SI-BONE (NASDAQ: SIBN) lifts 2026 outlook after double-digit Q1 growth
Filing Impact
Filing Sentiment
Form Type
8-K
Rhea-AI Filing Summary
SI-BONE, Inc. reported strong first quarter 2026 results and raised its full-year 2026 outlook. Worldwide revenue grew 11.2% to $52.6 million, with U.S. revenue up 10.0% to $49.3 million and international revenue up 33.9% to $3.3 million.
Gross margin remained high at 79.8%, while net loss narrowed to $4.3 million or $0.10 per share, a 33.8% improvement from the prior year period. Adjusted EBITDA turned meaningfully higher to $2.5 million from $0.5 million, and cash and equivalents were $144.7 million as of March 31, 2026.
Management increased 2026 worldwide revenue guidance to $230–$233 million, implying approximately 14–16% growth, and raised the full-year gross margin expectation to about 79%, while reaffirming expectations for positive adjusted EBITDA.
Positive
- Raised 2026 outlook with improving profitability: Management increased 2026 revenue guidance to $230–$233 million with ~14–16% growth and higher expected gross margin of ~79%, while delivering positive adjusted EBITDA of $2.5 million in Q1 2026, up sharply from $0.5 million a year earlier.
Negative
- None.
Insights
Revenue grew double digits, losses narrowed, and 2026 guidance was raised.
SI-BONE delivered Q1 2026 revenue of $52.6 million, up 11.2% year over year, with stable gross margin at 79.8%. Operating loss improved to $5.1 million, and net loss narrowed to $4.3 million.
Adjusted EBITDA rose to $2.5 million from $0.5 million, showing better operating leverage despite operating expenses growing 4.1%. Cash and equivalents were $144.7 million at March 31, 2026, versus $147.8 million at December 31, 2025, indicating modest cash usage.
Management raised 2026 revenue guidance to $230–$233 million with implied growth of about 14–16%, and increased expected gross margin to roughly 79% while still targeting positive adjusted EBITDA. Future results for fiscal 2026 will show whether the company sustains this combination of growth and margin performance.
8-K Event Classification
2 items: 2.02, 9.01
2 items
Item 2.02
Results of Operations and Financial Condition
Financial
Disclosure of earnings results, typically an earnings press release or preliminary financials.
Item 9.01
Financial Statements and Exhibits
Exhibits
Financial statements, pro forma financial information, and exhibit attachments filed with this report.
Key Figures
Q1 2026 Revenue: $52.6 million
Q1 2026 Gross Margin: 79.8%
Q1 2026 Net Loss: $4.3 million
+5 more
8 metrics
Q1 2026 Revenue
$52.6 million
Worldwide revenue, up 11.2% year over year
Q1 2026 Gross Margin
79.8%
Stable versus prior-year period
Q1 2026 Net Loss
$4.3 million
Improved 33.8% from $6.5 million in Q1 2025
Q1 2026 Adjusted EBITDA
$2.5 million
Up from $0.5 million in Q1 2025
Cash and Equivalents
$144.7 million
Balance as of March 31, 2026
2026 Revenue Guidance
$230–$233 million
Implied 14–16% year-over-year growth
2026 Gross Margin Guidance
≈79%
Raised from prior ≈78% outlook
Free Cash Flow Q1 2026
-$3.4 million
Negative free cash flow for the quarter
Key Terms
Adjusted EBITDA, free cash flow, gross margin, MS-DRG, +1 more
5 terms
Adjusted EBITDA financial
"Adjusted EBITDA was $2.5 million in the first quarter 2026, improving from an adjusted EBITDA of $0.5 million in the corresponding period in 2025."
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.
free cash flow financial
"Free cash flow is defined as net cash provided by operating activities less purchases of property and equipment."
Free cash flow is the amount of money a company has left over after paying all its expenses and investing in its business, like buying equipment or updating facilities. It shows how much cash is available to reward shareholders, pay down debt, or save for future growth. This helps investors understand if a company is financially healthy and able to grow.
gross margin financial
"Gross margin in the first quarter 2026 was stable compared to the prior year period at 79.8%."
