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MIMEDX Announces Record Fourth Quarter and Full Year 2025 Operating and Financial Results

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MIMEDX (Nasdaq: MDXG) reported record 2025 results with Q4 net sales $118M (+27% YoY) and full-year net sales $419M (+20% YoY). Q4 GAAP net income was $15M and full-year net income was $49M. Adjusted EBITDA for Q4 was $29M (25% of net sales). Cash totaled $166M at year-end. The board authorized a $100M share repurchase over two years. For 2026 the company estimates net sales of $340–360M and adjusted EBITDA margin in the mid-to-high teens.

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Positive

  • Q4 net sales +27% YoY to $118M
  • Full-year net sales $419M (+20% YoY)
  • Full-year net income $49M
  • Year-end cash $166M (net cash $148M)
  • Board authorized $100M share repurchase program

Negative

  • 2026 net sales guidance $340–360M, below 2025 sales
  • SG&A expenses increased 18% YoY for 2025
  • Short-term Medicare reimbursement changes may reduce 2026 revenue

News Market Reaction – MDXG

-6.44%
12 alerts
-6.44% Session close to close
-5.0% Trough in 16 hr 13 min
$781.98M Market Cap
1.0x Rel. Volume

In the Feb 26 session, MDXG declined 6.44%, reflecting a notable negative market reaction. Argus tracked a trough of -5.0% from its starting point during tracking. Our momentum scanner triggered 12 alerts that day, indicating notable trading interest and price volatility.

Data tracked by StockTitan Argus on the day of publication.

Market Context

The stock moved -6.4% in the session following this news. A negative reaction despite record 2025 re...
Analysis

The stock moved -6.4% in the session following this news. A negative reaction despite record 2025 results would fit the mixed pattern around past earnings, where some strong quarters saw selloffs. Investors may have focused on the $340–360 million 2026 net sales outlook and commentary about Medicare reimbursement disruptions. Still, the company reported full-year net sales of $419 million, robust margins, and authorized a $100 million repurchase, echoing prior fundamentally solid, but market‑volatile, updates.

Key Figures

Q4 2025 net sales: $118 million Full-year 2025 net sales: $419 million Q4 2025 net income: $15 million ($0.10 EPS) +5 more
8 metrics
Q4 2025 net sales $118 million Three months ended December 31, 2025; up 27% year-over-year
Full-year 2025 net sales $419 million Year ended December 31, 2025; up 20% year-over-year
Q4 2025 net income $15 million ($0.10 EPS) GAAP net income and earnings per share for Q4 2025
Q4 2025 Adjusted EBITDA $29 million (25% margin) Adjusted EBITDA for Q4 2025 as 25% of net sales
Full-year 2025 gross margin 83% (86% adjusted) Reported and adjusted gross margin for 2025
Year-end 2025 cash $166 million Cash and cash equivalents as of December 31, 2025
Share repurchase authorization $100 million Two-year common stock repurchase program authorization
2026 net sales outlook $340–360 million Company’s estimated net sales range for 2026

Previous Earnings Reports

5 past events · Latest: Jul 30 (Positive)
Same Type Pattern 5 events
Date Event Sentiment 24h Move Catalyst
Jul 30 Q2 2025 earnings Positive +10.3% Record Q2 2025 results with 13% net sales growth and higher guidance.
Apr 30 Q1 2025 earnings Positive -8.1% Solid Q1 2025 results with net income and reaffirmed outlook despite Wound softness.
Feb 26 Q4 2024 earnings Positive +1.6% Q4 and 2024 net sales growth with strong margins and positive 2025 outlook.
Oct 30 Q3 2024 earnings Positive +20.4% Q3 2024 net sales growth, solid margins, and raised 2024 guidance.
Jul 31 Q2 2024 earnings Positive -10.3% Q2 2024 growth with strong income and EBITDA but noted market challenges.

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

Pattern Detected

Earnings releases have generally been received positively, but reactions have been volatile, with both strong rallies and notable selloffs around past reports.

Recent Company History

Recent earnings history for MIMEDX shows recurring record or solid quarters with growing net sales, consistent GAAP profitability, and Adjusted EBITDA margins above 20%. Price reactions have been mixed: some reports, such as Q3 2024 and Q2 2025, saw double‑digit gains, while others like Q2 2024 and Q1 2025 traded down despite positive fundamentals. Today’s record 2025 results and outlook sit within this pattern of fundamentally strong, but market‑volatile, earnings events.

