Carlsmed (CARL) Q2 2026 earnings summary

Executive summary

• Achieved Q2 2026 revenue of $18.9 million, up 57% year-over-year, driven by strong surgeon adoption and expansion of lumbar and cervical platforms.

• Gross margin expanded by 340 basis points to 76.8% in Q2 2026, reflecting production efficiencies and lower per-unit costs.

• Net loss widened to $10.5 million in Q2 2026 from $6.8 million in Q2 2025, with adjusted EBITDA at $(8.6) million.

• Surgeon user base grew over 60% year-over-year, with increased adoption in both lumbar and cervical procedures.

• Raised full-year 2026 revenue guidance to $74–78 million, representing over 50% growth at the midpoint versus 2025.

Financial highlights

• Q2 2026 revenue: $18.9 million (Q2 2025: $12.1 million), 57% year-over-year growth; H1 2026 revenue: $35.1 million (up 57.4% YoY).

• Gross profit: $14.5 million (Q2 2025: $8.9 million); gross margin: 76.8% (Q2 2025: 73.4%).

• Total operating expenses: $25.6 million (Q2 2025: $15.4 million), with increases in R&D, sales & marketing, and G&A.

• GAAP net loss: $10.5 million (Q2 2025: $6.8 million); Adjusted EBITDA: -$8.6 million (Q2 2025: -$6.2 million).

• Cash and investments at June 30, 2026: $89.3 million; total liabilities: $34 million.

Outlook and guidance

• Full-year 2026 revenue guidance raised to $74–78 million, over 50% growth at midpoint.

• Anticipates sustaining gross margins in the high 70s for the remainder of 2026.

• Key catalysts: new CMS reimbursement rule effective October 2026, commercial launches of aprevo Bilateral and Corra Cervical Plating in Q4.

• Guidance does not include incremental revenue from the new CMS rule, which is expected to be a tailwind in 2027.

• Management expects continued operating losses as commercial expansion and R&D investments persist.