Key Highlights

  • Worldwide Revenue rose 14.5% to USD 55.7 million, and U.S. revenue rose 13.9% to USD 52.8 million.
  • U.S. procedure Volume grew about 19.5%, and active U.S. physicians rose roughly 16% to 1,770.
  • Net loss improved 20.7% to USD 3.6 million, and adjusted EBITDA was positive at USD 3.0 million.
  • Full-year revenue guidance of USD 231 million to USD 233 million was reaffirmed, with Operating Expense growth lowered to 10.5%.

Quarter in Numbers

SI-BONE, Inc. (NASDAQ:SIBN), a developer of procedural solutions for compromised bone, reported third-quarter 2026 worldwide revenue of USD 55.7 million, up 14.5% from USD 48.7 million. U.S. revenue was USD 52.8 million, up 13.9% from USD 46.4 million, and international revenue was USD 2.9 million, up 27.0% from USD 2.3 million on adoption of the iFuse TORQ and iFuse TORQ TNT products. U.S. growth benefited from roughly 19.5% growth in procedure volume, partly offset by a lower average selling price tied to procedure mix and growing Demand for the INTRA platform in office-based and ambulatory surgery settings.

Gross profit was USD 44.2 million, up 13.7%, and gross Margin was 79.3% versus 79.8%, reflecting procedure and site-of-care mix. Operating expenses rose 9.7% to USD 48.5 million from USD 44.2 million on sales commissions, Marketing for new product launches and research and development. The operating loss improved 19.2% to USD 4.4 million from USD 5.4 million.

Profitability and Cash

Net loss improved 20.7% to USD 3.6 million, or USD 0.08 per diluted share, from USD 4.6 million, or USD 0.11. Adjusted EBITDA was USD 3.0 million versus USD 2.3 million, an improvement of 32.4%. Cash from operations was USD 5.9 million, an improvement of 154.4%. Cash and equivalents were USD 146.3 million at September 30, 2026, compared with USD 145.9 million at June 30; net cash generated in the quarter was USD 0.4 million.

Product and Reimbursement Developments

The company reported 1,770 active U.S. physicians, about 16% more than a year earlier. In September it received 510(k) clearance for iFuse Granite Onyx, a breakthrough-designated device targeting failures in spine fusion procedures, with an estimated addressable market of about USD 1.5 billion annually. Chief executive Laura Francis said early uptake in the Alpha launch has been exceptional and that the new platform expands the estimated total addressable market to approximately USD 5 billion.

In October new MS-DRGs took effect for complex spinal fusion procedures incorporating iFuse Bedrock Granite, raising average hospital inpatient payments by up to about USD 50,000 per qualifying procedure. The chief executive said the company enters the fourth quarter with a record number of active physicians and favorable DRG changes.

Guidance Update Indicators

The company reaffirmed 2026 revenue guidance of USD 231 million to USD 233 million, about 15% to 16% growth, and gross margin of about 79.0%. It lowered its expectation for operating expense growth to about 10.5% at the revenue midpoint from about 12.0% in the prior guidance of August 3, and continues to project positive adjusted EBITDA.

By our calculation, third-quarter revenue of USD 55.7 million is about 24% of the midpoint of full-year guidance. Items to track include the pace of iFuse Granite Onyx adoption, the effect of lower average selling prices from procedure mix, operating expense discipline and the reimbursement change for complex fusion procedures.