SI-BONE, Inc. Reports Financial Results for the Third Quarter 2026 and Reaffirms 2026 Revenue Guidance

Expected operating expense growth was reduced while full-year revenue, gross margin and positive adjusted EBITDA guidance remained unchanged.

Rhea-AI Summary

SI-BONE (SIBN) reported third-quarter 2026 revenue of $55.7 million, up year over year, and reaffirmed its full-year revenue outlook. Revenue rose 14.5%, with U.S. revenue up 13.9% to $52.8 million and international revenue up 27.0% to $2.9 million. Net loss narrowed to $3.6 million, or $0.08 per diluted share, from $4.6 million, or $0.11 per share. Gross margin fell to 79.3% from 79.8%.

SI-BONE maintained 2026 revenue guidance of $231 million–$233 million, approximately 15–16% growth, and approximately 79.0% gross margin. It lowered expected operating expense growth at the revenue midpoint to approximately 10.5% from approximately 12.0%, while retaining positive adjusted EBITDA guidance. September brought FDA 510(k) clearance for iFuse Granite Onyx. New hospital payment classifications took effect in October, increasing average inpatient payments by up to approximately $50,000 per qualifying procedure incorporating iFuse Bedrock Granite.

21 points · 0 major

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0 major · 4 points

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

Positive

• Moderate pointThird-quarter revenue rose 14.5% year over year to $55.7 million.
• Moderate pointU.S. procedure volume grew approximately 20% year over year in the third quarter.
• Moderate pointThird-quarter operating loss narrowed 19.2% year over year to $4.4 million from $5.4 million.
• Moderate pointThird-quarter net loss narrowed 20.7% to $3.6 million; diluted loss per share improved to $0.08 from $0.11.
• Moderate pointThird-quarter adjusted EBITDA rose to $3.046 million from $2.301 million a year earlier.
• Moderate pointThird-quarter operating cash flow was positive $5.9 million, improving 154.4% year over year.
• Moderate point. Forward-looking: it has not happened yet and may not happen.Expected 2026 operating expense growth fell to approximately 10.5% from approximately 12.0%, at the revenue midpoint.

14 minor points

• Minor pointU.S. revenue increased 13.9% year over year to $52.8 million in the third quarter.
• Minor pointInternational revenue increased 27.0% year over year to $2.9 million in the third quarter.
• Minor pointActive U.S. physicians reached 1,770, up approximately 16% year over year.
• Minor pointThird-quarter gross profit increased 13.7% year over year to $44.2 million.
• Minor pointThird-quarter net cash generated reached $0.4 million, versus $0.2 million a year earlier.
• Minor point. Forward-looking: it has not happened yet and may not happen.2026 revenue guidance remains $231 million–$233 million, approximately 15–16% growth; gross margin guidance remains approximately 79.0%.
• Minor point. Forward-looking: it has not happened yet and may not happen.Positive adjusted EBITDA guidance remains in place for fiscal 2026.
• Minor pointiFuse Granite Onyx received FDA 510(k) clearance in September for targeting failures in spine fusion procedures.
• Minor pointOctober hospital payment changes increased average inpatient payments by up to approximately $50,000 per qualifying iFuse Bedrock Granite procedure.
• Minor pointNine-month revenue reached $164.302 million, versus $144.576 million in the corresponding 2025 period.
• Minor pointNine-month net loss narrowed to $12.042 million from $17.260 million; diluted loss per share improved to $0.27 from $0.40.
• Minor pointNine-month adjusted EBITDA increased to $8.432 million from $3.790 million a year earlier.
• Minor pointNine-month operating cash flow improved to positive $4.355 million from negative $2.403 million a year earlier.
• Minor pointNine-month free cash outflow narrowed to $4.634 million from $9.529 million a year earlier.

Negative

• Moderate pointThird-quarter operating expenses increased 9.7% year over year to $48.5 million.
• Minor pointThird-quarter gross margin declined to 79.3% from 79.8% a year earlier, driven by procedure and care-setting mix.
• Minor pointLower average selling prices partially offset U.S. procedure growth, reflecting procedure mix and growing INTRA demand in outpatient settings.
• Minor pointNine-month operating expenses increased to $144.909 million from $135.215 million a year earlier.

