SI-BONE, Inc. Reports Financial Results for the First Quarter 2026 and Raises 2026 Guidance
Rhea-AI Summary
SI-BONE (Nasdaq:SIBN) reported first quarter 2026 revenue of $52.6 million, up 11.2% year over year, with U.S. revenue of $49.3 million and international revenue of $3.3 million. Gross margin was 79.8% and adjusted EBITDA improved to $2.5 million.
Net loss narrowed to $4.3 million, or $0.10 per share. Cash and equivalents were $144.7 million. SI-BONE raised 2026 revenue guidance to $230–$233 million and increased expected full-year gross margin to about 79%, while maintaining a positive adjusted EBITDA outlook.
AI-generated analysis. Not financial advice.
Positive
- Worldwide revenue grew 11.2% year over year to $52.6 million
- International revenue increased 33.9% to $3.3 million, driven by iFuse TORQ demand
- Adjusted EBITDA improved to $2.5 million from $0.5 million year over year
- 2026 revenue guidance raised to $230–$233 million (~14–16% growth)
- 2026 gross margin outlook increased to approximately 79%
- Over 1,650 active U.S. physicians, up 17% year over year
Negative
- Company still reported a net loss of $4.3 million in Q1 2026
- Operating expenses rose 4.1% to $47.0 million year over year
- Cash and equivalents declined to $144.7 million from $147.8 million quarter over quarter
News Market Reaction – SIBN
On the day this news was published, SIBN gained 19.72%, reflecting a significant positive market reaction. Argus tracked a peak move of +14.1% during that session. Argus tracked a trough of -10.1% from its starting point during tracking. Our momentum scanner triggered 21 alerts that day, indicating elevated trading interest and price volatility. This price movement added approximately $102M to the company's valuation, bringing the market cap to $617.42M at that time. Trading volume was very high at 4.2x the daily average, suggesting strong buying interest.
Data tracked by StockTitan Argus on the day of publication.
Key Figures
Market Reality Check
Peers on Argus
SIBN fell 5.25% while peers were mixed: TNDM -22.6%, OFIX -6.5%, AXGN -3.27%, AVNS roughly flat and ZIMV unchanged, indicating a largely stock-specific reaction rather than a broad devices move.
Previous Earnings Reports
| Date | Event | Sentiment | Move | Catalyst |
|---|---|---|---|---|
| Feb 23 | Earnings and guidance | Positive | -2.1% | Record FY2025 results, strong Q4, 2026 guidance with growth and EBITDA. |
| Nov 10 | Earnings and guidance | Positive | +16.2% | Q3 2025 growth, margin improvement, NTAP support and raised 2025 guidance. |
| May 05 | Quarterly earnings | Positive | +15.4% | Q1 2025 revenue growth, positive adjusted EBITDA and higher 2025 outlook. |
| Feb 24 | Earnings and outlook | Positive | +5.5% | Record FY2024 and Q4, revenue growth and initial 2025 guidance. |
| Nov 12 | Quarterly earnings | Positive | -15.9% | Q3 2024 growth, loss reduction, improved EBITDA and guidance update. |
Earnings releases are generally positive and often see gains, but there are notable sell-offs on good results.
Over the last several earnings cycles, SI-BONE has consistently reported double-digit revenue growth, stable gross margins near 79–80%, and steady improvement in net loss and adjusted EBITDA. Prior updates, such as Q3 2025 and Q1 2025, combined strong growth with guidance raises, while full-year 2024 and 2025 results highlighted the shift to positive adjusted EBITDA. Price reactions have been mixed, with some earnings reports producing double-digit gains and others seeing declines, underscoring variable investor responses to fundamentally similar momentum.
Historical Comparison
Past five earnings releases averaged a 3.83% move with mostly positive reactions. Today’s -5.25% decline on raised 2026 guidance breaks that pattern, echoing prior instances where strong results still saw selling.
Earnings releases since late 2024 show a progression of rising revenue, stable ~79–80% gross margins, narrowing net losses and the transition to positive adjusted EBITDA, often paired with guidance raises.
