SI-BONE (SIBN) Q1 2026 earnings summary

Executive summary

• Achieved 11.2% worldwide revenue growth to $52.6 million in Q1 2026, with U.S. revenue at $49.3 million (+10%) and international revenue at $3.3 million (+33.9%).

• Adjusted EBITDA rose over 440% to $2.5 million, reflecting strong operating leverage.

• Net loss narrowed to $4.3 million ($0.10/share), improved from $6.5 million ($0.15/share) a year ago.

• Record physician engagement with over 1,650 active U.S. physicians and expanded international presence through new product launches.

• Raised full-year 2026 revenue guidance to $230–$233 million, implying 14–16% growth, and increased gross margin guidance to ~79%.

Financial highlights

• Gross profit reached $41.9 million (+11.3% year-over-year), with gross margin stable at 79.8%.

• Operating expenses grew 4.1% to $47.0 million, well below revenue growth, demonstrating strong operating leverage.

• Free cash flow improved to -$3.4 million, a 50.7% year-over-year improvement.

• Cash and marketable securities stood at $144.7 million at quarter-end.

• Annual revenue per territory manager: $2.2 million, up 11% year-over-year.

Outlook and guidance

• Full-year 2026 revenue guidance raised to $230–$233 million (14–16% growth), with acceleration expected in H2 2026 and into 2027.

• Gross margin guidance increased to ~79%, up 100 bps from prior guidance.

• Operating expenses expected to grow ~12.5% at the midpoint of revenue guidance.

• Management expects existing cash and marketable securities to fund operations for at least the next 12 months.

• Anticipates higher cash flow variability in Q2–Q3 due to headquarters build-out and timing of reimbursements.