News Explained

Positive adjusted EBITDA did not prevent SI-BONE from reporting a $3.6 million third-quarter net loss.

SI-BONE reported third-quarter results; at September 30, 2026, it listed $146.3 million in cash and equivalents, compared with $145.9 million at June 30, 2026, and reported $5.9 million of positive operating cash flow for the quarter.

Adjusted EBITDA was positive at $3.0 million alongside a $3.6 million net loss, so the reported measures present different quarterly earnings outcomes.

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Market Reaction – SIBN

$19.90 – $21.86 Day Range

$900.85M Mkt Cap at Last Price

On Nov 2, the day this news came out, the latest delayed price for SIBN is 0.59% below the previous close. Our momentum scanner has recorded 14 alerts for this stock so far that day. The latest delayed price is $20.10. Relative volume is elevated at 2.5x what this stock usually trades by this time of day.

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Key Figures

Worldwide revenue: $55.7 million; +14.5% Gross margin: 79.3% Net loss: $3.6 million +4 more

Worldwide revenue

$55.7 million; +14.5%

Q3 2026; compared with $48.7 million in Q3 2025

Gross margin

79.3%

Q3 2026; compared with 79.8% in Q3 2025

Net loss

$3.6 million

Q3 2026; improved from $4.6 million in Q3 2025

Adjusted EBITDA

$3.0 million

Q3 2026; compared with $2.3 million in Q3 2025

Cash and equivalents

$146.3 million

As of September 30, 2026

Worldwide revenue guidance

$231 million–$233 million

Fiscal 2026; reaffirmed

Operating expense growth expectation

~10.5%

Fiscal 2026 at the revenue midpoint; previously ~12.0%

Previous Earnings Reports

1 past event · Latest: Aug 03

Same Type 1 event

1. Aug 03

   Q2 earnings results

   24h Move

   -0.1%

   Raised 2026 revenue guidance to $231–$233 million and projected operating expense growth near 12%.

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

Key Terms

510(k) clearance, adjusted EBITDA, MS-DRGs, breakthrough device

4 terms

510(k) clearance regulatory

"received 510(k) clearance for iFuse Granite Onyx"

A 510(k) clearance is a U.S. regulatory approval that lets a medical device be sold because it is shown to be substantially similar to an already-legal device; think of it as a passport saying the new product is close enough to a known item to enter the market without a full, lengthy review. For investors, 510(k) clearance signals faster, lower-cost market access and reduced regulatory risk compared with new, untested device pathways, which can materially affect timelines, costs and revenue prospects.

adjusted EBITDA financial

"Positive adjusted EBITDA of $3.0 million"

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.

MS-DRGs regulatory

"new MS-DRGs took effect for complex spinal fusion procedures"

A system that groups hospital inpatient stays into categories called Medicare Severity Diagnosis-Related Groups (MS-DRGs) based on patients' main diagnoses, procedures and complication levels. Each group has a set payment weight used by Medicare and other payers to determine how much hospitals are reimbursed, so changes in groupings or reimbursement rates act like changing the price list for hospital services and can materially affect hospital revenue and margins.

breakthrough device regulatory

"a FDA breakthrough device targeting failures in spine fusion procedures"

'Breakthrough device' is a regulatory designation for a medical device judged to offer a substantial improvement in diagnosing or treating a serious or life‑threatening condition, granting it priority review and more intensive interaction with regulators to accelerate approval. For investors, it matters because the label can shorten time to market and reduce regulatory uncertainty—like putting a product into the fast lane—potentially raising commercial value and lowering development risk.

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

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Delivered ~20% U.S. procedure volume growth in the third quarter

Third Quarter 2026 Financial Highlights (all comparisons are to the prior year period)

• Worldwide revenue of $55.7 million, representing growth of 14.5%  
• U.S. revenue of $52.8 million, representing growth of 13.9%
• Gross margin of 79.3%  
• Net loss of $3.6 million, representing an improvement of 20.7%  
• Positive adjusted EBITDA of $3.0 million, representing an improvement of 32.4%
• Positive cash from operations of $5.9 million, representing an improvement of 154.4%
• $146.3 million in cash and equivalents
  

Recent Operational Highlights (any comparisons are to the prior year period)

• 1,770 active U.S. physicians, representing growth of ~16%      
• In September, received 510(k) clearance for iFuse Granite Onyx, a FDA breakthrough device targeting failures in spine fusion procedures, with an estimated total addressable market of ~$1.5 billion annually
• In October, new MS-DRGs took effect for complex spinal fusion procedures incorporating iFuse Bedrock Granite, increasing average hospital inpatient payments by up to ~$50,000 per qualifying procedure
  

SAN JOSE, Calif., Nov. 02, 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 September 30, 2026.

