Key Highlights

  • Third-quarter Revenue rose 64.9% to USD 21.6 million from USD 13.1 million, which the filing attributes to higher procedure Volume with average revenue per procedure substantially constant.
  • Net loss widened to USD 12.2 million, or USD 0.45 per share, from USD 8.5 million, or USD 0.40, while adjusted EBITDA improved to negative USD 7.3 million from negative USD 8.2 million.
  • Gross Margin expanded to 77.3% from 75.9%, and management raised 2026 revenue guidance to USD 78 million to USD 80 million from USD 74 million to USD 78 million.
  • Cash, restricted cash and investments totaled USD 80.3 million on September 30, 2026, with quarterly cash burn of USD 9 million and a term Loan balance of USD 15.6 million.

Procedure Volume Powers a 65% Jump in Quarterly Revenue

Carlsmed (NASDAQ:CARL) filed its Quarterly Report on November 10, 2026 and held its Earnings Call the same day. The medical technology company sells personalized spine surgery kits, pairing AI-built surgical plans with patient-specific implants for lumbar and cervical fusion. Revenue for the quarter ended September 30, 2026 was USD 21.6 million, against USD 13.1 million a year earlier. Management said procedure volume grew 76% and the trained surgeon base grew more than 60%, with the lumbar Franchise making up 88% of revenue. Nine-month revenue was USD 56.6 million, up 60.2%. Management said it delivers kits in about a week and that the new lumbar diagnosis-related group codes effective October 1 should ease hospital adoption.

Executive Transition Costs Lift the Loss Above Operating Gains

Net loss was USD 12.2 million against USD 8.5 million. Operating expenses rose 54.9% to USD 29.4 million, and general and administrative expense doubled to USD 10.0 million, including about USD 1.4 million of severance and accelerated share-based pay tied to executive separations plus USD 0.5 million of recruiting fees. The filing lists USD 2.4 million of executive transition costs and USD 0.45 million of legal settlements as adjustments. Excluding these, adjusted EBITDA, a non-GAAP measure, improved by about USD 1.0 million. Management called it the first quarter of positive Operating Leverage and said adjusted net loss per share was USD 0.34. Nine-month net loss was USD 31.5 million, or USD 1.16 per share, with the prior-year per-share figure affected by a smaller share count before the July 2025 offering.

Raised Outlook Rests on Reimbursement Changes and New Launches

On the call, management said fourth-quarter catalysts include higher lumbar volume after the October 1 payment rule and launches of the aprevo posterior bilateral system and the corra cervical plating system. It expects gross margin to remain in the high 70s and fourth-quarter stock-based compensation of USD 2.75 million to USD 3.0 million. Management said the new range represents over 56% growth at the midpoint. Risks include reliance on contract manufacturers, reimbursement changes, a loss-making cost base and USD 15.6 million of Debt due under a Facility that matures in October 2030. Cash burn of USD 9 million in the quarter against USD 80.3 million of Liquidity frames how long the growth plan can be self-funded.

Where Things Stand

Because revenue is scaling faster than most costs, though not yet fast enough to close the gap. Carlsmed (NASDAQ:CARL) lifted revenue 64.9% and widened gross margin by about 140 basis points, yet GAAP net loss grew 43.6% as it added sales staff, AI development and executive transition costs. Adjusted EBITDA improved, which management framed as an inflection point toward profitability without giving a date. Watch fourth-quarter volume after the new reimbursement codes, the two product launches, and how quickly cash burn compares with the USD 80.3 million on hand.