Key Terms

adjusted ebitda, non-gaap, randomized controlled trial, medicare reimbursement, +1 more
5 terms
adjusted ebitda financial
"Fourth Quarter Adjusted EBITDA1 was $29 Million, or 25% of Net Sales"
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.
non-gaap financial
"Adjusted EBITDA is a Non-GAAP Measure. This press release contains this and other Non-GAAP measures."
Non-GAAP refers to financial measures that companies use to show their earnings or performance without including certain expenses or income that are often added back to give a different picture. It matters because it can make a company's results look better or more favorable, but it may also hide important costs, so investors need to look at both GAAP (official rules) and non-GAAP numbers to get a full understanding.
View in glossary
randomized controlled trial medical
"R&D spend in the quarter and year was driven, in part, by the randomized controlled trial for EPIEFFECT"
A randomized controlled trial is a research method that tests the effects of a new idea or treatment by randomly dividing participants into two groups: one that receives the treatment and one that does not. This approach helps ensure that the results are fair and unbiased, providing clear evidence about whether the treatment actually works. Investors value such trials because they offer reliable information that can influence decision-making and reduce uncertainty.
medicare reimbursement regulatory
"The short-term disruptions caused by Medicare reimbursement changes in the Wound market"
Medicare reimbursement is the payment a government health insurance program makes to hospitals, doctors, drugmakers and device makers for covered treatments, drugs or services. Think of it as the price a very large customer agrees to pay a seller; the level and timing of those payments influence how much revenue a health company can earn, how it prices products, and how quickly new treatments are adopted, so changes in reimbursement often directly affect investor returns and risk.
cms regulatory
"impact of CMS' updated 2026 Medicare reimbursement rules and model"
The Centers for Medicare & Medicaid Services (CMS) is the U.S. federal agency that sets rules, payment rates and coverage decisions for major public health insurance programs; think of it as both a giant insurer and the rulebook maker for how many healthcare providers and drug makers get paid by government programs. Its policy changes and reimbursement decisions can materially affect revenue, profit forecasts and valuations for hospitals, insurers, device makers and drug companies, so investors watch CMS announcements closely.

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

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Net Sales Grew 27% Year-Over-Year for the Fourth Quarter and 20% for the Full Year

Fourth Quarter GAAP Net Income and Earnings Per Share were $15 million and $0.10, Respectively

Fourth Quarter Adjusted EBITDA1 was $29 Million, or 25% of Net Sales

Company Estimates 2026 Net Sales in a Range of $340-360 Million

Announces $100 Million Share Repurchase Program Authorization

Management to Host Conference Call Today, February 25, 2026, at 4:30 PM ET

MARIETTA, Ga., Feb. 25, 2026 (GLOBE NEWSWIRE) -- MiMedx Group, Inc. (Nasdaq: MDXG) (“MIMEDX” or the “Company”), today announced operating and financial results for the fourth quarter and full year 2025.

Joseph H. Capper, MIMEDX Chief Executive Officer, commented, "MIMEDX delivered a record year of revenue and profitability in 2025, with fourth quarter results that included net sales growth of 27% year-over-year, net income of $15 million, an Adjusted EBITDA margin of 25% of net sales, and robust free cash flow. These results were driven by strong double-digit contributions in both Wound and Surgical, which grew 28% and 25%, respectively, reflecting exceptional commercial execution across the markets we serve. We were particularly pleased with the durable double-digit growth seen in Surgical, and we are keenly focused on the untapped clinical opportunities for our current and future products."

Mr. Capper continued, "Looking ahead to 2026, the Company remains committed to providing a best-in-class portfolio of evidence-based, differentiated products to capitalize on the many opportunities in front of us. With the recent product additions to our Wound and Surgical offerings, I am as confident as ever in our ability to make significant headway this year in a variety of clinical settings."

"The short-term disruptions caused by Medicare reimbursement changes in the Wound market will likely have an impact on our 2026 revenue. Once demand patterns normalize, we expect to gain significant volume over time. Meanwhile, we believe the clear momentum we have across the rest of our business — Surgical, international and Wound commercial pay — will provide continued profitability and cash flow. Thus, enabling us to maintain our leadership position over both the short- and long-term," concluded Mr. Capper.

____________________
1 Adjusted EBITDA is a Non-GAAP Measure. This press release contains this and other Non-GAAP measures. For reconciliations of our Non-GAAP measures to their nearest GAAP measure, refer to the section titled "Reconciliation of Non-GAAP Measures" below.

