Alphatec (ATEC) Q2 2026 earnings summary

Executive summary

• Q2 2026 revenue reached $214 million, up 15% year-over-year, with surgical revenue up 17% driven by 20% case volume growth and net new surgeon users up 24%.

• Adjusted EBITDA was $36 million (16.8% margin), up 53% year-over-year and 420 basis points, reflecting improved profitability and operating leverage.

• Positive free cash flow was generated, maintaining a trend of trailing twelve-month free cash flow positivity.

• Net loss for Q2 2026 was $25.8 million, an improvement from $41.1 million in Q2 2025, with EPS at $(0.16).

Financial highlights

• Q2 2026 revenue: $214 million (up from $185.5 million in Q2 2025); surgical revenue: $196 million (up 17%); EOS revenue: $17 million.

• Gross margin improved to 72.5% (non-GAAP), up 260 basis points year-over-year; GAAP gross margin was 72.2%.

• Adjusted EBITDA reached $36 million, with a margin of 16.8%.

• Operating cash flow was $34 million; positive free cash flow of $1 million for Q2.

• Ended Q2 with $119 million in cash and $85 million in available borrowing capacity.

Outlook and guidance

• Full-year 2026 revenue guidance reaffirmed at $882 million (15% growth), with $805 million from surgical revenue and $77 million from EOS revenue.

• Adjusted EBITDA guidance raised to $140 million (16% margin), up from $134 million.

• Free cash flow guidance reaffirmed at $20 million+ for the year.

• High teens surgical case volume growth expected in the second half; average revenue per case to decline low single digits for the year.