Gross margin is the difference between how much money a company makes from selling its products and how much it costs to produce them, expressed as a percentage of sales. It shows how efficiently a company is turning sales into profit before other expenses like marketing or salaries. Higher gross margin means the company keeps more money from each sale, which is a good sign of financial health.
MS-DRG regulatory
"CMS proposes... the creation of a new MS-DRG family with higher payment for hospitals supporting complex spinal fusion procedures that incorporate iFuse Bedrock Granite"
MS-DRG stands for Medicare Severity Diagnosis Related Group, a hospital payment system that groups patient stays by diagnosis and how serious the case is to set a fixed payment amount. Think of it like a flat price tag for a particular level of care: hospitals receive that amount regardless of exact costs, so changes to MS-DRG rules or case mix directly affect hospital revenues, profit margins, and the financial outlook for companies that sell hospital services, equipment, or drugs.
Inpatient Rule regulatory
"including CMS's finalization of the proposed FY 2027 Inpatient Rule referenced herein"
Earnings Snapshot
Revenue: $52.6 million · Guidance included
Q1 2026
Revenue
$52.6 million
+11.2% YoY
Net loss
$4.3 million
33.8% improvement YoY
Gross margin
79.8%
stable YoY
Adjusted EBITDA
$2.5 million
up from $0.5 million YoY
Guidance
For 2026, SI-BONE guides revenue to $230–$233 million (≈14–16% growth), expects gross margin of about 79%, operating expenses growing ~12.5% at the revenue midpoint, and positive adjusted EBITDA.
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
____________________________________________________________________________
FORM 8-K
____________________________________________________________________________
CURRENT REPORT
Pursuant to Section 13 or 15(d) of
the Securities Exchange Act of 1934
Date of report (Date of earliest event reported): May 11, 2026
____________________________________________________________________________
(Exact name of registrant as specified in its charter)
____________________________________________________________________________
| (State or other jurisdiction of incorporation or organization) | (Commission File Number) | (I.R.S. Employer Identification No.) | ||||||||||||
(Address of principal executive offices) (Zip Code)
(408 ) 207-0700
(Registrant’s telephone number, include area code)
N/A
(Former Name or Former Address, if Changed Since Last Report)
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
| Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) | |||||
| Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) | |||||
| Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) | |||||
| Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) | |||||
Securities registered pursuant to Section 12(b) of the Act:
| Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||||||
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
Emerging growth company ☐
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Item 2.02. Results of Operations and Financial Condition.
On May 11, 2026, SI-BONE, Inc. (the “Company”) issued a press release (the “Press Release”) announcing results for the quarter ended March 31, 2026. A copy of the Press Release is attached as Exhibit 99.1 to this current report on Form 8-K and is incorporated by reference herein.
The information under Item 2.02 in this current report on Form 8-K and the related information in the exhibit attached hereto shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) or otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, regardless of any general incorporation language in such filing.
Item 9.01. Financial Statements and Exhibits.
(d) Exhibits
| Exhibit No. | Description | |||||||
| 99.1 | Press Release dated May 11, 2026 | |||||||
| 104 | Cover Page Interactive Date File (embedded within the Inline XBRL document) | |||||||
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
| SI-BONE, INC. | |||||||||||
| Date: | May 11, 2026 | By: | /s/ Anshul Maheshwari | ||||||||
| Anshul Maheshwari | |||||||||||
Chief Operating Officer & Financial Officer | |||||||||||
| (Principal Financial and Accounting Officer) | |||||||||||
Exhibit 99.1
SI-BONE, Inc. Reports Financial Results for the First Quarter 2026 and Raises 2026 Guidance
Delivered ~11% worldwide revenue growth, record physician engagement and ~440% improvement in adjusted EBITDA
First Quarter 2026 Financial Highlights (all comparisons are to the prior year period)
•Worldwide revenue of $52.6 million, representing growth of 11.2%
•U.S. revenue of $49.3 million, representing growth of 10.0%
•Gross margin of 79.8%
•Net loss of $4.3 million, representing an improvement of 33.8%
•Adjusted EBITDA of $2.5 million, representing an improvement of over 440%
•$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 of 11%
•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 - 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 $52.6 million in the first quarter 2026, a 11.2% increase from $47.3 million in the corresponding period in 2025. U.S. revenue for the first quarter 2026 was $49.3 million, a 10.0% increase from $44.8 million in the corresponding period in 2025. U.S revenue growth benefited from expanded adoption of the product portfolio across all sites of care and increased sales channel coverage. International revenue for the first quarter 2026 was $3.3 million, a 33.9% increase from $2.5 million in the corresponding period in 2025. International revenue growth reflects the growing demand for iFuse TORQ.
