Carlsmed® Reports Third Quarter 2026 Financial Results and Raises Full-Year Guidance

The surgeon user base grew more than 60% over the prior year.

Rhea-AI Summary

Carlsmed (CARL) reported third-quarter 2026 revenue of $21.6 million, up 65% year over year, and raised its full-year revenue outlook. The company now expects $78 million to $80 million, versus $74 million to $78 million previously, representing over 56% growth at the midpoint versus 2025. Gross margin increased to 77.3% from 75.9%.

The quarterly net loss widened to $12.2 million from $8.5 million, while adjusted EBITDA, an adjusted earnings measure excluding interest, taxes, depreciation and amortization, improved to negative $7.3 million from negative $8.2 million. Operating expenses rose to $29.4 million from $19.0 million. Cash, restricted cash and investments totaled $80.3 million at September 30, 2026. Increased inpatient reimbursement for aprevo lumbar procedures took effect October 1, 2026. Carlsmed also launched its aprevo Lumbar Bi-lateral Posterior System in October.

9 points · 1 major

PositiveiHow this balance works

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0 major · 8 points

Hollow bars mark forward-looking points. How the balance works

Positive

• Major point. Forward-looking: it has not happened yet and may not happen.2026 revenue guidance increased to $78 million–$80 million from $74 million–$78 million; midpoint growth exceeds 56% versus 2025.
• Moderate pointThird-quarter revenue rose 65% year over year to $21.6 million from $13.1 million.
• Moderate pointThird-quarter gross profit increased to $16.7 million from $9.9 million a year earlier.
• Moderate pointThird-quarter adjusted EBITDA loss narrowed to $7.3 million from $8.2 million a year earlier.
• Moderate pointSurgeon user base grew more than 60% over the prior year.
• Moderate pointIncreased inpatient reimbursement for aprevo lumbar procedures became effective October 1, 2026.

3 minor points

• Minor pointThird-quarter gross margin reached 77.3%, versus 75.9% a year earlier.
• Minor pointNine-month revenue increased to $56.610 million from $35.346 million in the comparable 2025 period.
• Minor pointNine-month gross profit increased to $43.632 million from $26.432 million in the comparable 2025 period.

Negative

• Moderate pointThird-quarter net loss widened to $12.2 million from $8.5 million a year earlier.
• Moderate pointThird-quarter operating expenses rose to $29.4 million from $19.0 million, including $2.8 million in executive-transition and legal-resolution expenses.
• Minor pointThird-quarter loss per share widened to $0.45 from $0.40 a year earlier.
• Minor pointThird-quarter operating loss widened to $12.701 million from $9.035 million a year earlier.
• Minor pointNine-month net loss widened to $31.451 million from $21.021 million in the comparable 2025 period.

3 minor points

• Minor pointNine-month operating expenses increased to $76.645 million from $47.688 million in the comparable 2025 period.
• Minor pointNine-month adjusted EBITDA loss widened to $23.452 million from $19.936 million in the comparable 2025 period.
• Minor pointNine-month stock-based compensation rose to $6.366 million from $1.137 million in the comparable 2025 period.

News Explained

Carlsmed reported 27,387,646 common shares outstanding on September 30, 2026, versus 26,604,505 on December 31, 2025; the increase in the share base reduces existing holders’ percentage ownership absent offsetting changes.

Key Figures

Q3 revenue: $21.6 million Full-year revenue guidance: $78 million to $80 million Gross margin: 77.3% +4 more

Q3 revenue

$21.6 million

Third quarter 2026; up 65% year over year

Full-year revenue guidance

$78 million to $80 million

2026; raised from prior guidance of $74 million to $78 million

Gross margin

77.3%

Third quarter 2026, compared with 75.9% in the third quarter of 2025

Operating expenses

$29.4 million

Third quarter 2026, compared with $19.0 million in the third quarter of 2025

Net loss

($12.2) million

Third quarter 2026, compared with ($8.5) million in the third quarter of 2025

Adjusted EBITDA

($7.3) million

Third quarter 2026, compared with ($8.2) million in the third quarter of 2025

Cash and investment resources

$80.3 million

As of September 30, 2026; includes cash, restricted cash, short-term investments and marketable securities

Previous Earnings Reports

1 past event · Latest: Aug 05

Same Type 1 event

1. Aug 05

   Earnings report

   24h Move

   +1.0%

   Q2 results raised 2026 revenue guidance to $74-$78 million.

24h Move is the share-price change in the day after each event; other market factors may also have contributed.

Key Terms

gaap, ebitda, inpatient prospective payment system, non-gaap financial measures

4 terms

gaap financial

"not presented in conformity with U.S. generally accepted accounting principles"

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.

