Carlsmed® Reports Second Quarter 2026 Financial Results and Raises Full-Year Guidance
Rhea-AI Summary
Carlsmed (Nasdaq: CARL) reported second quarter 2026 revenue of $18.9 million, up 57% year-over-year from $12.1 million, with gross margin improving to 76.8% from 73.4%. Gross profit rose to $14.5 million while operating expenses increased to $25.6 million, driving a net loss of ($10.5) million versus ($6.8) million a year earlier. Adjusted EBITDA was ($8.6) million compared to ($6.2) million. The company ended June 30, 2026 with $89.3 million in cash, equivalents, restricted cash, short-term investments and marketable securities.
Carlsmed raised its full-year 2026 revenue guidance to $74–$78 million from $72–$77 million, implying over 50% growth at the midpoint versus 2025. Management highlighted over 60% growth in trained surgeon users, aprevo® cervical reaching ~10% of quarterly revenue, and a finalized CMS IPPS rule adding three new MS-DRG codes with favorable reimbursement for inpatient aprevo® lumbar procedures effective October 1, 2026.
Positive
- Revenue +57% YoY to $18.9 million in Q2 2026
- Gross margin expansion to 76.8% from 73.4% year-over-year
- Full-year 2026 guidance raised to $74–$78 million from $72–$77 million
- Surgeon users +60%+ year-over-year, supporting procedure volume growth
- aprevo® cervical ~10% of quarterly revenue after second full commercialization quarter
- Liquidity of $89.3 million in cash, equivalents, and securities as of June 30, 2026
Negative
- Net loss widened to ($10.5) million from ($6.8) million year-over-year
- Adjusted EBITDA loss increased to ($8.6) million from ($6.2) million
- Total operating expenses +66% to $25.6 million in Q2 2026
- Stockholders’ equity declined to $84.2 million from $98.9 million at year-end 2025
- Cash and cash equivalents down to $46.2 million from $85.8 million at December 31, 2025
News Explained
The June 30 baseline is $89.3 million of mixed liquid resources against 27,225,759 common shares.
Carlsmed's August 5 release reports second-quarter results and updates the balance-sheet baseline for existing common holders: at June 30, the company had
Separately, at March 31, 2026, cash and equivalents equaled
Sources and calculations
- Carlsmed second-quarter 2026 results release (2026-08-05)
- Carlsmed first-quarter 2026 fundamentals (2026Q1)
- Cash and equivalents vs quarterly operating cash outflow, in days of cash use $73,016,000 / ($13,007,000 / 90) = [object Object]
Key Figures
Previous Earnings Reports
| Date | Event | Sentiment | 24h Move | Catalyst |
|---|---|---|---|---|
| May 05 | 1Q26 earnings | Positive | +10.3% | Revenue growth, raised guidance, and improved gross margin accompanied continued losses. |
| Feb 25 | 4Q25 earnings | Positive | +15.9% | Strong quarterly and annual revenue growth, margin expansion, and 2026 guidance supported the release. |
| Nov 06 | 3Q25 earnings | Positive | +14.9% | Revenue growth, raised guidance, shorter lead times, and reimbursement progress were reported. |
| Aug 28 | 2Q25 earnings | Negative | -2.9% | Revenue growth and reimbursement progress coincided with a net loss and lower guidance. |
| Aug 28 | 2Q25 earnings | Negative | -2.9% | Revenue growth and IPO proceeds were reported alongside continuing net and EBITDA losses. |
24h Move is the share-price change in the day after each event; other market factors may also have contributed.
Carlsmed's earnings announcements produced positive reactions in three of five tag-specific events and negative reactions in two.
Key Terms
adjusted ebitda financial
gaap financial
ms-drg regulatory
inpatient prospective payment system regulatory
AI-generated analysis. How Rhea-AI works. Not financial advice.
Second quarter 2026 revenue of
Full year 2026 revenue guidance raised to
CARLSBAD, Calif., Aug. 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 second quarter ended June 30, 2026.
