Q3 FY2026
Filed Nov 12, 2026Heartflow Q3 2026 revenue rose 57% to $72.9 million, gross margin reached 83.6%, and full-year 2026 revenue guidance was raised to $262 million to $264 million
Revenue grew 57% year-over-year with U.S. revenue up 60%, GAAP gross margin expanded from 76.5% to 83.6%, GAAP net loss narrowed from $(50,855) thousand to $(11,505) thousand, and the company raised its FY2026 revenue guidance. Operating expenses still exceed revenue, and GAAP operating loss remains $(13,846) thousand.
Key metrics
shortened, hover for the filing’s print| Metric | Value | q/q | y/y |
|---|---|---|---|
| Total revenue, Q3 2026GAAP | $72.9M | – | 57% |
| U.S. revenue, Q3 2026GAAP | $67.9M | – | 60% |
| International and other revenue, Q3 2026GAAP | $4.9M | – | 29% |
| Cost of revenue, Q3 2026GAAP | $11.94M | – | – |
| Gross profit, Q3 2026GAAP | $60.92M | – | – |
| Non-GAAP gross profit, Q3 2026non-GAAP | $61.08M | – | – |
| Gross margin, Q3 2026GAAP | 83.6% | – | – |
| Non-GAAP gross margin, Q3 2026non-GAAP | 83.8% | – | – |
| Research and development, Q3 2026GAAP | $29.49M | – | – |
| Non-GAAP research and development, Q3 2026non-GAAP | $26.75M | – | – |
| Selling, general and administrative, Q3 2026GAAP | $45.28M | – | – |
| Non-GAAP selling, general and administrative, Q3 2026non-GAAP | $39.34M | – | – |
| Total operating expenses, Q3 2026GAAP | $74.76M | – | – |
| Non-GAAP total operating expenses, Q3 2026non-GAAP | $66.09M | – | – |
| Net operating loss (loss from operations), Q3 2026GAAP | −$13.85M | – | – |
| Non-GAAP net operating loss, Q3 2026non-GAAP | −$5.01M | – | – |
| Interest income, Q3 2026GAAP | $2.28M | – | – |
| Interest expense, Q3 2026GAAP | −$5K | – | – |
| Net loss, Q3 2026GAAP | −$11.51M | – | – |
| Net loss per share, basic and diluted, Q3 2026GAAP | $(0.13) | – | – |
| Non-GAAP net loss, Q3 2026non-GAAP | −$2.67M | – | – |
| Non-GAAP net loss per share, basic and diluted, Q3 2026non-GAAP | $(0.03) | – | – |
| Adjusted EBITDA, Q3 2026non-GAAP | −$3.63M | – | – |
| Total revenue, nine months 2026GAAP | $189.5M | – | – |
| Cost of revenue, nine months 2026GAAP | $33.26M | – | – |
| Gross profit, nine months 2026GAAP | $156.3M | – | – |
| Non-GAAP gross profit, nine months 2026non-GAAP | $156.8M | – | – |
| Gross margin, nine months 2026GAAP | 82.4% | – | – |
| Non-GAAP gross margin, nine months 2026non-GAAP | 82.7% | – | – |
| Research and development, nine months 2026GAAP | $77.37M | – | – |
| Selling, general and administrative, nine months 2026GAAP | $132.7M | – | – |
| Asset impairment charge, nine months 2026GAAP | $7.48M | – | – |
| Total operating expenses, nine months 2026GAAP | $217.5M | – | – |
| Non-GAAP total operating expenses, nine months 2026non-GAAP | $184.8M | – | – |
| Net operating loss (loss from operations), nine months 2026GAAP | −$61.25M | – | – |
| Non-GAAP net operating loss, nine months 2026non-GAAP | −$27.99M | – | – |
| Interest income, nine months 2026GAAP | $7.05M | – | – |
| Interest expense, nine months 2026GAAP | −$8K | – | – |
| Net loss, nine months 2026GAAP | −$54.63M | – | – |
| Net loss per share, basic and diluted, nine months 2026GAAP | $(0.63) | – | – |
| Non-GAAP net loss, nine months 2026non-GAAP | −$21.37M | – | – |
| Non-GAAP net loss per share, basic and diluted, nine months 2026non-GAAP | $(0.25) | – | – |
| Adjusted EBITDA, nine months 2026non-GAAP | −$23.96M | – | – |
Segments
| Segment | Revenue | q/q | y/y |
|---|---|---|---|
| U.S.The release attributes the year-over-year increase in total global revenue primarily to an increase in U.S. FFR CT case volume and an increase in U.S. Plaque case volume. The release also states that U.S. revenue grew at its fastest pace in 11 quarters. | $67.9M | – | 60% |
| International and otherThe release reports growth of 29% year-over-year. It gives no further driver for this line. | $4.9M | – | 29% |
Amounts quoted below without a unit are in thousands, as in the filing’s tables. Per-share figures are as printed.