Regulatory & Risk Context
An effective S-3ASR shelf filed on 2026-02-24 registers an indefinite aggregate amount of securities, covering common and preferred stock, debt and warrants, with 0 recorded usage to date.
Market Pulse Summary
The stock surged +19.7% in the session following this news. A strong positive reaction aligns with SI-BONE’s pattern of rewarding solid earnings and guidance raises. The company reported Q1 2026 revenue of $52.6M, 11.2% growth, and adjusted EBITDA of $2.5M, while lifting 2026 revenue guidance to $230–233M with ~79% gross margin. Investors have previously bid up the stock on similar updates, though the existing shelf registration and past volatility around earnings remain factors to monitor.
Key Terms
adjusted EBITDA financial
gross margin financial
operating expenses financial
CMS regulatory
MS-DRG medical
IPPS Proposed Rule regulatory
AI-generated analysis. Not financial advice.
Delivered ~
First Quarter 2026 Financial Highlights (all comparisons are to the prior year period)
- Worldwide revenue of
$52.6 million , representing growth of11.2% - U.S. revenue of
$49.3 million , representing growth of10.0% - Gross margin of
79.8% - Net loss of
$4.3 million , representing an improvement of33.8% - Adjusted EBITDA of
$2.5 million , representing an improvement of over440% $144.7 million in cash and equivalents
Recent Operational Highlights (any comparisons are to the prior year period)
- Over 1,650 active U.S. physicians, representing growth of
17% $2.2 million in trailing 12-month average revenue per territory, representing an increase of11% - Expanded international presence with the launch of iFuse TORQ TNT in Europe and iFuse TORQ in Australia
- CMS proposes, in their FY2027 IPPS Proposed Rule, the creation of a new MS-DRG family with higher payment for hospitals supporting complex spinal fusion procedures that incorporate iFuse Bedrock Granite
SANTA CLARA, Calif., May 11, 2026 (GLOBE NEWSWIRE) -- SI-BONE, Inc. (Nasdaq: SIBN), the global leader in developing procedural solutions to address clinical challenges associated with compromised bone, today reported financial results for the quarter ended March 31, 2026.
"The first quarter demonstrated the strength and durability of our platform, with record physician engagement and double-digit growth across all key metrics," said Laura Francis, Chief Executive Officer. "We advanced several high-impact initiatives during the quarter, including the U.S. launch of INTRA Ti, our trauma partnership with Smith + Nephew, and the introduction of iFuse TORQ TNT and iFuse TORQ across various international markets, each of which expands our addressable market and deepens our competitive position. With growing commercial scale and our third breakthrough device on track for launch later this year, we are well positioned to accelerate revenue growth through 2026 and into 2027."
First Quarter 2026 Financial Results
Worldwide revenue was
Gross profit was
Operating expenses increased
Operating loss improved by
Net loss improved by
Adjusted EBITDA was
Cash and equivalents as of March 31, 2026 were
Updated Fiscal 2026 Financial Guidance
SI-BONE increased 2026 worldwide revenue expectation to be in the range of
| Fiscal Year 2026 Guidance | ||
| New (May 11, 2026) | Prior (February 23, 2026) | |
| Revenue | ~14 | ~ |
| Gross Margin | ~ | ~ |
| Operating Expenses | ~ at revenue midpoint | ~ at revenue midpoint |
| Adjusted EBITDA | Positive | Positive |
Webcast Information
SI-BONE will host a conference call to discuss the first quarter 2026 financial results after market close on Monday, May 11, 2026 at 4:30 P.M. Eastern Time. The conference call can be accessed live over webcast at https://edge.media-server.com/mmc/p/vde24u4q. Live audio of the webcast will be available on the “Investors” section of the company’s website at: www.si-bone.com. The webcast will be archived and available for replay for at least 90 days after the event.
About SI-BONE, Inc.
