Carlsmed (CARL) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue grew 58–58.2% year-over-year to $16.1 million, driven by increased surgeon adoption, higher procedure volumes, and strong product launches including AI-enabled personalized spine surgery solutions.

• Gross margin improved to 77.1% from 74.9% in Q1 2025, reflecting efficiency gains and production scale.

• Net loss widened to $8.7 million from $5.7 million year-over-year, primarily due to increased investments in R&D, sales, and administrative functions.

• Expanded surgeon user base by over 60% year-over-year, with new product launches such as the corra™ personalized cervical plating system and aprevo cervical fusion procedure.

• Maintained strong liquidity with $97.1 million in cash, restricted cash, and short-term investments as of March 31, 2026.

Financial highlights

• Q1 2026 revenue was $16.1 million, up from $10.2 million in Q1 2025, a 58–58.2% increase year-over-year.

• Gross profit rose to $12.4 million, with gross margin at 77.1% in Q1 2026.

• Operating expenses increased to $21.7 million, with R&D at $5.2 million, sales and marketing at $10.3 million, and G&A at $6.2 million.

• Adjusted EBITDA was -$7.5 million in Q1 2026.

• Cash used in operating activities was $13 million in Q1 2026.

Outlook and guidance

• Full-year 2026 revenue guidance raised to $72–77 million, representing 48% growth at the midpoint over 2025.

• Expect gross margins to remain in the mid to high 70s and operating expense leverage to improve with revenue ramp.

• Management anticipates continued operating losses as commercial expansion and product development continue, but expects improvement in adjusted EBITDA as revenue grows.