Organogenesis (ORGO) Q4 2025 earnings summary

Executive summary

• Achieved record Q4 and full-year 2025 revenue, with Q4 net product revenue of $225.1 million (up 78% YoY) and FY 2025 revenue of $563.0 million (up 17% YoY), driven by 83% YoY growth in advanced wound care sales.

• Net income rose to $43.7 million in Q4 2025 from $7.7 million in Q4 2024; FY 2025 net income was $37.0 million, up from $0.9 million in FY 2024.

• Faced a challenging environment in 2025 due to significant CMS health policy changes impacting reimbursement and market dynamics.

• Entering 2026 with near-term headwinds from clinician confusion and market disruption, but management remains optimistic about long-term prospects and expects normalized growth in 2027.

• Advanced strategic priorities, including new manufacturing/R&D facility and progress on the ReNu program for knee osteoarthritis.

Financial highlights

• Q4 2025 net product revenue was $225.1 million, up 78% year-over-year and 50% sequentially; FY 2025 revenue was $563.0 million, up 17% year-over-year.

• Advanced wound care revenue reached $217.2 million in Q4 (up 83% YoY) and $531.2 million for FY 2025 (up 17% YoY); Surgical and Sports Medicine revenue was $7.9 million in Q4 (down 2% YoY) and $31.8 million for FY 2025 (up 12% YoY).

• Gross profit for Q4 was $175.2 million (78% margin), up from 75% last year; FY 2025 gross margin was 76%.

• Operating income for Q4 was $63.3 million, up 519% YoY; FY 2025 operating income was $44.7 million, reversing a loss in FY 2024.

• Adjusted EBITDA for Q4 was $84.2 million (37% margin), up from $18.2 million last year; FY 2025 Adjusted EBITDA was $98.1 million (17% margin).

• GAAP net income for Q4 was $43.7 million, up from $7.7 million; adjusted net income was $52.9 million, up from $8.8 million.

Outlook and guidance

• FY 2026 net revenue guidance is $350–$420 million, a 25–38% decline from FY 2025, reflecting anticipated short-term disruption from CMS reimbursement changes and clinician confusion.

• Q1 2026 revenue projected to decline ~50% YoY; first-half revenue expected to decline 30–35%.

• Sequential revenue growth anticipated in Q2, with strong recovery and positive adjusted EBITDA in the second half, especially Q4.

• Management expects to return to normalized annual growth after 2026 transition, with recovery and normalized growth anticipated in 2027.