SI-BONE (NASDAQ: SIBN) is a global leader in developing procedural solutions to address clinical challenges associated with compromised bone. With expertise in biomechanical design and anatomy specific innovation, SI-BONE has built a technology platform with market-leading applications centered on the spinopelvic anatomy. SI-BONE continues to leverage the deep experience in addressing the challenges of low-density bone in the sacrum to develop unique technologies that are targeting new clinical adjacencies to help improve outcomes for patients with compromised bone. Since 2009, SI-BONE has supported physicians in performing nearly 150,000 procedures. A unique body of clinical evidence supports the use of SI-BONE's technologies, including four randomized controlled trials and over 185 peer reviewed publications.
For additional information on the company or the products, including risks and benefits, please visit www.si-bone.com.
SI-BONE®, iFuse Bedrock Granite®, iFuse TORQ® and iFuse TORQ TNT® are registered trademarks of SI-BONE, Inc. All other marks referenced herein are property of their respective owners. ©2026 SI-BONE, Inc. All Rights Reserved.
Forward-Looking Statements
The statements in this press release regarding expectations of future events or results, including SI-BONE’s expectations of continued revenue and procedure growth and financial outlook, are “forward-looking” statements. These forward-looking statements are based on SI-BONE’s current expectations and inherently involve significant risks and uncertainties. These risks include SI-BONE’s ability to introduce and commercialize new products and indications, SI-BONE’s ability to maintain favorable reimbursement for procedures using its products including CMS's finalization of the proposed FY 2027 Inpatient Rule referenced herein, the impact of any future economic weakness or deterioration in economic conditions as a result of tariffs and retaliation by U.S. trading partners on the ability and desire of patients to undergo elective procedures including those using SI-BONE’s products, SI-BONE’s ability to manage risks to its supply chain, future capital requirements driven by new surgical systems requiring instrument tray and implant inventory investment, and the pace of the re-normalization of the healthcare operating environment including the ability and desire of patients and physicians to undergo and perform procedures using SI-BONE’s products. Actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these and other risks and uncertainties, many of which are described in SI-BONE’s most recent filings on Form 10-K and Form 10-Q, and SI-BONE’s other filings with the Securities and Exchange Commission (SEC) available at the SEC’s Internet site (www.sec.gov), especially under the caption “Risk Factors.” SI-BONE does not undertake any obligation to update forward-looking statements and expressly disclaims any obligations or undertaking to release publicly any updates or revisions to any forward-looking statements contained herein, except as required by law.
Use of Non-GAAP Financial Measures
To supplement our condensed consolidated financial statements, which are prepared and presented in accordance with generally accepted accounting principles in the United States ("GAAP"), SI-BONE uses two non-GAAP financial measures: Adjusted EBITDA and free cash flow. Non-GAAP measures should be considered supplemental to, and not a substitute for, financial information prepared in accordance with GAAP. Adjusted EBITDA excludes the effect of items that increase or decrease SI-BONE’s reported results of operations. Free cash flow is not intended to represent our residual cash flow available for discretionary expenditures. Management strongly encourages investors to review, when they become available, the company's consolidated financial statements and publicly filed reports in their entirety. The company's definition of adjusted EBITDA and free cash flow may differ from similarly titled measures used by others.
Adjusted EBITDA excludes from net loss the effects of interest income, interest expense, depreciation and amortization, and stock-based compensation. Free cash flow is defined as net cash provided by operating activities less purchases of property and equipment. SI-BONE believes the presentation of these financial measures is useful to management because it allows management to more consistently analyze period-to-period financial performance and provides meaningful supplemental information with respect to core operational activities used to evaluate management's performance. SI-BONE also believes the presentation of non-GAAP financial measures is useful to investors and other interested persons as it enables these persons to use this additional information to assess the company’s performance in using this additional metric that management uses to assess the company’s performance.