“Our second quarter 2026 results reflect the growing momentum of aprevo® procedures and further progress on our path to profitability,” said Mike Cordonnier, Chairman and Chief Executive Officer. "We delivered
Recent Business Highlights
- Surgeon adoption grew significantly, with total trained surgeon users up over
60% year-over-year, led by strong engagement from early-career and post-fellowship surgeons - CMS Inpatient Prospective Payment System (IPPS) rule for fiscal year 2027 recently finalized to include three new MS-DRG codes and favorable reimbursement for inpatient aprevo® lumbar procedures, a significant milestone towards expanding access for Medicare patients
- aprevo® cervical completed second full quarter of commercialization, now representing approximately
10% of quarterly revenue, with surgeon training on the platform expanding significantly since last quarter - Raised full-year 2026 revenue guidance to a range of
$74 –$78 million , over50% growth at the midpoint versus full-year 2025, reflecting strong volume trends and a robust pipeline
Second Quarter 2026 Financial Results
- Revenue was
$18.9 million for the second quarter of 2026, a57% increase compared to$12.1 million in the second quarter of 2025. - Gross profit for the second quarter of 2026 was
$14.5 million compared to$8.9 million for the second quarter of 2025. Gross margin was76.8% for the second quarter of 2026, compared with73.4% in the second quarter of 2025. - Operating expenses were
$25.6 million for the second quarter of 2026, compared with$15.4 million for the second quarter of 2025, which consisted of:
- Research and development expenses of
$6.0 million for the second quarter of 2026, compared with$4.2 million for the second quarter of 2025. - Sales and marketing expenses of
$11.9 million for the second quarter of 2026, compared with$7.9 million for the second quarter of 2025. - General and administrative expenses of
$7.6 million for the second quarter of 2026, compared with$3.3 million for the second quarter of 2025.
- Research and development expenses of
- Net loss was (
$10.5) million for the second quarter of 2026, compared to a ($6.8) million net loss for the second quarter of 2025. - Adjusted EBITDA was (
$8.6) million for the second quarter of 2026, compared to ($6.2) million for the second quarter of 2025. - Cash and cash equivalents, restricted cash, short-term investments, and marketable securities were
$89.3 million as of June 30, 2026.
2026 Financial Outlook
- Revenue for the full year 2026 is expected to be in the range of
$74 t o$78 million , representing growth of over50% at the midpoint of the range over 2025. This compares to prior guidance of$72 t o$77 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. A live webcast of the conference call will be available in the Events & Presentations section of the Company’s investor website at investors.carlsmed.com. A replay will be archived on the Company’s website following completion of the 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 Statements
Any statements in this press release about future expectations, plans and prospects, including statements about Carlsmed’s growth prospects and future performance, the ability of Carlsmed to achieve profitability in the near term or at all, the scalability of Carlsmed’s business, the level of demand for Carlsmed’s products, the impact of the recent CMS ruling on Carlsmed’s business , 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
IR@Carlsmed.com
Media
Marketing@Carlsmed.com
| CARLSMED, INC. CONDENSED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS (in thousands, except share and per share amounts) (unaudited) | |||||||||||||||
| Three Months Ended June 30, | Six Months Ended June 30, | ||||||||||||||
| 2026 | 2025 | 2026 | 2025 | ||||||||||||
| Revenue | $ | 18,940 | $ | 12,083 | $ | 35,056 | $ | 22,272 | |||||||
| Cost of sales | 4,398 | 3,214 | 8,089 | 5,767 | |||||||||||
| Gross profit | 14,542 | 8,869 | 26,967 | 16,505 | |||||||||||
| Operating expenses: | |||||||||||||||
| Research and development | 6,040 | 4,160 | 11,218 | 7,310 | |||||||||||
| Sales and marketing | 11,920 | 7,869 | 22,217 | 14,608 | |||||||||||
| General and administrative | 7,618 | 3,342 | 13,844 | 6,808 | |||||||||||
| Total operating expenses | 25,578 | 15,371 | 47,279 | 28,726 | |||||||||||
| Loss from operations | (11,036 | ) | (6,502 | ) | (20,312 | ) | (12,221 | ) | |||||||
| Other income (expense): | |||||||||||||||
| Interest expense | (313 | ) | (363 | ) | (624 | ) | (720 | ) | |||||||
| Interest income | 839 | 336 | 1,730 | 716 | |||||||||||
