NeuroPace
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NeuroPace (NPCE) investor relations material

NeuroPace Q4 2025 earnings summary

Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.
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Q4 2025 earnings summary3 Mar, 2026

Executive summary

  • Achieved Q4 2025 revenue of $26.6M, up 24% year-over-year, and full-year revenue of $100M, up 25% year-over-year.

  • RNS System revenue grew 26% in Q4, driven by adoption in Level 4 centers, favorable product mix, and expanding community access.

  • Delivered second consecutive quarter of positive adjusted EBITDA and positive cash generation; Q4 adjusted EBITDA was $0.9M, full-year adjusted EBITDA was $(5.0)M.

  • Gross margin improved to 77.4% in Q4 and 77.2% for the year, reflecting manufacturing efficiencies and higher-margin product sales.

  • Submitted PMA supplement to FDA for IGE indication and launched AI-driven clinical tools.

Financial highlights

  • Q4 gross margin was 77.4%, up 200 bps year-over-year; RNS gross margin exceeded 80%.

  • Q4 operating expenses were $22.3M, up 13% year-over-year, below revenue growth.

  • Q4 net loss was $2.7M, improved from $5.3M prior year; full-year net loss was $21.5M, improved from $27.1M prior year.

  • Ended Q4 with $61.1M in cash and equivalents; long-term borrowings at year-end were $58.9M.

  • Full-year gross margin was 77.2%, up from 72.9% in 2024; RNS gross margin was 81.9%.

Outlook and guidance

  • Reiterated 2026 revenue guidance of $98M–$100M, reflecting 20–22% RNS growth, excluding IGE and DIXI contributions.

  • Q1 2026 revenue expected at $21M–$22M; full-year adjusted EBITDA loss projected at $9M–$10M.

  • Non-GAAP gross margin for 2026 expected at 81.5%–82.5%; adjusted operating expenses at $90M–$92M.

  • Expects IGE indication to contribute following potential NAUTILUS PMA-S approval in mid-2026.

  • Commercial investments front-loaded in 2026, with productivity and leverage expected to increase in H2 and 2027.

What drives IGE adoption dynamics?
Seizure ID's impact on RNS adoption
How will 2026 investments drive future leverage?
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Frequently asked questions

NeuroPace Inc designs and manufactures neurostimulation systems for the treatment of neurological disorders such as epilepsy. The company’s responsive neurostimulation technology monitors brain activity and delivers targeted stimulation to prevent seizures. It serves the medical device and neurology markets. The company is headquartered in Mountain View, California, and its shares are listed on the NASDAQ.

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