Fourth Quarter and Full Year 2025 Results Discussion

Net Sales

MIMEDX reported net sales for the three months ended December 31, 2025 of $118 million, compared to $93 million for the three months ended December 31, 2024, an increase of 27%. The increase was driven by Wound product sales growth of 28%, which reflected the introduction of EPIXPRESS® as well as the contribution from EMERGE™ during the quarter. Additionally, fourth quarter Surgical sales grew 25% and represented the sixth consecutive quarter of sequential sales growth for this product category, led by sustained momentum for AMNIOFIX® and AMNIOEFFECT® as well as another strong performance for the Company's particulate portfolio.

For the full year 2025 MIMEDX reported net sales of $419 million, compared to $349 million in the prior year period, reflecting growth of 20%. On a full year basis, Wound growth of 20% was led by sales of new products, including CELERA™, EMERGE, and EPIXPRESS, which more than offset pressure from lower-priced products. Also in 2025, Surgical net sales rose 21% compared to the prior year period, with strong contributions from AMNIOFIX, AMNIOEFFECT and HELIOGEN®.

Gross Profit and Margin

Gross profit for the three months ended December 31, 2025, was $99 million, an increase of $23 million as compared to the prior year period. Gross margin for the three months ended December 31, 2025 was 84%, compared to 82% in the prior year period. The increase was driven by favorable product mix. On an adjusted basis, fourth quarter 2025 gross margin was 86%, which reflects a roughly flat adjusted gross margin compared to the prior year period.

For the full year 2025, gross profit was $346 million, reflecting an increase of $57 million compared to the prior year period. Additionally, gross margin for the full year 2025 was 83%, flat compared to the full year 2024. On an adjusted basis, gross margin for the full year 2025 was 86% compared to 84% for the full year 2024.

Operating Expenses

Selling, general and administrative ("SG&A") expenses for the three months ended December 31, 2025, were $73 million compared to $61 million for the three months ended December 31, 2024. For the full year 2025, SG&A expenses totaled $266 million, compared to $225 million for the prior period, reflecting a year over year increase of 18%. For both the fourth quarter and full year 2025, the year-over-year increase in SG&A was driven primarily by higher commissions.

Research and development ("R&D") expenses for the three months ended December 31, 2025, were $5 million compared to $4 million for the three months ended December 31, 2024. For the full year 2025, research and development expenses totaled $15 million, compared to $12 million for 2024. R&D spend in the quarter and year was driven, in part, by the randomized controlled trial for EPIEFFECT and ongoing investments in the development of future products in our pipeline.

Net income for the three months and full year ended December 31, 2025 was $15 million and $49 million, respectively, compared to a net income of $7 million and $42 million for the three months and full year ended December 31, 2024, respectively.

Cash and Cash Equivalents

As of December 31, 2025, the Company had $166 million of cash and cash equivalents compared to $104 million as of December 31, 2024 and $142 million as of September 30, 2025. As of December 31, 2025, our cash position, net of debt on our balance sheet, was $148 million, representing a sequential increase of $24 million and an increase of $63 million for the year.

Share Repurchase Authorization Announced

Also today, the MIMEDX Board of Directors has authorized a share repurchase program of up to $100 million of the Company’s common stock over a two-year period.   The share repurchase program provides MIMEDX with the flexibility to purchase shares of its common stock in the open market or in privately negotiated transactions, subject to market conditions and other factors.

MIMEDX intends to use the repurchase program periodically on a discretionary basis, subject to general business and market conditions and balanced against other investment opportunities. The repurchase program may be commenced, suspended or discontinued at any time.

MIMEDX remains focused on executing its strategic priorities and its decision to establish this repurchase program reflects its balanced approach to capital allocation.  

Financial Outlook

For 2026, MIMEDX currently estimates net sales to be in a range of $340 to $360 million and for adjusted EBITDA margin to be in the mid-to-high teens.

Longer-term, the Company continues to expect to achieve annual net sales growth in the low double-digits as a percentage with an Adjusted EBITDA margin above 20%.

Conference Call and Webcast

MIMEDX will host a conference call and webcast to review its fourth quarter and full year 2025 results on Wednesday, February 25, 2026, beginning at 4:30 p.m., Eastern Time. The call can be accessed using the following information:

Webcast: Click here
U.S. Investors: 877-407-6184
International Investors: 201-389-0877
Conference ID: 13758446

A replay of the webcast will be available for approximately 30 days on the Company’s website at www.mimedx.com following the conclusion of the event.

