MiMedx Group (MDXG) Q1 2026 earnings summary

Executive summary

• Q1 2026 net sales were $59 million, down 33% year-over-year, with surgical sales up 13% and wound care sales down 60% due to Medicare reimbursement changes.

• The business faced significant disruption from new Medicare reimbursement rules, especially impacting wound care, while surgical and international revenues grew by double digits.

• A $40 million cost reduction initiative, including a 15% workforce reduction, was implemented to restore profitability.

• Cash balance at quarter-end was $160 million, with net cash position at $142 million.

• New product launches and exclusive distribution agreements expanded the surgical portfolio.

Financial highlights

• Gross profit margin declined to 70.6%-72% from 81%-81.2% last year, mainly due to lower ASPs and unfavorable product mix.

• Adjusted EBITDA loss was $11.6-$12 million, compared to a positive $17 million last year.

• GAAP net loss was $10.9-$11 million ($0.07/share); adjusted net loss was $7-$7.4 million ($0.05/share).

• Free cash flow was $1-$1.3 million, down from $4.9-$5 million in Q1 2025.

• SG&A expense decreased 11% to $53.2 million, with lower commissions and compensation.

Outlook and guidance

• Full-year 2026 net sales expected between $260 million and $290 million, with adjusted EBITDA roughly breakeven.

• Surgical segment projected to maintain double-digit growth; wound care to see sequential volume recovery but remain pressured.

• Adjusted EBITDA expected to be roughly break even for the year, with profitability returning in Q3.

• One-time expenses of ~$4 million expected in Q2 2026 related to cost actions.

• 2027 anticipated to deliver double-digit top-line growth in both wound and surgical segments.