growth vs. $27.2M in 2024

Q4 2025 gross margin 76.5% Fourth quarter 2025, up from 74.7% in Q4 2024

2025 gross margin 75.3% Full year 2025, up from 73.8% in 2024

Q4 2025 net loss $8.6M Fourth quarter 2025, vs. $4.7M net loss in Q4 2024

2025 net loss $29.6M Full year 2025, vs. $24.3M net loss in 2024

Cash & equivalents $109.9M Cash, restricted cash, and short-term investments as of Dec 31, 2025

2026 revenue outlook $70–$75M Guidance for 2026; midpoint implies 44% growth over 2025

Market Reality Check

Price: $13.21 Vol: Volume 211,091 is 2.34x t...

high vol

$13.21 Last Close

Volume Volume 211,091 is 2.34x the 20‑day average, indicating elevated interest ahead of earnings. high

Technical Price at 13.06 is slightly below the 200‑day MA of 13.23, with shares 24.04% under the 52‑week high and 22.61% above the 52‑week low.

Peers on Argus

Peers show mixed moves (e.g., OPRX +3.66%, SPOK -0.43%, TALK -1.53%), suggesting...

Peers show mixed moves (e.g., OPRX +3.66%, SPOK -0.43%, TALK -1.53%), suggesting CARL’s setup into earnings is more stock‑specific than sector‑driven.

Previous Earnings Reports

3 past events · Latest: Nov 06 (Positive)

Same Type Pattern 3 events

Date	Event	Sentiment	Move	Catalyst
Nov 06	Q3 2025 earnings	Positive	-1.7%	Strong Q3 growth, higher guidance, CMS NTAP and expanded credit facility.
Aug 28	Q2 2025 earnings	Positive	-2.9%	Q2 revenue near doubling YoY, NTAP reimbursement, IPO proceeds and guidance.
Aug 28	Q2 2025 earnings	Positive	-2.9%	Q2 financials with 99% revenue growth, solid margins and IPO completion.

Pattern Detected

Earnings releases have previously been followed by modest share price declines despite strong growth metrics and raised guidance.

Recent Company History

Recent history shows Carlsmed repeatedly delivering rapid growth and increasing guidance. Q2 2025 results featured $12.1M revenue and strong year‑over‑year expansion, followed by Q3 2025 revenue of $13.1M and a guidance raise to $49–$50M. Despite this, the stock moved about -1.7% to -2.9% after these earnings updates. Today’s fourth‑quarter and full‑year 2025 report, confirming $50.5M in revenue, continues that growth narrative against a backdrop of historically cautious post‑earnings trading.

Historical Comparison

-2.5% avg move · In the past year, Carlsmed’s earnings releases led to average moves of about -2.48%, with shares ten...

earnings

-2.5%

Average Historical Move earnings

In the past year, Carlsmed’s earnings releases led to average moves of about -2.48%, with shares tending to soften even when results and guidance trended positively.

Earnings updates have shown rising 2025 revenue guidance from $45.5–$47.5M (Q2) to $49–$50M (Q3), culminating in reported full‑year revenue of $50.5M and a 2026 outlook targeting further growth.

Market Pulse Summary

This announcement highlights rapid revenue growth to $50.5M in 2025 with gross margin expansion to 7...

Analysis

This announcement highlights rapid revenue growth to $50.5M in 2025 with gross margin expansion to 75.3%, alongside higher operating expenses and a full‑year net loss of $29.6M. The new 2026 revenue outlook of $70–$75M signals continued scaling. Historically, earnings releases have been followed by modest share price softness, so investors may watch how guidance, cash of $109.9M, and loss trends evolve in upcoming quarters.

Key Terms

adjusted ebitda, gaap, stock-based compensation, warrant liabilities

4 terms

adjusted ebitda financial

"The Company calculates Adjusted EBITDA as net income (loss), as adjusted to exclude..."

