MiMedx Group (MDXG) Q4 2025 earnings summary

Executive summary

• Achieved record highs for full-year revenue and adjusted EBITDA in 2025, with Q4 net sales up 27% year-over-year and full-year net sales up 20% year-over-year; net cash balance reached $148 million at year-end.

• Q4 net income reached $15 million, with adjusted EBITDA of $29 million (25% of net sales) and robust free cash flow.

• Both wound care and surgical businesses grew at or above 25% in Q4, with wound up 28% and surgical up 25%; full-year surgical growth was 20%.

• Successfully navigated Medicare reimbursement changes, maintaining profitability in wound care and strong momentum in surgical.

• Board authorized a $100 million share repurchase program over two years.

Financial highlights

• Q4 2025 net sales grew 27% year-over-year to $118 million; full-year net sales reached $419 million, up 20%.

• Q4 gross profit: $99 million (gross margin 84%, adjusted 86%); full-year gross profit: $346 million (gross margin 83%, adjusted 86%).

• Q4 adjusted EBITDA was $29 million (25% of net sales); full-year adjusted EBITDA was $106 million (over 25% margin).

• Q4 GAAP net income was $15 million ($0.10/share); adjusted net income was $20 million ($0.14/share); full-year adjusted EPS: $0.45.

• Free cash flow for 2025: $72.97 million; net cash increased by $63 million in 2025, ending at $148 million.

Outlook and guidance

• 2026 revenue guidance: $340–$360 million, with lowest revenue in Q1 and sequential increases each quarter.

• Full-year adjusted EBITDA margin expected in the mid to high teens.

• Anticipates return to double-digit, above-market top-line growth and mid-20% EBITDA margin by 2027.

• Short-term revenue impact anticipated from Medicare reimbursement changes in the wound market, but volume expected to recover over time.