Alphatec (ATEC) Q2 2026 earnings summary

Executive summary

• Q2 2026 revenue reached $214 million, up 15% year-over-year, with surgical revenue up 17% and case volume up 20%; net new surgeon users grew 24%.

• Adjusted EBITDA was $36 million (16.8%–17% margin), up 53% year-over-year and 420 basis points, with positive free cash flow.

• Net loss for Q2 2026 was $25.8 million, improved from $41.1 million in Q2 2025; non-GAAP net income was $11 million.

• Robust adoption of core procedures, international expansion, and new product launches supported growth.

• Strategic focus on clinical distinction, procedural innovation, and scalable sales force underpins long-term growth.

Financial highlights

• Q2 2026 revenue: $214 million (up from $185.5 million in Q2 2025); surgical revenue: $196 million (up 17%); EOS revenue: $17 million (flat year-over-year).

• Gross margin: 72.2% GAAP, 72.5% non-GAAP, up 260 basis points year-over-year.

• Operating expenses: $156 million GAAP, $135 million non-GAAP, up 10–11% year-over-year, but improved as a percentage of revenue.

• Adjusted EBITDA: $36 million, 16.8%–17% margin, up 420 basis points year-over-year.

• Positive free cash flow of $1 million for Q2; operating cash flow $34 million; ending cash $119 million.

Outlook and guidance

• Full-year 2026 revenue guidance reaffirmed at $882 million (15% growth), with $805 million from surgical and $77 million from EOS.

• Adjusted EBITDA guidance raised to $140 million (16% margin), up from $134 million.

• At least $20 million in free cash flow expected for the year; Q3 free cash flow projected at $4–6 million.

• High teens surgical case volume growth expected in H2, with average revenue per case to decline low single digits.