FY2026 outlook
- Revenue$262 million to $264 million (approximately 49% to 50% growth year-over-year)
- Gross marginNon-GAAP gross margin of approximately 82.5%
- NotePrevious FY2026 guidance cited in the release: revenue of $246 million to $250 million (approximately 40% to 42% growth year-over-year)
- NotePrevious FY2026 guidance cited in the release: non-GAAP gross margin of approximately 82%
- NoteThe release is titled 'Raises Full Year 2026 Guidance'
Capital returns
- The release reports no share repurchases and no dividends for the period.
What drove it
- Company explanation for revenue growth: increase in total U.S. FFR CT case volume and increase in total U.S. Plaque case volume.
- Company explanation for gross margin expansion: increase in total revenue case volume, increase in total U.S. Plaque revenue case volume, and improved production team productivity driven by AI efficiency initiatives, partially offset by the hiring and training of production team personnel.
- Company explanation for operating expense increase: increased investment in sales personnel and related expenses, and increased investments in technology and clinical research.
- Total operating expenses were 103% of total revenue in Q3 2026, compared with 109% in the prior year period (GAAP). Non-GAAP total operating expenses were 91% of total revenue, compared with 101% in the prior year period.
- Prior-year Q3 2025 GAAP net loss included a $32.1 million noncash charge from the remeasurement of the fair value of the warrant liability, a $4.8 million noncash benefit from the remeasurement of the derivative liability, and a $6.4 million loss on extinguishment of debt from the full prepayment of the term loan in August 2025.
- Q3 2026 GAAP operating expense includes stock-based compensation of $4.7 million in sales, general and administrative expense and litigation expenses of $1.3 million, per the footnotes to the reconciliation table.
Concerns
- GAAP operating loss was $(13,846) thousand in Q3 2026 and total operating expenses exceeded revenue, at 103% of total revenue on a GAAP basis.
- GAAP net loss was $(11,505) thousand and the company has not reported GAAP profitability in the periods shown. The release lists the risk that the company may not achieve or sustain profitability.
- Nine-month GAAP net loss was $(54,628) thousand, including a $7,482 thousand asset impairment charge.
- Accounts receivable, net rose from $29,343 thousand at December 31, 2025 to $48,195 thousand at September 30, 2026. The release does not comment on this change.
- The forward-looking statements section cites dependence on two products, Heartflow FFR CT Analysis and Heartflow Plaque Analysis, and states that the commercialization of Heartflow Plaque Analysis is nascent.
- The release states that the company's customer base is concentrated and that third-party payor coverage and reimbursement may affect adoption.
What to watch
- Delivery against the raised FY2026 revenue range of $262 million to $264 million.
- Ramp of Heartflow Plaque Analysis activations, which the CEO describes as ramping ahead of plan.
- Path to GAAP profitability, given the GAAP net operating loss of $(13,846) thousand for Q3 2026.
- Operating expense trajectory, given the company's stated investments in sales personnel, technology and clinical research.
- Movement in accounts receivable relative to revenue growth.
- Non-GAAP gross margin of approximately 82.5% for FY2026 against the 83.8% achieved in Q3 2026.
Balance sheet and cash flow
- Cash, cash equivalents and investments totaled $253.0 million as of September 30, 2026.
- Balance sheet at September 30, 2026 (thousands): cash and cash equivalents $31,649; short-term investments $136,088; accounts receivable, net $48,195; total current assets $235,505; long-term investments $85,254; total assets $355,339; total liabilities $72,802; total stockholders' equity $282,537.