Adjusted EBITDA is a way companies measure how much money they make from their core operations, like running a business, by removing certain costs or income that aren’t part of regular business activities. It helps investors see how well a company is doing without distractions from unusual expenses or gains, making it easier to compare companies or track performance over time.

gaap financial

"financial information that is not presented in conformity with U.S. generally accepted accounting principles (“GAAP”)"

GAAP, or Generally Accepted Accounting Principles, are a set of standardized rules and guidelines that companies follow when preparing their financial statements. They ensure consistency, transparency, and comparability across different companies, making it easier for investors to understand and compare financial information accurately. This helps investors make informed decisions based on trustworthy and uniform financial reports.

stock-based compensation financial

"exclude... (iv) stock-based compensation expense and (v) change in fair value of warrant liabilities."

Stock-based compensation is when a company pays employees, directors or consultants with shares or the right to buy shares instead of or in addition to cash. It matters to investors because issuing stock or options spreads ownership thinner (like cutting a pie into more slices), which can reduce each existing share’s claim on profits and can also change reported earnings; investors watch it to assess true cost of running the business and how management is incentivized.

warrant liabilities financial

"exclude... (iv) stock-based compensation expense and (v) change in fair value of warrant liabilities."

Warrant liabilities are the financial obligations a company records when it grants warrants—special rights allowing someone to buy shares at a set price in the future. If the warrants are expected to be exercised, they are treated as a liability because the company might need to deliver shares or cash later. This matters to investors because it affects the company’s reported financial health and the potential dilution of existing shares.

AI-generated analysis. Not financial advice.

Fourth quarter revenue of $15.2 million; 61% growth YoY 

Full year revenue of $50.5 million; 86% growth YoY 

CARLSBAD, Calif., Feb. 25, 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 fourth quarter and full year ended December 31, 2025. 

"We delivered another very strong quarter with 61% revenue growth year-over-year, gross margin expansion to 76.5%, and reduction of our lead times to within six business days. These achievements demonstrate our momentum and the speed at which we are scaling while maintaining our culture of patient-centric innovation,” said Mike Cordonnier, Chairman and CEO of Carlsmed. “With recent published data from a patient-matched cohort showing a 74% reduction in revision rates at two years for aprevo^® lumbar patients versus non-aprevo patients, we continue to advance our mission of improved outcomes and reduced cost of healthcare with a highly differentiated approach.”

Recent Business Highlights

• 2-year aprevo^® lumbar outcome data published in Global Spine Journal
• Launched aprevo^® cervical system
• Launched myaprevo^® ecosystem for browser and mobile integration
• First in-human aprevo^® bi-lateral posterior fusion procedure performed in February 2026 at University of Colorado
• First in-human personalized corra™ cervical plating procedure performed in February 2026 at UC San Francisco

 Fourth Quarter 2025 Financial Results

• Revenue was $15.2 million for the fourth quarter of 2025, a 61.2% increase compared to $9.4 million for the fourth quarter of 2024
• Gross profit for the fourth quarter of 2025 was $11.6 million compared to $7.0 million for the fourth quarter of 2024. Gross margin was 76.5% for the fourth quarter of 2025, compared with 74.7% for the fourth quarter of 2024  

• Operating expenses were $20.9 million for the fourth quarter of 2025, compared with $11.7 million for the fourth quarter of 2024, which consisted of:
  • Research and development expenses of $5.3 million for the fourth quarter of 2025, compared with $3.0 million for the fourth quarter of 2024 
  • Sales and marketing expenses of $10.8 million for the fourth quarter of 2025, compared with $6.4 million for the fourth quarter of 2024 
  • General and administrative expenses of $4.9 million for the fourth quarter of 2025, compared with $2.3 million for the fourth quarter of 2024 

• Net loss was ($8.6) million for the fourth quarter of 2025, compared to a ($4.7) million net loss for the fourth quarter of 2024  

• Adjusted EBITDA was ($8.4) million for the fourth quarter of 2025, compared to ($4.6) million for the fourth quarter of 2024 
• Cash and cash equivalents, restricted cash, and short-term investments were $109.9 million as of December 31, 2025 

Full Year 2025 Financial Results

• Revenue was $50.5 million for 2025, an 86% increase compared to $27.2 million for 2024
• Gross profit for 2025 was $38.0 million compared to $20.0 million for 2024. Gross margin was 75.3% for 2025, compared with 73.8% for 2024  

