Second Quarter 2026
Filed Aug 4, 2026ATEC Reports Second Quarter Financial Results: Total revenue of $214 million, up 15% year-over-year; surgical revenue of $196 million increased 17%; company reaffirms 2026 revenue outlook.
Revenue grew 15% year-over-year, surgical revenue grew 17% with 20 percent case volume growth, adjusted EBITDA expanded 420 basis points year-over-year, and the company raised adjusted EBITDA guidance while reaffirming revenue guidance.
Key metrics
as reported| Metric | Value | q/q | y/y |
|---|---|---|---|
| Total revenueother | $214 million | – | 15% |
| GAAP gross marginGAAP | 72.2% | – | – |
| Non-GAAP gross marginnon-GAAP | 72.5% | – | – |
| GAAP operating expensesGAAP | $156 million | – | – |
| Non-GAAP operating expensesnon-GAAP | $135 million | – | – |
| GAAP net income / (loss)GAAP | ($26) million | – | – |
| Non-GAAP net income / (loss)non-GAAP | $11 million | – | – |
| Non-GAAP adjusted EBITDAnon-GAAP | $36 million | – | expanded 420 basis points year-over-year |
| Non-GAAP adjusted EBITDA marginnon-GAAP | 16.8% | – | expanded 420 basis points year-over-year |
| Net new surgeon usersother | increased 24% | – | increased 24% |
| Case volume growthother | 20% | – | 20% |
Segments
| Segment | Revenue | q/q | y/y |
|---|---|---|---|
| Surgical revenuedriven by 20% case volume growth | $196 million | – | 17%, or $28 million year-over-year |
fiscal year 2026 outlook
- Revenueapproximately $882 million
- Noteapproximately $805 million of surgical revenue
- Noteapproximately $77 million of EOS revenue
- Noteapproximately 15% total revenue growth
- Noteapproximately 17% surgical revenue growth
- Noteadjusted EBITDA of approximately $140 million
- Noteat least $20 million of free cash flow
What drove it
- Surgical revenue of $196 million increased 17%, driven by 20% case volume growth.
- Net new surgeon users increased 24%, supporting continued durable growth.
- The company cited continued surgeon adoption, expanding profitability, and positive free cash flow generation in reaffirming its full-year revenue outlook and increasing adjusted EBITDA guidance.
- The adjusted EBITDA outlook increase reflects continued progress in operating leverage and margin expansion.
Concerns
- GAAP net income / (loss) was ($26) million.
- The release did not provide a quarterly EOS revenue figure.
- No quantitative operating cash flow, capital expenditures, free cash flow, debt, or capital-return amount was reported.
What to watch
- Progress toward fiscal year 2026 total revenue of approximately $882 million, including approximately $805 million of surgical revenue and approximately $77 million of EOS revenue.
- Delivery against adjusted EBITDA guidance of approximately $140 million, increased from the prior expectation of approximately $134 million.
- Whether case volume growth and net new surgeon-user growth continue to support surgical revenue growth.
- Progress toward at least $20 million of free cash flow for fiscal year 2026.
Balance sheet and cash flow
- Ending cash balance $119 million
- Generated positive free cash flow with continued trailing twelve-month free cash flow positivity
- The Company continues to expect at least $20 million of free cash flow for fiscal year 2026.
Analysis
ATEC reported second-quarter total revenue of $214 million, up 15% year-over-year. Surgical revenue was $196 million, up 17%, or $28 million year-over-year, and the company attributed that increase to 20% case volume growth. Net new surgeon users increased 24%, providing a second reported indicator of adoption alongside case-volume expansion.
Reported profitability metrics improved on a non-GAAP basis. Non-GAAP adjusted EBITDA was $36 million and non-GAAP adjusted EBITDA margin was 16.8%. The company said adjusted EBITDA expanded 420 basis points year-over-year and also described adjusted EBITDA as 17% of revenue. GAAP gross margin was 72.2% and non-GAAP gross margin was 72.5%, while GAAP operating expenses were $156 million and non-GAAP operating expenses were $135 million.
GAAP net income / (loss) remained ($26) million, compared with non-GAAP net income / (loss) of $11 million. The release said the company generated positive free cash flow and maintained trailing twelve-month free cash flow positivity, but it did not disclose a quarterly free-cash-flow amount, operating-cash-flow amount, or capital-expenditure amount. Ending cash balance was $119 million.
For fiscal year 2026, ATEC reaffirmed total revenue guidance of approximately $882 million, comprising approximately $805 million of surgical revenue and approximately $77 million of EOS revenue. That outlook represents approximately 15% total revenue growth and approximately 17% surgical revenue growth. The company increased adjusted EBITDA guidance to approximately $140 million from its prior expectation of approximately $134 million, while continuing to expect at least $20 million of free cash flow. The guide centers attention on sustaining surgical demand, surgeon adoption, margin expansion, and free-cash-flow delivery.
Management, verbatim
During the quarter, we saw 20 percent case volume growth, continued to expand our surgeon user base, and generated strong profitability.
Pat Miles, Chairman and Chief Executive Officer
Not in the filing
stated, not guessed- GAAP and non-GAAP EPS were not reported.
- GAAP and non-GAAP gross profit were not reported.
- GAAP and non-GAAP operating income were not reported.
- Prior-year and prior-quarter absolute figures were not reported for total revenue, gross margins, operating expenses, net income / (loss), or adjusted EBITDA.
- Prior-quarter comparisons were not reported for surgical revenue, case volume growth, or net new surgeon users.
- Quarterly EOS revenue was not reported.
- A quarterly operating cash flow amount, capital expenditures amount, and free cash flow amount were not reported.
- Debt balance was not reported.
- Share repurchases, dividends, and other capital-return figures were not reported.
- Full-year 2026 gross-margin, operating-expense, and tax-rate guidance were not reported.
- A prior outlook section was not provided, so no actual-versus-prior-guidance comparison is included.
AlphaAI analysis generated from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure was cross-checked against the filing text; consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.