Q3 FY2026
Filed Nov 10, 2026Carlsmed Q3 2026 revenue rises 65% to $21.6 million; full-year 2026 revenue guidance raised to $78 million to $80 million
Revenue grew 65% year over year, gross margin rose to 77.3% from 75.9%, and full-year revenue guidance was raised. Net loss widened to $(12,245) thousand from $(8,526) thousand as operating expenses rose 55% year over year, and the company reports $80.3 million in cash and investments.
Actuals vs. the company’s prior outlook
from its previous release| Metric | Guided | Reported | Verdict |
|---|---|---|---|
| FY2026 revenue guidance | $74 to $78 million | Nine months ended Sep 30, 2026 revenue of $56,610 thousand; full-year 2026 actual not yet reported. Guidance now $78 million to $80 million. | n/a |
Key metrics
shortened, hover for the filing’s print| Metric | Value | q/q | y/y |
|---|---|---|---|
| Revenue, Q3 2026 (three months ended Sep 30)GAAP | $21.55M | – | 65% |
| Cost of sales, Q3 2026GAAP | $4.89M | – | – |
| Gross profit, Q3 2026GAAP | $16.66M | – | – |
| Gross margin, Q3 2026GAAP | 77.3% | – | – |
| Research and development expenses, Q3 2026GAAP | $6.38M | – | – |
| Sales and marketing expenses, Q3 2026GAAP | $13.00M | – | – |
| General and administrative expenses, Q3 2026GAAP | $9.98M | – | – |
| Total operating expenses, Q3 2026GAAP | $29.37M | – | – |
| Loss from operations, Q3 2026GAAP | −$12.70M | – | – |
| Interest expense, Q3 2026GAAP | −$316K | – | – |
| Interest income, Q3 2026GAAP | $772K | – | – |
| Net loss, Q3 2026GAAP | −$12.24M | – | 43.6% |
| Net loss per share, basic and diluted, Q3 2026GAAP | $(0.45) | – | – |
| EBITDA, Q3 2026non-GAAP | −$12.57M | – | 39.4% |
| Adjusted EBITDA, Q3 2026non-GAAP | −$7.27M | – | (11.9)% |
| Adjusted net loss, Q3 2026non-GAAP | −$9.40M | – | 11.2% |
| Adjusted net loss per share, Q3 2026non-GAAP | $(0.34) | – | (15.0)% |
| Revenue, nine months ended Sep 30, 2026GAAP | $56.61M | – | – |
| Cost of sales, nine months ended Sep 30, 2026GAAP | $12.98M | – | – |
| Gross profit, nine months ended Sep 30, 2026GAAP | $43.63M | – | – |
| Research and development expenses, nine months ended Sep 30, 2026GAAP | $17.60M | – | – |
| Sales and marketing expenses, nine months ended Sep 30, 2026GAAP | $35.22M | – | – |
| General and administrative expenses, nine months ended Sep 30, 2026GAAP | $23.83M | – | – |
| Total operating expenses, nine months ended Sep 30, 2026GAAP | $76.64M | – | – |
| Loss from operations, nine months ended Sep 30, 2026GAAP | −$33.01M | – | – |
| Net loss, nine months ended Sep 30, 2026GAAP | −$31.45M | – | 49.6% |
| Net loss per share, basic and diluted, nine months ended Sep 30, 2026GAAP | $(1.16) | – | – |
| EBITDA, nine months ended Sep 30, 2026non-GAAP | −$32.66M | – | 52.6% |
| Adjusted EBITDA, nine months ended Sep 30, 2026non-GAAP | −$23.45M | – | 17.6% |
| Adjusted net loss, nine months ended Sep 30, 2026non-GAAP | −$28.61M | – | 38.3% |
| Adjusted net loss per share, nine months ended Sep 30, 2026non-GAAP | $(1.06) | – | (48.5)% |
| Cash and cash equivalents, restricted cash, short-term investments and marketable securities, as of Sep 30, 2026other | $80.3M | – | – |
FY2026 outlook
- Revenue$78 million to $80 million
- NoteRevenue growth of over 56% at the midpoint versus full-year 2025 (company statement)
- NotePrior annual revenue guidance: $74 to $78 million
What drove it
- Company states that it grew its surgeon user base by more than 60% over the prior year, which the CEO cited as part of the quarter's strong execution.
- Company states that the CMS Inpatient Prospective Payment System rule for fiscal year 2027, effective October 1, 2026, increased reimbursement for inpatient aprevo lumbar procedures.
- Company launched the aprevo Lumbar Bi-lateral Posterior System in October and estimates it addresses approximately 30,000 U.S. lumbar fusion procedures annually.
- Company states that Q3 2026 operating expenses of $29.4 million included $2.8 million in expenses related to executive transition costs and the expected resolution of certain legal matters.
- Company raised full-year 2026 revenue guidance to $78 million to $80 million from $74 million to $78 million.
Concerns
- Net loss widened to $(12,245) thousand in Q3 2026 from $(8,526) thousand in Q3 2025, and to $(31,451) thousand for the nine months from $(21,021) thousand.
- General and administrative expenses rose to $9,982 thousand from $4,907 thousand in Q3, and to $23,826 thousand from $11,715 thousand for the nine months.
- Stock-based compensation in the Adjusted EBITDA reconciliation was $2,466 thousand for Q3 2026 versus $704 thousand for Q3 2025.
- Interest income was $772 thousand in Q3 2026 versus $954 thousand in Q3 2025.
- Total stockholders' equity declined to $75,674 thousand from $98,869 thousand at December 31, 2025, and cash and cash equivalents declined to $35,945 thousand from $85,793 thousand.
What to watch
- Full-year 2026 revenue against the $78 million to $80 million guidance range.