“Robust third-quarter growth in procedure volumes and active physicians underscores rising demand for our diversified and differentiated platform technologies,” said Laura Francis, Chief Executive Officer. “We enter the fourth quarter with a record number of active physicians, favorable DRG changes and exceptional early uptake in our alpha launch of iFuse Granite Onyx, our new platform technology that expands our estimated total addressable market to approximately $5 billion. These drivers position us for an excellent finish to 2026 and enter 2027 with the strongest foundation for growth acceleration in our company's history.”

Third Quarter 2026 Financial Results
Worldwide revenue was $55.7 million in the third quarter 2026, a 14.5% increase from $48.7 million in the corresponding period in 2025. U.S. revenue for the third quarter 2026 was $52.8 million, a 13.9% increase from $46.4 million in the corresponding period in 2025. U.S. revenue growth benefited from approximately 19.5% growth in procedure volume partially offset by lower average selling price due to procedure mix and the growing interventional spine physician demand for the INTRA platform in the office-based and ASC sites of care. International revenue for the third quarter 2026 was $2.9 million, a 27.0% increase from $2.3 million in the corresponding period in 2025. International revenue growth reflects the increasing adoption of iFuse TORQ and iFuse TORQ TNT.

Gross profit was $44.2 million in the third quarter 2026, an increase of 13.7% from $38.8 million in the corresponding period in 2025. Gross margin was 79.3% for the third quarter 2026, compared to 79.8% in the corresponding period in 2025 driven by procedure and site of care mix.

Operating expenses increased 9.7% to $48.5 million in the third quarter 2026, as compared to $44.2 million in the corresponding period in 2025. The increase was primarily driven by higher sales commissions on increased revenue, marketing to support new product launches and continued investment in research and development.

Operating loss improved by 19.2% to $4.4 million in the third quarter 2026, as compared to an operating loss of $5.4 million in the corresponding period in 2025.

Net loss improved by 20.7% to $3.6 million, or $0.08 per diluted share, in the third quarter 2026, as compared to a net loss of $4.6 million, or $0.11 per diluted share, in the corresponding period in 2025.

Adjusted EBITDA was $3.0 million in the third quarter 2026, improving from an adjusted EBITDA of $2.3 million in the corresponding period in 2025.

Cash and equivalents as of September 30, 2026 were $146.3 million, compared to $145.9 million as of June 30, 2026. Net cash generated was $0.4 million in the third quarter 2026, compared to $0.2 million in net cash generated during the corresponding period in 2025.

Updated Fiscal 2026 Outlook
SI-BONE reaffirms its previously issued 2026 worldwide revenue and gross margin guidance. Based on year to date operating expense trend the Company is reducing the operating expense growth expectation to 10.5%.

	Fiscal Year 2026 Guidance
	Updated (November 2, 2026)	Prior (August 3, 2026)
Revenue	$231M - $233M ~15-16% growth	$231M - $233M ~15-16% growth
Gross Margin	~79.0%	~79.0%
Operating Expenses	~10.5% growth at revenue midpoint	~12.0% growth at revenue midpoint
Adjusted EBITDA	Positive	Positive