View in glossary

ebitda financial

"including EBITDA, adjusted EBITDA, adjusted net loss and adjusted net loss per share"

EBITDA stands for earnings before interest, taxes, depreciation, and amortization. It measures a company's profitability by focusing on the money it makes from its core operations, ignoring expenses like taxes and accounting adjustments. Investors use EBITDA to compare how well different companies are performing financially, as it provides a clearer picture of operational success without the influence of financial structure or accounting choices.

View in glossary

inpatient prospective payment system regulatory

"CMS Inpatient Prospective Payment System (IPPS) rule for fiscal year 2027"

A government-run method for paying hospitals a fixed amount for each patient’s inpatient stay, set in advance based on the patient’s diagnosis and severity. It works like a bundled, pre-priced menu item: hospitals receive a predetermined payment that covers most services for that stay rather than being paid for every test or day separately. Investors care because it shapes hospitals’ revenue, margins and cash flow predictability and influences how hospitals manage costs and services.

non-gaap financial measures financial

"The non-GAAP financial measures are provided as supplemental information"

Non-GAAP financial measures are numbers companies use to show their financial performance that exclude certain expenses or income. They help investors see how the company might perform without one-time costs or other unusual items, giving a different perspective from official reports. However, since they can be adjusted, they don’t always tell the full story and should be looked at alongside standard financial figures.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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Third quarter 2026 revenue of $21.6 million, representing 65% growth year-over-year

Full year 2026 revenue guidance raised to $78 million to $80 million

CARLSBAD, Calif., Nov. 10, 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 third quarter ended September 30, 2026.

“The third quarter represented strong execution against our long-term strategy as we delivered 65% revenue growth and advanced our leadership position in AI-enabled personalized surgery as we grew our surgeon user base by more than 60% over the prior year,” said Mike Cordonnier, Chairman and CEO of Carlsmed. "We broadened our personalized surgery platform, strengthened our leadership team, and secured new inpatient CMS reimbursement for our aprevo® lumbar spine fusion procedure. Taken together with our differentiated, capital-light model, these accomplishments reinforce our foundation for sustainable, profitable long-term growth as we head into 2027."

Recent Business Highlights

• CMS Inpatient Prospective Payment System (IPPS) rule for fiscal year 2027 became effective October 1, 2026, with increased reimbursement for inpatient aprevo® lumbar procedures
• Launched aprevo® Lumbar Bi-lateral Posterior System in October, which the Company estimates addresses approximately 30,000 U.S. lumbar fusion procedures annually
• Further strengthened leadership team to drive productivity, scale, and patient-centric innovation with the promotion of Jeff Bertolini to Chief Operating Officer, the appointment of Rich Heppenstall as Chief Financial Officer, and the addition of Tony Jarc, Ph.D., as Chief Product and AI Officer
• Raised full-year 2026 revenue guidance to a range of $78 million to $80 million, over 56% growth at the midpoint versus full-year 2025
  
  

Third Quarter 2026 Financial Results

• Revenue was $21.6 million for the third quarter of 2026, a 65% increase compared to $13.1 million in the third quarter of 2025.
• Gross profit for the third quarter of 2026 was $16.7 million compared to $9.9 million for the third quarter of 2025. Gross margin was 77.3% for the third quarter of 2026, compared with 75.9% in the third quarter of 2025.
• Operating expenses were $29.4 million for the third quarter of 2026, compared with $19.0 million for the third quarter of 2025, and included $2.8 million in expenses related to executive transition costs and the expected resolution of certain legal matters. Operating expenses consisted of:
  • Research and development expenses of $6.4 million for the third quarter of 2026, compared with $4.4 million for the third quarter of 2025.
  • Sales and marketing expenses of $13.0 million for the third quarter of 2026, compared with $9.6 million for the third quarter of 2025.
  • General and administrative expenses of $10.0 million for the third quarter of 2026, compared with $4.9 million for the third quarter of 2025.
• Net loss was ($12.2) million for the third quarter of 2026, compared to ($8.5) million for the third quarter of 2025.
• Adjusted EBITDA was ($7.3) million for the third quarter of 2026, compared to ($8.2) million for the third quarter of 2025.
• Cash and cash equivalents, restricted cash, short-term investments, and marketable securities were $80.3 million as of September 30, 2026.
  
  

2026 Financial Outlook

Revenue for the full year 2026 is expected to be in the range of $78 million to $80 million, representing growth of over 56% at the midpoint. This compares to prior annual revenue guidance of $74 to $78 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 EBITDA, adjusted EBITDA, adjusted net loss and adjusted net loss per share. 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 EBITDA as net income (loss), adjusted to exclude: (i) net interest (income) expense, (ii) income tax expense (benefit), (iii) depreciation expense from property and equipment, and (iv) amortization expense from long-lived assets. We define “Adjusted EBITDA” as EBITDA adjusted to exclude (i) stock-based compensation expense, (ii) acquisition and transaction costs, (iii) acquired intangible asset amortization and impairments, (iv) restructuring and cost reduction initiatives, (v) executive transition costs, (vi) legal settlements net of proceeds from insurance in excess of legal fees, (vii) changes in fair value of warrant liabilities and gains and losses on debt extinguishments or modifications, and (viii) non-operating investment gains and losses. 

