CARLSMED, INC. Q4 FY2025 earnings call

• 2025 was a rapid growth year; successfully completed IPO in July 2025, raising over $100 million. • Patient-centric innovation: announced first in human bilateral posterior aprivo procedure and CORA personalized fixation portfolio. • Surgeon education: expanded medical education team, with second annual residents and fellows course fully enrolled. • Commercial execution: added 101 new fully trained surgeons in 2025, doubled sales regions in U.S. with direct sales team and contracted sales agents.

2025 full year revenue was $50.5 million with 75.3% gross margins, representing 86% year-over-year top line growth. Fourth quarter 2025 revenue was $15.2 million, with 61% year-over-year growth and 76.5% gross margins. The growth was driven by expansion of total surgeon users and utilization rates. Gross margins improvement in fourth quarter was due to lower contract manufacturing costs and internal efficiencies.

• 2026 revenue range is expected to be $70 million to $75 million, representing an annual growth of 44% at the midpoint over 2025. • Anticipate continued improvement in adjusted EBITDA over coming years driven by revenue growth and operating leverage. • Balance sheet in solid position to drive revenue growth and expansion of surgical planning and manufacturing capacities.

• Comments include forward-looking statements subject to known and unknown risks and uncertainties that could cause actual results to differ materially from those expressed. • Need to review cautionary notes on earnings materials, SEC filings, especially risk factors in annual report on Form 10-K.

Q: David Roman of Goldman Sachs asked about new indications/platforms and market impact.

A: Bilateral aprivo lumbar accelerates posterior surgery market adoption; CORA is first foray outside disc space, with full commercial launch in back half of 2026.

Q: Richard Newiter of Truist Securities asked about cervical contribution and ramp in 2026.

A: Cervical launch has positive response, with 10% of total users trained in short time, anticipating ramp with personalized CORA plates.

Q: Travis Steed of Bank of America asked about 2026 guidance and lead time impact.

A: Guidance is prudent with momentum in training and adoption; lead time reduction impacts new surgeon adoption and emergent cases.

Q: Ryan Zimmerman of BTIG asked about ASPs and G&A.

A: ARP stable in lumbar, cervical has different reimbursement profile; GNA to maintain infrastructure, focus on R&D and sales/marketing investment for leverage.

Q: Matthew O'Brien at Piper Sandler asked about lead time impact on gross margin and utilization.

A: Lead time reduction drives manufacturing capacity and gross margin improvement; continue to invest in surgeon education for incremental procedure volume utilization