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Alphatec
Alphatec (ATEC) investor relations material
Alphatec Q4 2025 earnings summary
Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.Q4 2025 earnings summary24 Feb, 2026
Executive summary
Achieved Q4 2025 revenue of $213 million, up 20% year-over-year, and full-year revenue of $764 million, a 25% increase, driven by increased surgical volume and surgeon adoption.
Adjusted EBITDA for Q4 was $33 million (up 61% year-over-year, 16% margin), and $93 million for the full year (12% margin), marking significant profit margin expansion.
Free cash flow turned positive for the first full year, with $8 million in Q4 and $3 million for 2025, an improvement of $131 million year-over-year.
Net new surgeon users grew 23% in Q4 and 20% for the year, supporting durable growth and continued leadership in lateral and deformity spine procedures.
Maintained leadership in spine-focused procedural innovation, launching new platforms and expanding the procedural ecosystem.
Financial highlights
Q4 revenue: $213 million (+20% year-over-year); surgical revenue $190 million (+21%), EOS revenue $23 million (+14%).
Full-year revenue: $764 million (+25% year-over-year); surgical revenue $687 million (+26%), EOS revenue $77 million (+15%).
Q4 non-GAAP gross margin: 71%; full-year non-GAAP gross margin: 70%.
Q4 Adjusted EBITDA: $33 million (16% margin); full-year Adjusted EBITDA: $93 million (12% margin).
Ended Q4 with $161 million in cash and $60 million undrawn credit, totaling $221 million in available liquidity.
Outlook and guidance
2026 revenue guidance: $890 million (+17% year-over-year), with $805 million surgical and $85 million EOS revenue.
2026 Adjusted EBITDA guidance raised to $134 million (15% margin), up from $130 million.
Expected 2026 free cash flow of at least $20 million, with continued investment in inventory and PP&E.
Gross margin expected to approach 71% by end of 2026; operating expenses to grow ~11% vs. 17% revenue growth, driving ~400 bps operating margin improvement.
Revenue growth algorithm driven by continued surgeon adoption and utilization, with existing surgeons supporting a significant portion of 2026 volume.
Drivers of 2026 free cash flow growth
Impact of Valence/EOS on surgeon loyalty
Key drivers of operating leverage for 2026
What drives 2026 SG&A % of revenue reduction?
How to convert $2B TLIF/PLIF to PTPT procedures?
OsteoAdapt: What is the 2026 revenue contribution?
How do unique platforms like SafeOp and Valence impact future growth?
What is the market potential of Theradaptive BNP?
Drivers of improved EBITDA drop-through rate?
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Next Alphatec earnings date
Q1 202630 Apr, 2026
Alphatec
Next Alphatec earnings date
Q1 202630 Apr, 2026
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Frequently asked questions
Alphatec Holdings Inc. is a medical technology company dedicated to designing, developing, and marketing solutions for the surgical treatment of spinal disorders. The company’s product portfolio includes implants, biologics, and surgical instruments that support spine fusion and other procedures. The company serves healthcare providers specializing in spine surgery, offering solutions for degenerative conditions, deformities, and other spine-related issues. Alphatec Holdings Inc. is headquartered in Carlsbad, California, and its shares are listed on the NASDAQ.
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