We define “Adjusted Net Loss” as net loss, adjusted to exclude: (i) acquisition and transaction costs, (ii) acquired intangible asset amortization and impairments, (iii) restructuring and cost reduction initiatives, (iv) executive transition costs, (v) legal settlements net of proceeds from insurance in excess of legal fees, (vi) change in fair value of warrant liabilities and gains and losses on debt extinguishments or modifications, and (vii) non-operating investment gains and losses. We define “Adjusted Net Loss Per Share” as Adjusted Net Loss divided by the weighted-average number of shares of common stock outstanding during the period, adjusted to exclude shares that were accelerated upon executive severance. Each item excluded in a period is separately identified and quantified in the reconciliation that follows. 

These non-GAAP measures are presented because management believes they allow 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 non-GAAP metrics, in addition to considering the Company’s GAAP financial measures. 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. These non-GAAP measures 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. Reconciliations of EBITDA and adjusted EBITDA, as well as Adjusted Net Loss and Adjusted Net Loss Per Share, are reported in this press release to the most comparable GAAP measure for the respective periods and appears in the table captioned “Reconciliation of GAAP Net Loss to Adjusted EBITDA” and “Reconciliation of GAAP Net Loss to Adjusted Net Loss Per Share” respectively. 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, our expectations regarding potential market size, Carlsmed’s ability to continue improving our products and technology and to develop new 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 Carlsmed’s Annual Report on Form 10-K for the year ended December 31, 2025, and subsequent Quarterly Reports on Form 10-Q 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 September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
Revenue		$	21,554			$	13,074			$	56,610			$	35,346
Cost of sales			4,889				3,147				12,978				8,914
Gross profit			16,665				9,927				43,632				26,432
Operating expenses:
Research and development			6,380				4,445				17,598				11,755
Sales and marketing			13,004				9,610				35,221				24,218
General and administrative			9,982				4,907				23,826				11,715
Total operating expenses			29,366				18,962				76,645				47,688
Loss from operations			(12,701	)			(9,035	)			(33,013	)			(21,256	)
Other income (expense):
Interest expense			(316	)			(380	)			(940	)			(1,100	)
Interest income			772				954				2,502				1,670
Change in fair value of warrant liabilities			—				(65	)			—				(335	)
Total other income (expense), net			456				509				1,562				235
Net loss			(12,245	)			(8,526	)			(31,451	)			(21,021	)
Deemed dividend to preferred stockholders			—				—				—				(584	)
Net loss attributable to common stockholders		$	(12,245	)		$	(8,526	)		$	(31,451	)		$	(21,605	)
Net loss		$	(12,245	)		$	(8,526	)		$	(31,451	)		$	(21,021	)
Other comprehensive loss:
Unrealized loss on available-for-sale debt securities			(21	)			—				(38	)			—
Total other comprehensive loss			(21	)			—				(38	)			—
Total comprehensive loss		$	(12,266	)		$	(8,526	)		$	(31,489	)		$	(21,021	)
Net loss per share attributable to common stockholders, basic and diluted		$	(0.45	)		$	(0.40	)		$	(1.16	)		$	(2.15	)
Weighted-average number of common shares used to compute basic and diluted net loss per share			27,303,162				21,081,330				27,104,729				10,051,623

CARLSMED, INC. CONDENSED BALANCE SHEETS (in thousands, except for share and par value amounts) (unaudited)
		September 30, 2026				December 31, 2025
Assets
Current assets:
Cash and cash equivalents		$	35,945			$	85,793
Restricted cash			100				100
Short-term investments			24,000				24,000
Marketable securities			20,262				—
Accounts receivable, net of allowances of $1,495 and $1,653, as of September 30, 2026, and December 31, 2025, respectively			16,884				11,362
Inventory			2,987				1,845
Prepaid expenses and other current assets			5,377				3,573
Total current assets			105,555				126,673
Property and equipment, net			3,611				1,487
Operating lease right-of-use assets			5,707				1,826
Other assets			397				134
Total assets		$	115,270			$	130,120
Liabilities and Stockholders’ Equity
Current liabilities:
Accounts payable		$	3,311			$	4,481
Accrued liabilities			6,766				3,287
Accrued compensation			7,371				5,760
Short-term operating lease liabilities			789				752
Total current liabilities			18,237				14,280
Long-term portion of term loan, net			15,400				15,346
Long-term operating lease liabilities			5,596				1,316
Other long-term liabilities			363				309
Total liabilities			39,596				31,251
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.00001 par value; 10,000,000 shares authorized and zero shares issued and outstanding as of September 30, 2026, and December 31, 2025			—				—
Common stock, $0.00001 par value; 600,000,000 shares authorized, 27,387,646 shares issued and outstanding as of September 30, 2026; 600,000,000 shares authorized, 26,664,243 shares issued, and 26,604,505 shares outstanding as of December 31, 2025			—				—
Additional paid-in capital			207,968				199,674
Accumulated deficit			(132,256	)			(100,805	)
Accumulated other comprehensive loss			(38	)			—
Total stockholders’ equity			75,674				98,869
Total liabilities and stockholders’ equity		$	115,270			$	130,120