• Operating expenses were $68.6 million for 2025, compared with $44.2 million for 2024, which consisted of:
  • Research and development expenses of $17.0 million for 2025, compared with $14.3 million for 2024 
  • Sales and marketing expenses of $35.0 million for 2025, compared with $21.5 million for 2024 
  • General and administrative expenses of $16.6 million for 2025, compared with $8.4 million for 2024 

• Net loss was ($29.6) million for 2025, compared to ($24.3) million for 2024  

• Adjusted EBITDA was ($28.4) million for 2025, compared to ($23.7) million for 2024 

2026 Financial Outlook 

• Revenue for 2026 is expected to be in the range of $70 to $75 million, representing growth at the midpoint of the range of 44% over 2025. 

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 fourth quarter and full year 2025 performance. To access the webcast, please use the following link, which will provide you with dial-in details: https://investors.carlsmed.com/events/event-details/carlsmed-fourth-quarter-2025-earnings-conference-call

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 the Carlsmed’s ability to scale its business, the potential of its products to improve patient outcomes, 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 
Caroline Corner, PhD 

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 December 31,								Year Ended December 31,
	2025				2024				2025				2024
Revenue	$	15,165			$	9,408			$	50,511			$	27,165
Cost of sales		3,557				2,384				12,471				7,117
Gross profit		11,608				7,024				38,040				20,048
Operating expenses:
Research and development		5,264				3,015				17,019				14,304
Sales and marketing		10,809				6,380				35,027				21,472
General and administrative		4,853				2,326				16,568				8,394
Total operating expenses		20,926				11,721				68,614				44,170
Loss from operations		(9,318	)			(4,697	)			(30,574	)			(24,122	)
Other income (expense):
Interest expense		(330	)			(378	)			(1,430	)			(1,321	)
Interest income		1,028				410				2,698				1,330
Change in fair value of warrant liabilities		7				(55	)			(328	)			(144	)
Total other income (expense), net		705				(23	)			940				(135	)
Net loss and comprehensive loss		(8,613	)			(4,720	)			(29,634	)			(24,257	)
Deemed dividend to preferred stockholders		—				—				(584	)			(592	)
Net loss attributable to common stockholders	$	(8,613	)		$	(4,720	)		$	(30,218	)		$	(24,849	)
Net loss per share attributable to common stockholders, basic and diluted	$	(0.32	)		$	(1.14	)		$	(2.12	)		$	(6.11	)
Weighted-average number of common shares used to compute basic and diluted net loss per share		26,597,105				4,126,371				14,221,991				4,066,395

CARLSMED, INC.
CONDENSED BALANCE SHEETS
(in thousands, except for share and par value amounts)
(unaudited)
	December 31, 2025				December 31, 2024
Assets
Current assets:
Cash and cash equivalents	$	85,793			$	40,125
Restricted cash		100				100
Short-term investments		24,000				—
Accounts receivable, net of allowances of $1,653 and $1,239, as of December 31, 2025 and December 31, 2024, respectively		11,362				6,766
Inventory		1,845				995
Prepaid expenses and other current assets		3,573				1,365
Total current assets		126,673				49,351
Property and equipment, net		1,487				260
Operating lease right-of-use assets		1,826				1,644
Other assets		134				569
Total assets	$	130,120			$	51,824
Liabilities, Convertible Preferred Stock, and Stockholders’ Equity (Deficit)
Current liabilities:
Accounts payable	$	4,481			$	2,412
Accrued liabilities		3,287				2,687
Accrued compensation		5,760				3,270
Short-term operating lease liabilities		752				449
Total current liabilities		14,280				8,818
Long-term portion of term loan, net		15,346				15,414
Long-term operating lease liabilities		1,316				1,317
Warrant liabilities		—				457
Other long-term liabilities		309				222
Total liabilities		31,251				26,228
Commitments and contingencies (Note 9)
Series A convertible preferred stock, $0.00001 par value; zero shares authorized, issued, and outstanding and zero liquidation preference as of December 31, 2025; 4,902,814 shares authorized, issued, and outstanding, and $13,767 liquidation preference as of December 31, 2024		—				13,578
Series B convertible preferred stock, $0.00001 par value; zero shares authorized, issued, and outstanding and zero liquidation preference as of December 31, 2025; 4,393,481 shares authorized, 4,335,051 shares issued and outstanding, and $30,000 liquidation preference as of December 31, 2024		—				29,801
Series C convertible preferred stock, $0.00001 par value; zero shares authorized, issued, and outstanding and zero liquidation preference as of December 31, 2025; 4,910,500 shares authorized, 4,890,123 shares issued and outstanding, and $52,500 liquidation preference as of December 31, 2024		—				52,847
Stockholders’ equity (deficit):
Preferred stock, $0.00001 par value; 10,000,000 shares authorized and zero shares issued and outstanding as of December 31, 2025; zero shares authorized, issued, and outstanding as of December 31, 2024		—				—
Common stock, $0.00001 par value; 600,000,000 shares authorized, 26,664,243 shares issued, and 26,604,505 shares outstanding as of December 31, 2025; 21,835,801 shares authorized, 4,234,798 shares issued, and 4,139,219 shares outstanding as of December 31, 2024		—				—
Additional paid-in capital		199,674				541
Accumulated deficit		(100,805	)			(71,171	)
Total stockholders’ equity (deficit)		98,869				(70,630	)
Total liabilities, convertible preferred stock, and stockholders’ equity (deficit)	$	130,120			$	51,824

