Key Highlights

  • Net sales of USD 62.3 million fell 45% and came in below the USD 68.56 million consensus estimate.
  • Surgical sales rose 9% to USD 40.0 million, while Wound sales dropped 71% to USD 22.3 million after Medicare changes.
  • Gross margin improved about 11 percentage points from the second quarter to 79.8%, helping adjusted EBITDA return to positive territory.
  • The pending Sanara MedTech acquisition received an FTC second request on October 15, extending the antitrust waiting period.

MiMedx Group, Inc. (NASDAQ:MDXG) reported third-quarter 2026 net sales of USD 62.3 million, down 45.2% from USD 113.7 million a year earlier and below a consensus estimate of USD 68.56 million. The GAAP net loss was USD 8.7 million, or USD 0.06 per diluted share, against net income of USD 16.7 million, or USD 0.11, in the prior-year quarter.

Adjusted net loss was about USD 1 million, or USD 0.01 per share, compared with adjusted net income of USD 23 million, or USD 0.15. Chief executive Joe Capper said the Surgical business performed well despite softer procedure volumes across the industry, while Wound Care continued to work through the reset triggered by Medicare reimbursement changes.

Segment Split and Cost Reset

Surgical contributed 64% of net sales, with volume growth in the mid-teens, though a placental tissue business-to-business sale of close to USD 1 million in the prior-year quarter and higher promotional rebates dampened the 9% revenue gain. Wound Care fell to USD 22.3 million as the January 1, 2026 reimbursement changes cut both pricing and volumes. Wound Care Center unit volume rose more than 20% year over year and 7% sequentially.

Gross margin was 79.8% versus 83.5% a year earlier, as lower Wound pricing and mix offset cost savings. Selling and marketing expense fell 26.3% to USD 39.6 million, and research and development dropped 24.5% to USD 2.8 million. General and administrative expense rose 22.4% to USD 18.7 million on USD 6 million of added legal and Sanara transaction costs. Adjusted EBITDA was about USD 2 million, against USD 35 million a year earlier and roughly USD 10 million better than the second quarter.

Guidance, Sanara Deal and Financing

The company updated its stand-alone 2026 outlook to net sales of USD 250 million to USD 260 million, excluding Sanara, and anticipates modest sequential growth in fourth-quarter adjusted EBITDA. Management also pointed to fourth-quarter gross margin near the third-quarter level, sales and marketing at 58% to 60% of net sales, general and administrative of USD 18 million to USD 19 million, and research and development of USD 3 million to USD 3.5 million.

The Sanara agreement values the target at about USD 350 million in enterprise value, with roughly USD 303 million of cash and 4.4 million shares as consideration. A USD 300 million Hayfin term loan commitment is contingent on closing. At quarter end, cash was USD 120.8 million with no borrowings outstanding, but the company was out of compliance with Citizens Credit Agreement covenants, which the lenders waived until compliance returns.

Items to Monitor

Four items stand out. The first is the Sanara review: the FTC second request extends the waiting period until 30 days after substantial compliance, and the merger agreement has an end date of July 29, 2027. The second is the 2026 net sales guide of USD 250 million to USD 260 million against USD 185.6 million booked through nine months. The third is intellectual property, with a USD 25 million patent settlement announced and two other cases in litigation. The fourth is regulatory: at least one Surgical 510(k) clearance is targeted before year end, and final Medicare rules are due within weeks.