| Change in fair value of warrant liabilities | — | (237 | ) | — | (270 | ) | |||||||||
| Total other income (expense), net | 526 | (264 | ) | 1,106 | (274 | ) | |||||||||
| Net loss | (10,510 | ) | (6,766 | ) | (19,206 | ) | (12,495 | ) | |||||||
| Deemed dividend to preferred stockholders | — | — | — | (584 | ) | ||||||||||
| Net loss attributable to common stockholders | $ | (10,510 | ) | $ | (6,766 | ) | $ | (19,206 | ) | $ | (13,079 | ) | |||
| Net loss | $ | (10,510 | ) | $ | (6,766 | ) | $ | (19,206 | ) | $ | (12,495 | ) | |||
| Other comprehensive loss: | |||||||||||||||
| Unrealized loss on available-for-sale debt securities | (17 | ) | — | (17 | ) | — | |||||||||
| Total other comprehensive loss | (17 | ) | — | (17 | ) | — | |||||||||
| Total comprehensive loss | $ | (10,527 | ) | $ | (6,766 | ) | $ | (19,223 | ) | $ | (12,495 | ) | |||
| Net loss per share attributable to common stockholders, basic and diluted | $ | (0.39 | ) | $ | (1.47 | ) | $ | (0.71 | ) | $ | (2.94 | ) | |||
| Weighted-average number of common shares used to compute basic and diluted net loss per share | 27,190,765 | 4,589,717 | 27,003,868 | 4,445,384 | |||||||||||
| CARLSMED, INC. CONDENSED BALANCE SHEETS (in thousands, except for share and par value amounts) (unaudited) | |||||||
| June 30, 2026 | December 31, 2025 | ||||||
| Assets | |||||||
| Current assets: | |||||||
| Cash and cash equivalents | $ | 46,244 | $ | 85,793 | |||
| Restricted cash | 100 | 100 | |||||
| Short-term investments | 24,000 | 24,000 | |||||
| Marketable securities | 18,980 | — | |||||
| Accounts receivable, net of allowances of | 13,775 | 11,362 | |||||
| Inventory | 2,275 | 1,845 | |||||
| Prepaid expenses and other current assets | 4,224 | 3,573 | |||||
| Total current assets | 109,598 | 126,673 | |||||
| Property and equipment, net | 2,400 | 1,487 | |||||
| Operating lease right-of-use assets | 5,951 | 1,826 | |||||
| Other assets | 253 | 134 | |||||
| Total assets | $ | 118,202 | $ | 130,120 | |||
| Liabilities and Stockholders’ Equity | |||||||
| Current liabilities: | |||||||
| Accounts payable | $ | 3,704 | $ | 4,481 | |||
| Accrued liabilities | 4,113 | 3,287 | |||||
| Accrued compensation | 3,877 | 5,760 | |||||
| Short-term operating lease liabilities | 703 | 752 | |||||
| Total current liabilities | 12,397 | 14,280 | |||||
| Long-term portion of term loan, net | 15,382 | 15,346 | |||||
| Long-term operating lease liabilities | 5,832 | 1,316 | |||||
| Other long-term liabilities | 345 | 309 | |||||
| Total liabilities | 33,956 | 31,251 | |||||
| Commitments and contingencies | |||||||
| Stockholders’ equity: | |||||||
| Preferred stock, | — | — | |||||
| Common stock, | — | — | |||||
| Additional paid-in capital | 204,274 | 199,674 | |||||
| Accumulated deficit | (120,011 | ) | (100,805 | ) | |||
| Accumulated other comprehensive loss | (17 | ) | — | ||||
| Total stockholders’ equity | 84,246 | 98,869 | |||||
| Total liabilities and stockholders’ equity | $ | 118,202 | $ | 130,120 | |||
| RECONCILIATION OF GAAP NET LOSS TO ADJUSTED EBITDA (unaudited) | |||||||||||||||
| Three Months Ended June 30, | $ | % | |||||||||||||
| 2026 | 2025 | Change | Change | ||||||||||||
| (in thousands, except percentages) | |||||||||||||||
| Net loss | $ | (10,510 | ) | $ | (6,766 | ) | $ | (3,744 | ) | 55.3 | % | ||||
| Interest (income) expense | (526 | ) | 27 | (553 | ) | ** | |||||||||
| Income taxes | — | — | — | — | |||||||||||
| Depreciation and amortization | 130 | 61 | 69 | 113.1 | % | ||||||||||
| EBITDA | (10,906 | ) | (6,678 | ) | (4,228 | ) | 63.3 | % | |||||||
| Stock-based compensation | 2,271 | 258 | 2,013 | 780.2 | % | ||||||||||
| Change in fair value of warrant liabilities | — | 237 | (237 | ) | (100.0 | ) | % | ||||||||
| Adjusted EBITDA | $ | (8,635 | ) | $ | (6,183 | ) | $ | (2,452 | ) | 39.7 | % | ||||
| Six Months Ended June 30, | $ | % | |||||||||||||
| 2026 | 2025 | Change | Change | ||||||||||||
| (in thousands, except percentages) | |||||||||||||||
| Net loss | $ | (19,206 | ) | $ | (12,495 | ) | $ | (6,711 | ) | 53.7 | % | ||||
| Interest (income) expense | (1,106 | ) | 4 | (1,110 | ) | ** | |||||||||
| Income taxes | — | — | — | — | |||||||||||
| Depreciation and amortization | 229 | 101 | 128 | 126.7 | % | ||||||||||
| EBITDA | (20,083 | ) | (12,390 | ) | (7,693 | ) | 62.1 | % | |||||||
| Stock-based compensation | 3,900 | 433 | 3,467 | 800.7 | % | ||||||||||
| Change in fair value of warrant liabilities | — | 270 | (270 | ) | (100.0 | ) | % | ||||||||
| Adjusted EBITDA | $ | (16,183 | ) | $ | (11,687 | ) | $ | (4,496 | ) | 38.5 | % | ||||
**Change not meaningful