RECONCILIATION OF GAAP NET LOSS TO ADJUSTED EBITDA
(unaudited)
	Three Months Ended December 31,								$				%
	2025				2024				Change				Change
(in thousands, except percentages)
Net loss	$	(8,613	)		$	(4,720	)		$	(3,893	)		82.5		%
Interest (income) expense, net		(698	)			(32	)			(666	)		**
Income taxes		—				—				—			—
Depreciation and amortization		98				37				61			164.9		%
EBITDA		(9,213	)			(4,715	)			(4,498	)		95.4		%
Stock-based compensation		790				100				690			690.0		%
Change in fair value of warrant liabilities		(7	)			55				(62	)		(112.7	)	%
Adjusted EBITDA	$	(8,430	)		$	(4,560	)		$	(3,870	)		84.9		%

	Year Ended December 31,								$				%
	2025				2024				Change				Change
(in thousands, except percentages)
Net loss	$	(29,634	)		$	(24,257	)		$	(5,377	)		22.2		%
Interest income, net		(1,268	)			(9	)			(1,259	)		**
Income taxes		—				—				—			—
Depreciation and amortization		281				145				136			93.8		%
EBITDA		(30,621	)			(24,121	)			(6,500	)		26.9		%
Stock-based compensation		1,927				253				1,674			661.7		%
Change in fair value of warrant liabilities		328				144				184			127.8		%
Adjusted EBITDA	$	(28,366	)		$	(23,724	)		$	(4,642	)		19.6		%

** Change not meaningful

FAQ

What were Carlsmed (CARL) fourth quarter 2025 results?

Carlsmed reported Q4 2025 revenue of $15.2 million, a 61.2% year-over-year increase. According to the company, gross margin for the quarter was 76.5% and net loss was ($8.6) million, with adjusted EBITDA of ($8.4) million.

How did Carlsmed (CARL) perform for full-year 2025?

Carlsmed reported 2025 revenue of $50.5 million, up 86% year-over-year. According to the company, gross profit was $38.0 million, net loss totaled ($29.6) million, and adjusted EBITDA was ($28.4) million for 2025.

What is Carlsmed's 2026 revenue guidance and growth expectation?

Carlsmed expects $70 to $75 million in revenue for 2026, implying roughly 44% growth at the midpoint. According to the company, this guidance reflects continued product launches and scaling of personalized spine surgery solutions.

How strong is Carlsmed's cash position at year-end 2025 (CARL)?

Carlsmed held $109.9 million in cash, restricted cash, and short-term investments as of December 31, 2025. According to the company, this liquidity supports ongoing R&D, commercial expansion, and near-term operating plans.

What clinical data did Carlsmed (CARL) cite in the announcement?

Carlsmed cited published 2-year aprevo lumbar data showing a 74% reduction in revision rates for aprevo versus non-aprevo patients. According to the company, this outcome was published in Global Spine Journal and supports clinical differentiation.