Important Cautionary Statement

This press release and our investor conference call include forward-looking statements, which reflect management's current beliefs and expectations regarding future events and operating performance and speak only as of the date hereof. These forward-looking statements are not guarantees of future performance and involve a number of risks and uncertainties. These statements include statements regarding: (i) future sales, sales growth, and Adjusted EBITDA margin; (ii) our longer term financial goals and expectations for future financial results, including levels of net sales, Adjusted EBITDA, and Adjusted EBITDA margin; (iii) our expectations regarding the size of the market for our products;(iv) our expectations regarding the impact of CMS' updated 2026 Medicare reimbursement rules and model and our belief that Medicare is likely to introduce national coverage policy, given the withdrawal of the LCDs; (v) continued growth in different care settings and different products, specifically accounting for the change caused by CMS' updated 2026 reimbursement rules and model; and (vi) our expected outcomes relating to improving workflow and strengthening bonds between the Company and its customers. Additional forward-looking statements may be identified by words such as "believe," "expect," "may," "plan," “goal,” “outlook,” "potential," "will," "preliminary," and similar expressions, and are based on management's current beliefs and expectations.

Forward-looking statements are subject to risks and uncertainties, and the Company cautions investors against placing undue reliance on such statements. Actual results may differ materially from those set forth in the forward-looking statements. Factors that could cause actual results to differ from expectations include: (i) future sales are uncertain and are affected by competition, access to customers, patient access to healthcare providers, the reimbursement environment, particularly in light of CMS' updated 2026 Medicare spending rules and reimbursement model, and many other factors; (ii) the Company may change its plans due to unforeseen circumstances; (iii) the results of scientific research are uncertain and may have little or no value; (iv) our ability to sell our products in other countries depends on a number of factors including adequate levels of reimbursement, market acceptance of novel therapies, and our ability to build and manage a direct sales force or third party distribution relationship; (v) the effectiveness of amniotic tissue as a therapy for particular indications or conditions is the subject of further scientific and clinical studies; (vi) we may alter the timing and amount of planned expenditures for research and development based on regulatory developments; (vii) the impact of CMS' updated 2026 spending rules and reimbursement model, particularly the shift to a capped rate for Medicare reimbursement, including the impact on our product utilization given the potential shift to alternate treatment modalities; and (viii) changes in the size of the addressable market for our products. Additional factors that could impact outcomes and our results include those described in the Risk Factors section of our Annual Report on Form 10-K and our Quarterly Reports on Form 10-Q. filed with the Securities and Exchange Commission. Any forward-looking statements speak only as of the date of this press release and the Company assumes no obligation to update any forward-looking statement.

About MIMEDX

MIMEDX is a pioneer and leader focused on helping humans heal. With more than a decade and a half of helping clinicians manage chronic and other hard-to-heal wounds, MIMEDX provides a leading portfolio of products for applications in the wound care, burn, and surgical sectors of healthcare. The Company’s vision is to be the leading global provider of healing solutions through relentless innovation to restore quality of life. For additional information, please visit www.mimedx.com.

Contact:
Matt Notarianni
Investor Relations
470.304.7291
mnotarianni@mimedx.com


Selected Unaudited Financial Information

MiMedx Group, Inc.
Condensed Consolidated Balance Sheets
(in thousands) Unaudited
 December 31,
  2025   2024 
ASSETS   
Current assets:   
Cash and cash equivalents$166,121  $104,416 
Accounts receivable, net 75,707   55,828 
Inventory 25,340   23,807 
Other current assets 10,303   7,835 
Total current assets 277,471   191,886 
Property and equipment, net 4,713   5,944 
Deferred tax assets 19,596   28,306 
Goodwill 19,441   19,441 
Intangible assets, net 14,158   11,626 
Other assets 7,274   6,712 
Total assets$342,653  $263,915 
LIABILITIES AND STOCKHOLDERS’ EQUITY   
Current liabilities:   
Current portion of long term debt$1,500  $1,000 
Accounts payable 14,528   7,409 
Accrued compensation 31,065   23,667 
Accrued expenses 11,383   9,012 
Other current liabilities 5,790   4,507 
Total current liabilities 64,266   45,595 
Long term debt, net 16,467   17,830 
Other liabilities 5,372   7,383 
Total liabilities$86,105  $70,808 
Stockholders’ equity   
Common stock; $.001 par value; 250,000,000 shares authorized, 148,093,920 issued and outstanding at December 31, 2025 and 146,932,032 issued and outstanding at December 31, 2024 148   147 
Additional paid-in capital 299,081   284,219 
Accumulated deficit (42,681)  (91,259)
Total stockholders’ equity 256,548   193,107 
Total liabilities and stockholders’ equity$342,653  $263,915 
    


