Xtant Medical (XTNT) Q4 2025 earnings summary

Executive summary

• Full year 2025 revenue reached $134.0 million, up 14% year-over-year, with Q4 revenue of $32.4 million, despite a $2 million impact from the early closing of the Companion Spine transaction.

• Returned to profitability with net income of $5.0 million for 2025, compared to a net loss of $16.5 million in 2024.

• Achieved positive adjusted EBITDA of $16.3 million for 2025, reversing a $2.3 million loss in 2024.

• Completed divestiture of non-core Coflex, CoFix, and international hardware businesses for $21.4 million in cash, sharpening focus on high-margin biologics.

• Launched new products, including nanOss Strata and CollagenX, and expanded the sales force to drive growth.

Financial highlights

• Q4 2025 gross margin was 54.9%, up from 50.8% in Q4 2024; full year 2025 gross margin was 62.9%, up from 58.2% in 2024.

• Q4 2025 net income was $57,000; full year 2025 net income was $5 million.

• Adjusted EBITDA for 2025 was $16.3 million, up from a $2.3 million loss in 2024.

• Operating expenses for 2025 were $77.0 million, down from $80.3 million in 2024.

• Cash and equivalents at year-end 2025 were $17.3 million, with an additional $10.7 million received post-year-end.

Outlook and guidance

• 2026 revenue guidance is $95–$99 million, reflecting the impact of divestitures and non-recurring license revenue expirations.

• Organic growth in core biologics is expected to accelerate as the expanded commercial team and new products gain traction.

• Commitment to maintaining positive free cash flow at guided revenue levels and no anticipated need for additional outside capital.

• Biologics revenue expected to decline low double digits in Q1 2026 year-over-year, with sequential growth anticipated in later quarters.

• Hardware revenue expected to decline at a steady high-teens percentage rate in 2026.