RECONCILIATION OF GAAP NET LOSS TO ADJUSTED EBITDA (unaudited)
		Three Months Ended September 30,											$				%
			2026					2025					Change				Change
(in thousands, except percentages)
Net loss		$		(12,245	)		$		(8,526	)		$		(3,719	)			43.6		%
Interest (income) expense				(456	)				(574	)				118			(20.6		)	%
Income taxes				—					—					—				**
Depreciation and amortization				126					82					44				53.7		%
EBITDA				(12,575	)				(9,018	)				(3,557	)			39.4		%
Stock-based compensation				2,466					704					1,762				250.3		%
Executive transition costs				2,390					—					2,390				**
Legal settlements				450					—					450				**
Change in fair value of warrant liabilities				—					65					(65	)			(100.0	)	%
Adjusted EBITDA		$		(7,269	)		$		(8,249	)		$		980				(11.9	)	%

		Nine Months Ended September 30,											$				%
			2026					2025					Change				Change
(in thousands, except percentages)
Net loss		$		(31,451	)		$		(21,021	)		$		(10,430	)			49.6		%
Interest (income) expense				(1,562	)				(570	)				(992	)		174.0			%
Income taxes				—					—					—				**
Depreciation and amortization				355					183					172				94.0		%
EBITDA				(32,658	)				(21,408	)				(11,250	)			52.6		%
Stock-based compensation				6,366					1,137					5,229				459.9		%
Executive transition costs				2,390					—					2,390				**
Legal settlements				450					—					450				**
Change in fair value of warrant liabilities				—					335					(335	)			(100.0	)	%
Adjusted EBITDA		$		(23,452	)		$		(19,936	)		$		(3,516	)			17.6		%

**Prior year amount was $0, percentage change not meaningful

RECONCILIATION OF GAAP NET LOSS TO ADJUSTED NET LOSS PER SHARE (unaudited)
		Three Months Ended September 30,						$		%
		2026			2025			Change		Change
(in thousands, except share, per share amounts, and percentages)
Net loss	$	(12,245	)	$	(8,526	)	$	(3,719	)	43.6		%
Executive transition costs		2,390			—			2,390		**
Legal settlements		450			—			450		**
Change in fair value of warrant liabilities		—			65			(65	)	(100.0	)	%
Adjusted Net Loss		(9,405	)		(8,461	)		(944	)	11.2		%
Weighted average common shares outstanding		27,303,162			21,081,330			6,221,832		29.5		%
Less: Accelerated shares from executive transition		(959	)		—			(959	)	**
Adjusted weighted average common shares outstanding		27,302,203			21,081,330			6,220,873		29.5		%
Adjusted Net Loss Per Share	$	(0.34	)	$	(0.40	)	$	0.06		(15.0	)	%

		Nine Months Ended     September 30,						$		%
		2026			2025			Change		Change
(in thousands, except share, per share amounts, and percentages)
Net loss	$	(31,451	)	$	(21,021	)	$	(10,430	)	49.6		%
Executive transition costs		2,390			—			2,390		**
Legal settlements		450			—			450		**
Change in fair value of warrant liabilities		—			335			(335	)	(100.0	)	%
Adjusted Net Loss		(28,611	)		(20,686	)		(7,925	)	38.3		%
Weighted average common shares outstanding		27,104,729			10,051,623			17,053,106		169.7		%
Less: Accelerated shares from executive transition		(323	)		—			(323	)	**
Adjusted weighted average common shares outstanding		27,104,406			10,051,623			17,052,783		169.7		%
Adjusted Net Loss Per Share	$	(1.06	)	$	(2.06	)	$	1.00		(48.5	)	%

**Prior year amount was $0, percentage change not meaningful

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What is Carlsmed's updated full-year 2026 revenue guidance?

Carlsmed expects $78 million to $80 million in full-year 2026 revenue, up from its previous $74 million to $78 million range. The updated outlook represents growth of over 56% at the midpoint versus full-year 2025.

What were Carlsmed's third-quarter 2026 revenue and net loss?

Carlsmed reported $21.6 million in revenue and a $12.2 million net loss for the third quarter of 2026. Revenue increased 65% from $13.1 million a year earlier, while the net loss widened from $8.5 million.