- Whether operating expense growth moderates relative to revenue, given the net loss trend.
- Commercial adoption of the aprevo Lumbar Bi-lateral Posterior System and the effect of the FY2027 IPPS reimbursement change, as described by the company.
- Progress on the expected resolution of legal matters and the executive transition costs referenced in the release.
- Cash, restricted cash, short-term investments and marketable securities of $80.3 million, and the trajectory of the net loss.
Balance sheet and cash flow
- Cash and cash equivalents: $35,945 thousand as of Sep 30, 2026 versus $85,793 thousand as of Dec 31, 2025.
- Restricted cash: $100 thousand as of Sep 30, 2026 versus $100 thousand as of Dec 31, 2025.
- Short-term investments: $24,000 thousand as of Sep 30, 2026 versus $24,000 thousand as of Dec 31, 2025.
- Marketable securities: $20,262 thousand as of Sep 30, 2026 versus none reported (shown as a dash) as of Dec 31, 2025.
- Total assets: $115,270 thousand as of Sep 30, 2026 versus $130,120 thousand as of Dec 31, 2025.
- Long-term portion of term loan, net: $15,400 thousand as of Sep 30, 2026 versus $15,346 thousand as of Dec 31, 2025.
- Total liabilities: $39,596 thousand as of Sep 30, 2026 versus $31,251 thousand as of Dec 31, 2025.
- Total stockholders' equity: $75,674 thousand as of Sep 30, 2026 versus $98,869 thousand as of Dec 31, 2025.
- Accumulated deficit: $(132,256) thousand as of Sep 30, 2026 versus $(100,805) thousand as of Dec 31, 2025.
- Common shares issued and outstanding: 27,387,646 as of Sep 30, 2026 versus 26,604,505 outstanding as of Dec 31, 2025.
- The release does not include a cash flow statement.
Analysis
Carlsmed reported third quarter 2026 revenue of $21,554 thousand, up from $13,074 thousand in the third quarter of 2025, a 65% increase as stated in the release. Gross profit rose to $16,665 thousand and gross margin was 77.3%, compared with 75.9% in the prior-year quarter. Nine-month revenue was $56,610 thousand against $35,346 thousand a year earlier. The release does not print a prior-quarter (second quarter 2026) comparison, so sequential trends cannot be read from this filing.
Operating expenses grew faster than revenue in dollar terms. Total operating expenses were $29,366 thousand versus $18,962 thousand, with general and administrative expenses rising to $9,982 thousand from $4,907 thousand and sales and marketing to $13,004 thousand from $9,610 thousand. The company states that the third quarter included $2.8 million of expenses related to executive transition costs and the expected resolution of certain legal matters. Loss from operations was $(12,701) thousand, and net loss was $(12,245) thousand, or $(0.45) per share on a GAAP basis, compared with $(8,526) thousand, or $(0.40) per share, a year earlier.
On a non-GAAP basis, Adjusted EBITDA was $(7,269) thousand versus $(8,249) thousand, and adjusted net loss per share was $(0.34) versus $(0.40). The reconciliation adds back stock-based compensation of $2,466 thousand, executive transition costs of $2,390 thousand and legal settlements of $450 thousand in Q3 2026. Stock-based compensation was $704 thousand in the prior-year quarter, so the non-GAAP and GAAP losses diverge by different amounts across the two periods, and readers should compare both lines.
On guidance, the company raised its full-year 2026 revenue range to $78 million to $80 million from $74 million to $78 million, and describes the midpoint as growth of over 56% versus full-year 2025. The release attributes the guidance context to the FY2027 IPPS reimbursement change for inpatient aprevo lumbar procedures, the October launch of a bilateral posterior system and a growing surgeon base, as described by management. The release gives no gross margin, operating expense or tax guidance.
On the balance sheet, cash, restricted cash, short-term investments and marketable securities totaled $80.3 million at September 30, 2026. Cash and cash equivalents alone fell to $35,945 thousand from $85,793 thousand at December 31, 2025, while marketable securities of $20,262 thousand were added. Total stockholders' equity declined to $75,674 thousand from $98,869 thousand, and the accumulated deficit increased to $(132,256) thousand. No cash flow statement, share repurchase or dividend appears in the release.
Management, verbatim
The third quarter represented strong execution against our long-term strategy as we delivered 65% revenue growth and advanced our leadership position in AI-enabled personalized surgery as we grew our surgeon user base by more than 60% over the prior year,
Mike Cordonnier, Chairman and CEO, Carlsmed
Not in the filing
stated, not guessed- Prior-quarter (second quarter 2026) figures for every line item, so sequential changes cannot be stated.
- Year-over-year percentage change for revenue, cost of sales, gross profit, operating expense lines and loss from operations for the three-month and nine-month periods, which the release does not print.
- Year-over-year change in gross margin in basis points or percentage points for the nine-month period, and the nine-month gross margin itself.
- Revenue by segment, product line or geography, as the release does not disclose any breakdown.
- Cash flow statement, operating cash flow and free cash flow for any period.
- Full-year 2025 actual revenue figure (only the growth reference is printed).
- Full-year 2026 actual results, which are not yet reported.
- Any guidance for gross margin, operating expenses, tax rate or 2027.
- Share repurchases, dividends or other capital returns (none are reported).
- Prior-year cash position comparable to the $80.3 million figure (the release does not print a September 30, 2025 equivalent).
- Share price reaction, consensus estimates and analyst expectations (not in the document).
Written by an AI language model from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure is checked against the filing text, and a metric the filing does not print, or whose value, prior period and change do not add up, is dropped from the metrics. The model can still misread a table, in the metrics or in the text, so check a number in the filing before you rely on it. Consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.