MiMedx Group, Inc.
Condensed Consolidated Statements of Operations
(in thousands, except share and per share amounts) Unaudited
 Three Months Ended December 31, Year Ended December 31,
  2025   2024   2025   2024 
Net sales$118,095  $92,907  $418,630  $348,879 
Cost of sales 19,055   16,909   73,013   60,073 
Gross profit 99,040   75,998   345,617   288,806 
        
Operating expenses:       
Selling, general and administrative 73,073   61,043   266,194   225,087 
Research and development 4,761   3,571   15,097   12,341 
Investigation, restatement and related    43      (8,698)
Amortization of intangible assets 128   194   439   765 
Impairment of intangible assets    94      446 
Operating income 21,078   11,053   63,887   58,865 
        
Other income (expense), net       
Interest income (expense), net 904   403   2,933   (1,006)
Other expense, net (186)  (208)  (558)  (565)
Income from continuing operations before income tax 21,796   11,248   66,262   57,294 
Income tax provision (expense) benefit from continuing operations (6,605)  (3,811)  (17,684)  (15,296)
Net income from continuing operations 15,191   7,437   48,578   41,998 
Income (loss) from discontinued operations, net of tax          421 
Net income$15,191  $7,437  $48,578  $42,419 
Net income available to common stockholders from continuing operations$15,191  $7,437  $48,578  $41,998 
        
Basic net income (loss) per common share:       
Continuing operations$0.10  $0.05  $0.33  $0.29 
Discontinued operations           
Basic net income per common share:$0.10  $0.05  $0.33  $0.29 
        
Diluted net income (loss) per common share:       
Continuing operations$0.10  $0.05  $0.32  $0.28 
Discontinued operations           
Diluted net income (loss) per common share:$0.10  $0.05  $0.32  $0.28 
        
Weighted average common shares outstanding - basic 148,091,670   147,008,235   147,793,069   146,979,354 
Weighted average common shares outstanding - diluted 150,189,160   149,242,415   149,724,507   149,049,197 
                


MiMedx Group, Inc.
Condensed Consolidated Statements of Cash Flows
(in thousands) Unaudited
 Three Months Ended December 31, Year Ended December 31,
  2025   2024   2025   2024 
Net cash flows provided by operating activities$24,956  $18,782  $74,003  $66,198 
Net cash flows used in investing activities (335)  (2,767)  (6,886)  (9,583)
Net cash flows used in financing activities (583)  (400)  (5,412)  (34,199)
Net change in cash$24,038  $15,615  $61,705  $22,416 
                

Reconciliation of Non-GAAP Measures

In addition to our GAAP results, we provide certain non-GAAP measures including Adjusted EBITDA, related margins, Free Cash Flow, Adjusted Gross Profit, Adjusted Gross Margin and Adjusted Net Income. We believe that the presentation of these measures provides important supplemental information to management and investors regarding our performance. These measures are not a substitute for GAAP measures. Company management uses these non-GAAP measures as aids in monitoring our ongoing financial performance from quarter-to-quarter and year-to-year on a regular basis and for benchmarking against comparable companies.

These non-GAAP financial measures reflect the exclusion of the following items:

