PROCEPT BioRobotics Corporation Q4 FY2026 earnings call

Larry outlined a near-term plan for the company, emphasizing moving with vision, urgency, discipline, and accountability. The next stage requires increasing procedure volume, expanding margins, achieving profitability, and gaining market share. Two commercial changes were made: realigning the commercial team into an integrated regional structure and forming a dedicated launch team. The realignment and launch team formation cause short-term disruption but are expected to position the company for sustained growth. In Q4, procedures were 12,200 (69% growth), handpiece unit sales were 80% of procedures, average selling price increased, and 2026 guidance was reset due to business practice changes and sales organization disruption. Kevin walked through financials, including revenue, procedures, handpieces, systems, gross margin, operating expenses, net loss, adjusted EBITDA, and 2026 guidance. Investor day tomorrow will provide detailed multi-year financial guidance, path to profitability, update on Water 4 prostate cancer trial, and future vision

In the fourth quarter, total revenue was $76.4 million, up 12% year-over-year. U.S. revenue was $66.6 million, up 10% year-over-year. U.S. procedures were approximately 12,200, up 69% year-over-year. Handpieces sold totaled 9,400 units with an average selling price of $3,340, a 5% increase sequentially. Other consumable revenue was $2.3 million. U.S. robot placements were 65 new hydro systems, with an installed base of 718 systems at year-end 2025, up 42% from year-end 2024. U.S. system revenue was $27.6 million. International revenue was $9.8 million, up 25% year-over-year. Gross margin for Q4 2025 was 60.6% vs. 64% in Q4 2024. Full-year 2025 gross margin was 63.7% vs. 61.1% in 2024. Total operating expenses in Q4 2025 were $77.4 million vs. $63.4 million in prior year. Net loss in Q4 2025 was $29.8 million vs. $18.9 million in prior year. Adjusted EBITDA was a loss of $19 million in Q4 2025 vs. a loss of $10.3 million in prior year. Cash, cash equivalents, and restricted cash totaled $285 million as of December 31, 2025. 2026 guidance is $390 - $410 million revenue, 2026 U.S. procedures expected 60,000 - 64,000, full-year 2026 gross margin expected ~65% including tariff expense, operating expenses expected $350 million, adjusted EBITDA loss expected $30 - $17 million, Q1 2026 U.S. procedures expected 12,000 - 12,800, Q1 2026 revenue expected $79 - $82 million

2026 total revenue expected $390 - $410 million (27 - 33% growth from 2025). 2026 U.S. procedures expected 60,000 - 64,000 (39 - 48% growth). Full-year 2026 gross margin expected ~65% including tariff expense. Operating expenses expected $350 million, adjusted EBITDA loss expected $30 - $17 million. Q1 2026 U.S. procedures expected 12,000 - 12,800 (29 - 37% growth), Q1 2026 revenue expected $79 - $82 million

Forward-looking statements are subject to risks, uncertainties, assumptions, and other factors that could cause results to differ materially. Risks and uncertainties are disclosed in Procept Biorobotics filings with the Securities Exchange Commission. The short-term disruption from sales realignment and launch team formation is a risk. Changes in customer ordering behavior and potential impact on revenue and margins are risks. Disruption from commercial organization changes and potential attrition or challenges in rebuilding relationships are risks. Variability in clinical durability and payer coverage for PAE are risks

Q: Matthew O'Brien asked about Q4 unfolding and inventory flushing.

A: Larry said there were two dynamics, with business practice changes leading to ASP increase and alignment of shipments with procedure volumes.

Q: Chris Pasquale asked about confidence in one-to-one handpiece to procedure ratio.

A: Larry said they modeled one-to-one based on analysis and recent ordering patterns.

Q: Josh Jennings asked about customer dissatisfaction and utilization.

A: Larry said no customer dissatisfaction seen, and ordering patterns didn't impact utilization.

Q: Richard Newwitter asked about systems ASP and 2026 systems placement.

A: Kevin said capital pricing varies, modeling ASB for systems flat to up.

Q: Brandon Vasquez asked about confidence in growth despite noise.

A: Larry said they have confidence due to recent ordering alignment and sales organization changes.

Q: Suraj Kavya asked about why now for new sales process.

A: Larry said it was due to inventory levels and desire to improve ASP and margins.

Q: Michael Sarcone asked about launch team details and procedure growth split.

A: Larry said launch team focuses on standardized playbook and pilot showed reduced time to first cases.

Q: Mason Carrico asked about IDN strategy and patient activation.

A: Larry said IDN strategy is ongoing, and patient activation is part of future plans.

Q: Stephanie Piazzolla asked about procedure walk and ASP uplift.

A: Larry said ASP uplift is from practice changes, and procedure walk will detail drivers.

Q: Daniela and Taffy asked about market development and ASC capacity.

A: Larry said market development work needed and ASC capacity is long-term plan.

Q: Mike Kratke asked about handpiece inventory and utilization.

A: Larry said customers need inventory, but recent changes led to one-to-one modeling.

Q: Nathan Trebek asked about utilization and capital funnel.

A: Kevin said utilization is variable, and capital funnel is modeled to be flat