Xtant Medical Holdings, Inc. Q4 FY2025 earnings call

• Solid financial performance in Q4 2025 with $32.4 million revenue, 3% growth over Q4 2024, but affected by Companion's fine transaction closing a month earlier costing $2 million in revenue. - Companion Spine transaction closed in early December with final purchase price ~$21.4 million, proceeds used to reduce borrowings and strengthen cash position. - Full year 2025 revenue $133.9 million within guidance range, up over 14% from 2024. Adjusted EBITDA improved to $16.3 million from a loss in 2024. - Biologics product family focus, recent emphasis on self-sustainability, positive cash flows, tighter operating discipline, in-house manufacturing achieved. - Invested in expanding commercial reach, doubled regional sales reps in 2025-2026, plan to add resources to national accounts team. - Launched new products in December: NanoStratta, a next-generation synthetic bone graft, and CollagenX, a bovine collagen particulate for surgical wound closure. - Now offer and internally produce solutions across all five major orthobiologic categories, well positioned in surgical repair and wound care markets.

Fourth quarter 2025 revenue was $32.4 million, up 3% from Q4 2024. Full year 2025 revenue was $133.9 million, within the guidance range of $131 - $135 million, up over 14% from 2024. Adjusted EBITDA for full year 2025 was $16.3 million vs a loss of $1.9 million in 2024. Biologics product family was essentially flat in Q4 2025. Gross margin in Q4 2025 was 54.9% vs 50.8% in 2024. Full year 2025 gross margin was 62.9% vs 58.2% in 2024. Operating expenses in Q4 2025 were $18.7 million vs $17.9 million in 2024. Full year 2025 operating expenses were $77 million vs $80.3 million in 2024. Net income in Q4 2025 was $57,000 vs a net loss of $3.2 million in 2024. Full year 2025 net income was $5 million vs a net loss of $16.5 million in 2024.

• 2026 Revenue Outlook: Range of 95 to 99 million, reflecting impact of Companion's fine divestiture and expiration of license revenue from Q-code and amniotic membrane agreements. - Anticipate continued organic growth in core biologics business to accelerate as expanded commercial team is deployed and new products gain traction. - Committed to maintaining positive free cash flow at 2026 revenue levels and no need for additional outside capital.

Q: Outlook for 2026, especially underlying organic growth in core biologics business.

A: Expect sequential quarter-over-quarter growth from new products and expanding commercial organization, seasonality present, Q1 biologics down low double digits, hardware down mid-teens after adjusting for divestiture revenue.

Q: Headwind from loss of license revenue relating to Q codes.

A: Q-code revenue all goes away, but business will ramp up with X-Stance brand in advanced wound care, pickup likely in late second quarter to second half of 2026.

Q: Decline in hardware business throughout 2026.

A: Slow decline throughout the year, already seen decline post-divestiture and expect continued decline approaching high teens.

Q: Cadence of biologics growth, products supporting growth, and distribution vs white label.

A: Osteo 5 Plus, Osteo Factor Pro, Collagen X, Trivium are big drivers, about 20% of biologics business in OEM channel, growth from XTAN branded products through independent agent networks.

Q: Hardware business plans and gross margin in 2026.

A: Hardware business still helps set table for biologics but under review, gross margin in 2026 likely low 60s, new biologics launches help margins but hardware excess and obsolete charges offset some.