  • Share-based compensation expense - expense recognized related to awards to employees and our board of directors pursuant to our share-based compensation plans. This expense is reflected amongst cost of sales, research and development expense, and selling, general, and administrative expense in the consolidated statements of operations.
  • Investigation, restatement, and related (benefit) expense - expenses incurred toward the legal defense of the Company and advanced on behalf of certain former officers and directors, net of negotiated reductions and settlements of amounts previously advanced, related to certain legal matters. This expense is reflected in the line of the same name in our consolidated statements of operations.
  • Impairment of intangible assets - reflects the impairment of intangibles. This expense is reflected in the line of the same name in our consolidated statements of operations.
  • Transaction-related expenses - reflects expenses incrementally incurred resulting from the consummation of material strategic transactions or the integration of acquired assets or operations into our core business.
  • Strategic legal and regulatory expenses - With respect to the three months and year ended December 31, 2025, this relates to litigation and regulatory expenses. Litigation expenses incurred relate to suits filed against former employees and their employers for violation of non-compete and non-solicitation agreements and related matters. Regulatory expenses relate to legal fees incurred stemming from action taken against the United States Food & Drug Administration ("FDA") surrounding the designation of one of our products.
  • Loss on extinguishment of debt - reflects the excess of cash paid to extinguish debt over the carrying value of the debt on our balance sheet upon the repayment and termination of a loan agreement. With respect to the year ended December 31, 2025, this relates to the repayment and termination of the Company's loan agreement with Hayfin. Amounts in this line reflect (i) prepayment premium paid and (ii) write-offs of unamortized original issue discount and deferred financing costs.
  • Expenses related to the Disbanding of Regenerative Medicine - incremental expenses recognized or incurred directly as a result of our announcement to disband our Regenerative Medicine segment.
  • Amortization of acquired intangible assets - reflects amortization expense recognized solely related to assets which were acquired as part of a transaction. These expenses are reflected in cost of sales in our consolidated statements of operations.
  • Reorganization expenses - reflects severance expense arising from the enactment of various strategic initiatives, including separations from certain officers of the Company.
  • Income Tax Adjustment - for purposes of calculating Adjusted Net Income and Adjusted Earnings Per Share, reflects our expectation of a long-term effective tax rate, which is normalized and balance sheet-agnostic. Actual reporting tax expense will be based on GAAP earnings, and may differ from the expected long-term effective tax rate due to a variety of factors, including the tax treatment of various transactions included in GAAP net income and other reconciling items that are excluded in determining Adjusted Net Income and Adjusted EPS. The actual long-term normalized effective tax rate was 25% for each of the years ended December 31, 2025 and 2024.

Adjusted EBITDA and Adjusted EBITDA margin

Adjusted EBITDA consists of GAAP net income excluding: (i) share-based compensation, (ii) income tax provision, (iii) amortization of intangible assets, (iv) strategic legal and regulatory expenses, (v) interest (income) expense, net, (vi) depreciation expense, (vii) reorganization expenses, (viii) transaction-related expenses, (ix) investigation, restatement and related expense (benefit), (x) impairment of intangible assets, and (xi) expenses related to disbanding of the Regenerative Medicine business unit.

A reconciliation of GAAP net income to Adjusted EBITDA appears in the table below (dollars in thousands):

 Three Months Ended December 31, Year Ended December 31,
  2025   2024   2025   2024 
Net Income$15,191  $7,437  $48,578  $42,419 
Non-GAAP Adjustments:       
Share-based compensation 2,463   4,693   16,396   16,933 
Income tax provision 6,605   3,811   17,684   15,296 
Amortization of intangible assets 2,648   2,426   12,617   3,762 
Strategic legal and regulatory expenses 2,494   1,140   9,185   2,806 
Interest (income) expense, net (904)  (403)  (2,933)  1,006 
Depreciation expense 572   564   2,264   2,279 
Reorganization expense 203      1,029    
Transaction related expenses 103   (38)  902   612 
Investigation, restatement and related expenses    44      (8,698)
Impairment of intangible assets    94      446 
Expenses related to disbanding of Regenerative Medicine business unit          (421)
Adjusted EBITDA$29,375  $19,768  $105,722  $76,440 
Adjusted EBITDA margin 24.9%  21.3%  25.3%  21.9%


Adjusted Net Income and Adjusted Gross Margin

Adjusted Net Income provides a view of our operating performance, exclusive of certain items which are non-recurring or not reflective of our core operations.

Adjusted Net Income is defined as GAAP net income plus (i) amortization of acquired intangible assets, (ii) strategic legal and regulatory expenses, (iii) transaction-related expenses, (iv) reorganization expenses, (v) investigation, restatement and related expense (benefit), (vi) impairment of intangible assets, (vii) loss on extinguishment of debt, (viii) expenses related to disbanding of Regenerative Medicine business unit, and (ix) the long-term effective income tax rate adjustment.

Each of the adjustments to reconcile Adjusted Net Income to GAAP net income affect individual financial statement captions which are reflected in our consolidated statements of operations, including gross profit. Adjusted Gross Profit is therefore defined as GAAP gross profit plus (i) amortization of acquired intangible assets, (ii) strategic legal and regulatory expenses, (iii) transaction-related expenses, (iv) reorganization expenses, (v) investigation, restatement and related expense (benefit), (vi) impairment of intangible assets, (vii) loss on extinguishment of debt, (viii) expenses related to disbanding of Regenerative Medicine business unit, and (ix) the long-term effective income tax rate adjustment
to the extent that these adjustments impact GAAP gross profit. Adjusted Gross Margin is calculated as Adjusted Gross Profit divided by GAAP net sales.
A reconciliation of GAAP net income to Adjusted Net Income appears in the table below (in thousands):