- Comparison balance sheet at December 31, 2025 (thousands): cash and cash equivalents $44,776; short-term investments $132,010; accounts receivable, net $29,343; total current assets $220,204; long-term investments $103,365; total assets $359,452; total liabilities $58,805; total stockholders' equity $300,647.
- Accumulated deficit was $(1,142,378) thousand at September 30, 2026 compared with $(1,087,750) thousand at December 31, 2025.
- The release contains no operating or free cash flow figures and no cash flow statement.
Analysis
Heartflow reported Q3 2026 total revenue of $72.9 million, up 57% year-over-year, with U.S. revenue of $67.9 million (up 60%) and international and other revenue of $4.9 million (up 29%). The release states that revenue accelerated for the third consecutive quarter. For the nine months, total revenue was $189,526 thousand against $126,904 thousand in the prior year period. The company attributes the growth primarily to higher U.S. FFR CT and U.S. Plaque case volumes.
Gross margin on a GAAP basis was 83.6% against 76.5% in the prior year period, and non-GAAP gross margin was 83.8% against 76.8%. The company attributes the expansion to case volume, Plaque volume and production team productivity from AI efficiency initiatives, partly offset by hiring and training of production staff. Gross margin for the nine months was 82.4% on a GAAP basis against 75.7% a year earlier.
Operating spending increased. GAAP total operating expenses were $74,763 thousand, against $50,514 thousand, and research and development rose to $29,487 thousand from $17,297 thousand. The release ties the increase to investment in sales personnel and to technology and clinical research. Despite this, the GAAP loss from operations narrowed to $(13,846) thousand from $(15,099) thousand, and the GAAP net loss narrowed to $(11,505) thousand from $(50,855) thousand. The prior-year net loss included a $32.1 million warrant remeasurement charge, a $4.8 million derivative benefit and a $6.4 million debt extinguishment loss, so the year-over-year net loss comparison is affected by those items. Non-GAAP net loss was $(2,673) thousand against $(13,236) thousand, and Adjusted EBITDA was $(3,629) thousand against $(9,835) thousand.
On guidance, the company raised FY2026 revenue to $262 million to $264 million, described as approximately 49% to 50% growth, from a prior range of $246 million to $250 million. Non-GAAP gross margin guidance moved to approximately 82.5% from approximately 82%. The release reports cash, cash equivalents and investments of $253.0 million at September 30, 2026. Total assets were $355,339 thousand, against $359,452 thousand at December 31, 2025. The release contains no cash flow statement, no share repurchase activity and no dividend.
The figures that deserve attention are the GAAP operating loss, the rise in accounts receivable from $29,343 thousand to $48,195 thousand since year-end, and the gap between GAAP and non-GAAP results, which is driven by stock-based compensation of $7,573 thousand in the quarter according to the Adjusted EBITDA reconciliation. The company describes its path to profitability as a stated focus but does not give a profitability date or a GAAP operating income target in this release.
Management, verbatim
Our third quarter was excellent, with revenue accelerating for the third consecutive quarter and U.S. revenue growing at its fastest pace in 11 quarters,
John Farquhar, President and CEO, Heartflow
Not in the filing
stated, not guessed- Prior-quarter (Q2 2026) figures for all metrics were not printed in the release, so prior_quarter and qoq_change are null.
- The release does not print the prior-year U.S. and international revenue amounts in dollars, so their prior_year fields are null.
- The release does not print the year-over-year percentage change for GAAP gross profit, cost of revenue or operating expense lines, so those yoy_change fields are null.
- The release does not print the year-over-year change in basis points for gross margin, so yoy_change is null.
- No operating cash flow, free cash flow or capital expenditure figures are printed in the release.
- No share repurchases or dividends are reported in the release.
- Operating expense and tax rate guidance for FY2026 are not printed, so those guidance fields are null.
- The separate OUTLOOK section of the previous release was not supplied, so vs_prior_guidance is empty. The release itself cites the prior ranges, which are shown under guidance.other.
- Balance sheet figures at September 30, 2026 are not compared with a September 30, 2025 or June 30, 2026 balance sheet in the release, so no balance sheet prior fields are populated in key_metrics.
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.