Gross profit was $41.9 million in the first quarter 2026, an increase of 11.3% from $37.7 million in the corresponding period in 2025. Gross margin in the first quarter 2026 was stable compared to the prior year period at 79.8%.
Operating expenses increased 4.1% to $47.0 million in the first quarter 2026, as compared to $45.2 million in the corresponding period in 2025. The change in operating expenses was primarily driven by general commercial activity related to higher revenue and new product rollout.
Operating loss improved by 31.9% to $5.1 million in the first quarter 2026, as compared to an operating loss of $7.5 million in the corresponding period in 2025.
Net loss improved by 33.8% to $4.3 million, or $0.10 per diluted share, in the first quarter 2026, as compared to a net loss of $6.5 million, or $0.15 per diluted share, in the corresponding period in 2025.
Adjusted EBITDA was $2.5 million in the first quarter 2026, improving from an adjusted EBITDA of $0.5 million in the corresponding period in 2025.
Cash and equivalents as of March 31, 2026 were $144.7 million, compared to $147.8 million as of December 31, 2025.
Updated Fiscal 2026 Financial Guidance
SI-BONE increased 2026 worldwide revenue expectation to be in the range of $230 million to $233 million, implying year-over-year growth of ~14% to 16%. SI-BONE increased its estimate for full year 2026 gross margin to ~79%.
Fiscal Year 2026 Guidance | ||||||||
New (May 11, 2026) | Prior (February 23, 2026) | |||||||
| Revenue | $230.0M - $233.0M ~14-16% growth | $228.5M - $232.5M ~14%-16% growth | ||||||
| Gross Margin | ~79.0% | ~78.0% | ||||||
| Operating Expenses | ~12.5% growth at revenue midpoint | ~12.5% growth 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) | ||||||||||
FAQ
How did SI-BONE (SIBN) perform financially in Q1 2026?
SI-BONE reported Q1 2026 revenue of $52.6 million, up 11.2% year over year. Gross margin stayed strong at 79.8%. Net loss improved to $4.3 million, or $0.10 per share, and adjusted EBITDA increased to $2.5 million.
What were SI-BONE (SIBN) U.S. and international revenues in Q1 2026?
In Q1 2026, SI-BONE generated $49.3 million of U.S. revenue, a 10.0% increase from 2025, and $3.3 million of international revenue, up 33.9%. International growth reflected rising demand for the company’s iFuse TORQ product portfolio.
Did SI-BONE (SIBN) improve profitability metrics in Q1 2026?
Yes. SI-BONE’s net loss narrowed to $4.3 million, a 33.8% improvement versus 2025. Adjusted EBITDA rose to $2.5 million from $0.5 million, supported by double-digit revenue growth and relatively modest operating expense growth of 4.1%.
What guidance did SI-BONE (SIBN) provide for fiscal year 2026?
For 2026, SI-BONE now expects worldwide revenue of $230–$233 million, implying about 14–16% growth. The company raised its full-year gross margin outlook to approximately 79% and continues to anticipate positive adjusted EBITDA for the year.
What is SI-BONE (SIBN)'s cash position after Q1 2026?
As of March 31, 2026, SI-BONE held $144.7 million in cash and equivalents. Total current assets were $214.7 million, including short-term investments of $111.1 million, providing a substantial liquidity cushion to support ongoing operations and growth initiatives.
How did SI-BONE (SIBN) define its non-GAAP measures in this report?
SI-BONE uses non-GAAP Adjusted EBITDA and free cash flow. Adjusted EBITDA adds back interest income and expense, depreciation and amortization, and stock-based compensation. Free cash flow is defined as net cash provided by operating activities minus purchases of property and equipment.