SI-BONE (SIBN) Q3 2026 earnings summary

Executive summary

• Q3 worldwide revenue rose 14.5% YoY to $55.7M; U.S. procedure volume increased 19.5%, and adjusted EBITDA reached $3.046M.

• Active U.S. physicians reached 1,770, up 16%; FY26 revenue guidance was reaffirmed at $231M–$233M.

Financial highlights

• Q3 gross profit rose 13.7% to $44.2M; gross margin was 79.3%, versus 79.8% a year earlier.

• Operating expenses increased 9.7% to $48.5M, below revenue growth; operating loss narrowed to $4.4M from $5.4M.

• Net loss narrowed to $3.620M, or $0.08 per diluted share, from $4.566M, or $0.11.

• Adjusted EBITDA rose 32.4% to $3.046M from $2.301M, with a 5.5% margin.

• Nine-month revenue increased 13.6% to $164.3M; net loss narrowed to $12.0M from $17.3M.

Outlook and guidance

• FY26 worldwide revenue guidance remained $231M–$233M, implying 15%–16% growth; gross margin guidance remained 79%.

• Operating expense growth outlook was reduced to 10.5% from 12%; adjusted EBITDA outlook remained positive.

• Guidance midpoint implies Q4 revenue growth above 20% YoY; Onyx is expected to contribute modestly in Q4, with full launch planned for January.

• Q4 growth drivers include procedure demand, physician and territory expansion, trauma seasonality, new Granite DRGs and Onyx rollout.

• Long-term operating leverage target remains OPEX growth at 1.25x–1.75x revenue growth; 2027 gross margin may face modest Onyx capacity depreciation pressure.