Investor Contact
Saqib Iqbal
VP, FP&A, and Investor Relations
investors@SI-BONE.com
| SI-BONE, INC. CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (In thousands, except share and per share amounts) (Unaudited) | |||||||
| Three Months Ended March 31, | |||||||
| 2026 | 2025 | ||||||
| Revenue | $ | 52,588 | $ | 47,290 | |||
| Cost of goods sold | 10,644 | 9,595 | |||||
| Gross profit | 41,944 | 37,695 | |||||
| Operating expenses: | |||||||
| Sales and marketing | 32,808 | 30,681 | |||||
| Research and development | 4,192 | 4,534 | |||||
| General and administrative | 10,037 | 9,960 | |||||
| Total operating expenses | 47,037 | 45,175 | |||||
| Loss from operations | (5,093 | ) | (7,480 | ) | |||
| Interest and other income (expense), net: | |||||||
| Interest income | 1,350 | 1,592 | |||||
| Interest expense | (592 | ) | (662 | ) | |||
| Other income (expense) | 1 | 8 | |||||
| Net loss | $ | (4,334 | ) | $ | (6,542 | ) | |
| Net loss per share, basic and diluted | $ | (0.10 | ) | $ | (0.15 | ) | |
| Weighted-average number of common shares used to compute basic and diluted net loss per share | 43,959,760 | 42,337,481 | |||||
| SI-BONE, INC. CONDENSED CONSOLIDATED BALANCE SHEETS (in thousands) (unaudited) | |||||||
| March 31, 2026 | December 31, 2025 | ||||||
| ASSETS | |||||||
| Current assets: | |||||||
| Cash and cash equivalents | $ | 33,535 | $ | 42,240 | |||
| Short-term investments | 111,148 | 105,583 | |||||
| Accounts receivable | 30,961 | 29,915 | |||||
| Inventory | 35,534 | 33,897 | |||||
| Prepaid expenses and other current assets | 3,542 | 4,480 | |||||
| Total current assets | 214,720 | 216,115 | |||||
| Property and equipment, net | 20,455 | 21,298 | |||||
| Operating lease right-of-use assets | 7,326 | 1,087 | |||||
| Other non-current assets | 217 | 55 | |||||
| TOTAL ASSETS | $ | 242,718 | $ | 238,555 | |||
| LIABILITIES AND STOCKHOLDERS’ EQUITY | |||||||
| Current liabilities: | |||||||
| Accounts payable | $ | 6,761 | $ | 4,631 | |||
| Accrued liabilities and other | 14,068 | 19,704 | |||||
| Operating lease liabilities, current portion | 658 | 944 | |||||
| Total current liabilities | 21,487 | 25,279 | |||||
| Long-term borrowings | 35,599 | 35,569 | |||||
| Operating lease liabilities, net of current portion | 6,690 | 175 | |||||
| TOTAL LIABILITIES | 63,776 | 61,023 | |||||
| STOCKHOLDERS’ EQUITY | |||||||
| Common stock | 4 | 4 | |||||
| Additional paid-in capital | 633,029 | 626,970 | |||||
| Accumulated other comprehensive income | 501 | 816 | |||||
| Accumulated deficit | (454,592 | ) | (450,258 | ) | |||
| TOTAL STOCKHOLDERS’ EQUITY | 178,942 | 177,532 | |||||
| TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY | $ | 242,718 | $ | 238,555 | |||
| SI-BONE, INC. RECONCILIATION OF NET LOSS TO NON-GAAP ADJUSTED EBITDA (In thousands) (unaudited) | ||||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Net loss | $ | (4,334 | ) | $ | (6,542 | ) | ||
| Interest income | (1,350 | ) | (1,592 | ) | ||||
| Interest expense | 592 | 662 | ||||||
| Depreciation and amortization | 1,617 | 1,278 | ||||||
| Stock-based compensation | 6,025 | 6,663 | ||||||
| Adjusted EBITDA | $ | 2,550 | $ | 469 | ||||
| SI-BONE, INC. RECONCILIATION OF FREE CASH FLOW (In thousands) (unaudited) | ||||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Net cash used in operating activities | $ | (2,362 | ) | $ | (4,911 | ) | ||
| Less: | ||||||||
| Purchases of property and equipment | (1,077 | ) | (2,072 | ) | ||||
| Free cash flow | $ | (3,439 | ) | $ | (6,983 | ) | ||