 Three Months Ended December 31, Year Ended December 31,
  2025   2024   2025   2024 
Net income$15,191  $7,437  $48,578  $42,419 
Amortization of acquired intangible assets 2,519   2,232   12,178   2,997 
Strategic legal and regulatory expenses 2,494   1,140   9,185   2,806 
Transaction related expenses 103   (38)  902   612 
Reorganization expense 203      1,029    
Investigation, restatement and related expense (benefit)    43      (8,698)
Impairment of intangible assets    94      446 
Loss on extinguishment of debt          1,401 
Expenses related to disbanding of Regenerative Medicine business unit          (421)
Long-term effective income tax rate adjustment (174)  130   (4,705)  1,082 
Adjusted net income$20,336  $11,038  $67,167  $42,644 


A reconciliation of various line items included in our GAAP unaudited condensed consolidated statements of operations to Adjusted Net Income, including Adjusted Gross Profit for the three months and years ended December 31, 2025 and 2024 are presented in the tables below (in thousands):

 Three months ended December 31, 2025
 Gross Profit Selling, General & Administrative Expense Research and Development Expense Net Income
Reported GAAP Measure$99,040  $73,073  $4,761 $15,191 
Amortization of acquired intangible assets 2,519        2,519 
Strategic legal and regulatory expenses    (2,494)    2,494 
Reorganization expense   (203)    203 
Transaction-related expenses    (90)    103 
Long-term effective income tax rate adjustment         (174)
Non-GAAP Measure$101,559  $70,286  $4,761 $20,336 
        
Reported Gross Profit Margin 83.9%      
Adjusted Gross Profit Margin 86.0%      


 Three months ended December 31, 2024
 Gross Profit Selling, General & Administrative Expense Research and Development Expense Net Income
Reported GAAP Measure$75,998  $61,043  $3,571 $7,437 
Investigation, restatement and related expenses         43 
Impairment of intangible assets         94 
Amortization of acquired intangible assets 2,232        2,232 
Transaction-related expenses    (30)    (38)
Strategic legal and regulatory expenses    (1,140)    1,140 
Long-term effective income tax rate adjustment         130 
Non-GAAP Measure$78,230  $59,873  $3,571 $11,038 
        
Reported Gross Profit Margin 81.8%      
Adjusted Gross Profit Margin 84.2%      


 Year Ended December 31, 2025
 Gross Profit Selling, General & Administrative Expense Research and Development Expense Net Income
Reported GAAP Measure$345,617  $266,194  $15,097 $48,578 
Amortization of acquired intangible assets 12,178        12,178 
Strategic legal and regulatory expenses    (9,185)    9,185 
Transaction-related expenses    (779)    902 
Reorganization expense    (1,029)    1,029 
Long-term effective income tax rate adjustment         (4,705)
Non-GAAP Measure$357,795  $255,201  $15,097 $67,167 
        
Reported Gross Profit Margin 82.6%      
Adjusted Gross Profit Margin 85.5%      


 Year Ended December 31, 2024
 Gross Profit Selling, General & Administrative Expense Research and Development Expense Net Income
Reported GAAP Measure$288,806  $225,087  $12,341  42,419 
Loss on extinguishment of debt         1,401 
Investigation, restatement and related expenses         (8,698)
Impairment of intangible assets         446 
Amortization of acquired intangible assets 2,997        2,997 
Transaction-related expenses    (551)    612 
Strategic legal and regulatory expenses    (2,806)    2,806 
Expenses related to disbanding of Regenerative Medicine Business Unit         (421)
Long-term effective income tax rate adjustment         1,082 
Non-GAAP Measure$291,803  $221,730  $12,341 $42,644 
        
Reported Gross Profit Margin 82.8%      
Adjusted Gross Profit Margin 83.6%      


Adjusted Earnings Per Share

Adjusted Earnings Per Share is intended to provide a normalized view of earnings per share by removing items that may be irregular, one-time, or non-recurring from net income. This enables us to identify underlying trends in our business that could otherwise be masked by such items. Adjusted Earnings Per Share consists of GAAP diluted net income per common share including adjustments for: (i) amortization of acquired intangible assets, (ii) strategic legal and regulatory expenses, (iii) transaction-related expenses, (iv) reorganization expenses, (v) investigation, restatement and related expense (benefit), (vi) impairment of intangible assets, (vii) loss on extinguishment of debt, (viii) expenses related to disbanding of Regenerative Medicine business unit, and (ix) the long-term effective income tax rate adjustment. The effect of antidilution reflects the changes resulting from the removal of the dilutive impact of convertible securities which were dilutive for purposes of calculating GAAP net income per common share, but are antidilutive for non-GAAP purposes.

