Organogenesis (ORGO) Q4 2025 earnings summary

Executive summary

• Achieved record Q4 and FY 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.

• Navigated significant CMS policy changes, shifting reimbursement to PMA products and supporting innovation and higher-value offerings.

• Faced market disruption and clinician confusion in early 2026 due to CMS commentary and withdrawal of LCD coverage, impacting utilization of PMA-approved products.

• Advanced strategic initiatives, including a new manufacturing and R&D center and progress on the ReNu program targeting 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); Surgical and Sports Medicine revenue was $7.9 million in Q4 (down 2% 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.

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.

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

• Sequential revenue growth anticipated in Q3 and Q4 2026, with positive adjusted EBITDA and high teens EBITDA margins in Q4.

• Management expects normalized annual growth post-2026, with recovery and normalized growth anticipated in 2027.