SI-BONE (SIBN) Q4 2025 earnings summary

Executive summary

• Achieved record worldwide revenue of $200.9 million in 2025, up 20.2% year-over-year, with Q4 revenue of $56.3 million, up 15% year-over-year.

• Delivered first full year of positive adjusted EBITDA ($8.9 million) and positive free cash flow in Q4 2025.

• Net loss improved 38.8% year-over-year to $18.9 million for 2025, with Q4 net loss at $1.6 million.

• Expanded commercial footprint with new product launches (INTRA Ti), strategic partnership with Smith+Nephew, and increased physician engagement.

• Ended 2025 with $147.8 million in cash and equivalents, supporting growth investments.

Financial highlights

• Q4 2025 worldwide revenue: $56.3 million (+15% YoY); U.S. revenue: $53.5 million (+13.9% YoY); international revenue: $2.9 million (+38.8% YoY).

• FY 2025 worldwide revenue: $200.9 million (+20.2% YoY); U.S. revenue: $191.1 million (+20.6% YoY); international revenue: $9.8 million (+12.4% YoY).

• Q4 gross profit: $44.5 million (+14.8% YoY); FY 2025 gross profit: $159.9 million (+21% YoY).

• Gross margin: 79% in Q4 and 79.6% for FY 2025.

• Q4 adjusted EBITDA: $5.1 million (9.1% margin); FY 2025 adjusted EBITDA: $8.9 million (vs. $5.1 million loss in 2024).

Outlook and guidance

• 2026 worldwide revenue guidance: $228.5–$232.5 million, implying 14–16% growth, with growth weighted to the second half.

• 2026 gross margin expected at ~78%.

• Operating expenses to grow ~12.5% at midpoint, funding new product launches and sales expansion.

• Adjusted EBITDA expected to increase from 2025, with continued positive free cash flow.