Webcast Information
SI-BONE will host a conference call to discuss the third quarter 2026 financial results after market close on Monday, November 2, 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/qa2u8o97. 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 over 160,000 procedures. A unique body of clinical evidence supports the use of SI-BONE's technologies, including four randomized controlled trials and nearly 200 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^®, iFuse TORQ TNT^®, iFuse Granite Onyx™, and iFuse INTRA^® are 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, 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 September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
Revenue	$	55,704			$	48,656			$	164,302			$	144,576
Cost of goods sold		11,537				9,810				33,643				29,228
Gross profit		44,167				38,846				130,659				115,348
Operating expenses:
Sales and marketing		33,850				29,956				100,682				91,418
Research and development		4,562				4,242				13,975				13,085
General and administrative		10,106				10,031				30,252				30,712
Total operating expenses		48,518				44,229				144,909				135,215
Loss from operations		(4,351	)			(5,383	)			(14,250	)			(19,867	)
Interest and other income (expense), net:
Interest income		1,348				1,515				4,030				4,627
Interest expense		(608	)			(670	)			(1,798	)			(1,998	)
Other income (expense)		(9	)			(28	)			(24	)			(22	)
Net loss	$	(3,620	)		$	(4,566	)		$	(12,042	)		$	(17,260	)
Net loss per share, basic and diluted	$	(0.08	)		$	(0.11	)		$	(0.27	)		$	(0.40	)
Weighted-average number of common shares used to compute basic and diluted net loss per share		44,899,517				43,188,524				44,451,298				42,775,206

SI-BONE, INC. CONDENSED CONSOLIDATED BALANCE SHEETS (in thousands) (unaudited)
	September 30, 2026				December 31, 2025
ASSETS
Current assets:
Cash and cash equivalents	$	35,311			$	42,240
Short-term investments		110,949				105,583
Accounts receivable		31,469				29,915
Inventory		42,354				33,897
Prepaid expenses and other current assets		4,567				4,480
Total current assets		224,650				216,115
Property and equipment, net		25,304				21,298
Operating lease right-of-use assets		6,613				1,087
Other non-current assets		204				55
TOTAL ASSETS	$	256,771			$	238,555
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable	$	10,503			$	4,631
Accrued liabilities and other		18,785				19,704
Operating lease liabilities, current portion		331				944
Total current liabilities		29,619				25,279
Long-term borrowings		35,657				35,569
Operating lease liabilities, net of current portion		6,813				175
TOTAL LIABILITIES		72,089				61,023
STOCKHOLDERS’ EQUITY
Common stock		4				4
Additional paid-in capital		646,696				626,970
Accumulated other comprehensive income		282				816
Accumulated deficit		(462,300	)			(450,258	)
TOTAL STOCKHOLDERS’ EQUITY		184,682				177,532
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$	256,771			$	238,555

SI-BONE, INC. RECONCILIATION OF NET LOSS TO NON-GAAP ADJUSTED EBITDA (In thousands) (unaudited)
		Three Months Ended September 30,								Nine Months Ended September 30,
			2026				2025				2026				2025
Net loss		$	(3,620	)		$	(4,566	)		$	(12,042	)		$	(17,260	)
Interest income			(1,348	)			(1,515	)			(4,030	)			(4,627	)
Interest expense			608				670				1,798				1,998
Depreciation and amortization			1,693				1,486				4,989				4,132
Stock-based compensation			5,713				6,226				17,717				19,547
Adjusted EBITDA		$	3,046			$	2,301			$	8,432			$	3,790

SI-BONE, INC. RECONCILIATION OF FREE CASH FLOW (In thousands) (unaudited)
		Nine Months Ended September 30,
			2026				2025
Net cash provided by (used in) operating activities		$	4,355			$	(2,403	)
Less:
Purchases of property and equipment			(8,989	)			(7,126	)
Free cash flow		$	(4,634	)		$	(9,529	)

FAQ

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

What were SI-BONE's third-quarter 2026 revenue and earnings results?

SI-BONE reported $55.7 million in revenue and a $3.6 million net loss, or $0.08 per diluted share. Revenue increased 14.5% year over year, while net loss improved 20.7% from $4.6 million, or $0.11 per diluted share.

What is SI-BONE's full-year 2026 guidance?

SI-BONE expects $231 million–$233 million in revenue, approximately 15–16% growth, approximately 79.0% gross margin and positive adjusted EBITDA. Expected operating expense growth at the revenue midpoint was reduced to approximately 10.5% from approximately 12.0%.

Why did SI-BONE's operating expenses increase in the third quarter of 2026?

Operating expenses increased primarily because of higher sales commissions on increased revenue, marketing supporting new product launches and continued research and development investment. Total operating expenses reached $48.5 million, up 9.7% from the corresponding 2025 quarter.