A reconciliation of GAAP diluted earnings per share to Adjusted Earnings Per Share appears in the table below (per diluted share):

 Three Months Ended December 31, Year Ended December 31,
  2025  2024  2025   2024 
GAAP net income (loss) per common share - diluted$0.10 $0.05 $0.32  $0.28 
Loss on extinguishment of debt 0.00  0.00  0.00   0.01 
Investigation, restatement and related (benefit) expense 0.00  0.00  0.00   (0.06)
Impairment of intangible assets 0.00  0.00  0.00   0.00 
Amortization of acquired intangible assets 0.02  0.01  0.08   0.02 
Transaction related expenses 0.00  0.00  0.01   0.00 
Strategic legal and regulatory expenses 0.02  0.01  0.06   0.02 
Expenses related to disbanding of Regenerative Medicine business unit 0.00  0.00  0.00   0.00 
Reorganization expenses 0.00  0.00  0.01   0.00 
Long-term effective income tax rate adjustment 0.00  0.00  (0.03)  0.01 
Adjusted Earnings Per Share$0.14 $0.07 $0.45  $0.28 
        
Weighted average common shares outstanding - adjusted 150,189,160  149,242,415  149,724,507   149,049,197 


Free Cash Flow

Free Cash Flow is intended to provide a measure of our ability to generate cash in excess of capital investments. It provides management with a view of cash flows which can be used to finance operational and strategic investments.

Free Cash Flow is defined as net cash provided by operating activities less capital expenditures, including purchases of equipment.

A reconciliation of GAAP net cash flows provided by operating activities to Free Cash Flow appears in the table below (in thousands):

 Three Months Ended December 31, Year Ended December 31,
  2025   2024   2025   2024 
Net cash flows provided by operating activities$24,956  $18,782   74,003   66,198 
Capital expenditures, including purchases of equipment (285)  (263)  (1,033)  (1,683)
Free Cash Flow$24,671  $18,519  $72,970  $64,515 


Other Information

Net Sales by Product Category by Quarter

Below is a summary of net sales by product category (in thousands):

  2025  2024
 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
Wound$56,073 $64,476 $77,098 $78,679 $57,049 $57,547 $55,052 $61,357
Surgical 32,132  34,129  36,627  39,416  27,660  29,660  29,005  31,550
Net sales$88,205 $98,605 $113,725 $118,095 $84,709 $87,207 $84,057 $92,907


Selling, General and Administrative

Below is the breakout of selling, general and administrative expense by selling and marketing and general and administrative (in thousands):

  2025  2024
 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
Selling and marketing$46,861 $47,867 $53,720 $61,233 $44,477 $41,725 $41,721 $47,638
General and administrative 13,108  16,284  15,281  11,840  10,652  13,676  11,795  13,403
Selling, general and administrative$59,969 $64,151 $69,001 $73,073 $55,129 $55,401 $53,516 $61,041



FAQ

What were MIMEDX (MDXG) fourth quarter 2025 net sales and growth rate?

MIMEDX reported Q4 2025 net sales of $118 million, up 27% year-over-year. According to the company, growth was driven by Wound product introductions including EPIXPRESS and contributions from EMERGE, plus a 25% increase in Surgical sales.

How much cash did MIMEDX (MDXG) hold at year-end 2025 and net cash position?

At December 31, 2025 MIMEDX held $166 million in cash and a net cash position of $148 million. According to the company, cash increased sequentially and rose $63 million year-over-year, supporting capital flexibility.

What is the scope and timeline of MIMEDX's $100 million share repurchase authorization (MDXG)?

The board authorized a $100 million repurchase program over two years, to be used opportunistically in open market or private transactions. According to the company, repurchases are discretionary and may be paused based on market conditions.

What 2026 guidance did MIMEDX (MDXG) provide for net sales and adjusted EBITDA margin?

MIMEDX estimates 2026 net sales of $340–360 million with adjusted EBITDA margin in the mid-to-high teens. According to the company, longer-term targets remain low double-digit sales growth and adjusted EBITDA margin above 20%.

How did Medicare reimbursement changes factor into MIMEDX's 2026 outlook (MDXG)?

MIMEDX cautioned that short-term disruptions from 2026 Medicare reimbursement changes may impact revenue. According to the company, demand patterns should normalize over time and other segments should sustain profitability and cash flow.