Carlsmed® Reports Second Quarter 2025 Financial Results
Q2’25 revenue of
Full year revenue guidance of
“Our strong commercial performance was driven by the continued adoption of our highly differentiated AI-enabled aprevo® technology platform and growing recognition of its ability to deliver more favorable patient outcomes than legacy devices,” said
Second Quarter Financial Results & Recent Highlights
- Revenue was
$12.1 million for the second quarter of 2025; a 99% increase compared to$6.1 million for the second quarter of 2024. This increase was driven by the increased number of surgical procedures utilizing the aprevo® technology platform in the second quarter of 2025, with average revenue per procedure flat between these periods. - Gross profit for the second quarter of 2025 was
$8.9 million compared to$4.6 million for the second quarter of 2024, due to our increased revenue. Gross margin was 73.4% for the second quarter of 2025, compared with 75.0% for the second quarter of 2024; this decrease was primarily driven by expedite production fees charged by our contract manufacturer in the second quarter to meet customer timing requirements. - Operating expenses were
$15.4 million for the second quarter of 2025, compared with$10.9 million for the second quarter of 2024.- Research and development expenses were
$4.2 million for the second quarter of 2025, compared with$4.0 million for the second quarter of 2024. This increase was primarily driven by higher personnel costs to support product development and artificial intelligence initiatives, partially offset by lower prototype and materials costs and reduced COMPASS registry costs following enrollment completion in second half of 2024. - Sales and marketing expenses were
$7.9 million for the second quarter of 2025, compared with$4.9 million for the second quarter of 2024. This increase was primarily driven by personnel additions and variable sales expenses associated with our revenue growth, as well as an increase in marketing expenses. - General and administrative expenses were
$3.3 million for the second quarter of 2025, compared with$2.0 million for the second quarter of 2024. This increase was primarily due to personnel additions to support business growth and costs associated with the transition to being a publicly traded company, including associated legal, accounting, and other professional fees.
- Research and development expenses were
- Net loss was
$6.8 million for the second quarter of 2025, compared to a$6.3 million net loss for the second quarter of 2024. - Adjusted EBITDA loss was
$6.2 million for the second quarters of 2025 and 2024. - Cash and cash equivalents were
$33.5 million as ofJune 30, 2025 . The Company received$93.5 million of net proceeds, after deducting underwriting discounts and commissions and before other additional offering expenses, from its initial public offering inJuly 2025 . - The first personalized cervical spine surgery using the AI-enabled aprevo® technology platform was performed.
- aprevo® cervical procedures received CMS New Technology Add-On Payment (NTAP) reimbursement, in effect
October 1, 2025 .
2025 Full Year Financial Outlook
- Revenue for the full year 2025 is expected to be in the range of
$45.5 million to$47.5 million , representing growth of 67% to 75% over 2024.
Webcast & Conference Call Details
Carlsmed will host a conference call and concurrent webcast today at
Non-GAAP Financial Measures
This press release contains certain financial information that is not presented in conformity with
The Company calculates Adjusted EBITDA as net income (loss), as adjusted to exclude (i) net interest expense and income, (ii) income tax expense (benefit), (iii) depreciation and amortization expense, (iv) stock-based compensation expense and (v) change in fair value of warrant liabilities.
This non-GAAP measure is presented because management believes it allows investors to view the Company’s performance in a manner similar to the method used by management to evaluate financial performance for both strategic and annual operating planning. Management believes that to properly understand short-term and long-term financial trends, it is helpful for investors to understand the impact of the items excluded from the calculation of Adjusted EBITDA, in addition to considering the Company’s GAAP financial measures. The excluded items vary in frequency and/or impact on our results of operations and management believes that the excluded items are not reflective of the Company’s ongoing core business operations and financial condition. Excluding such items allows investors and analysts to compare our operating performance to other companies in our industry and to compare the Company’s period-over-period results.
The non-GAAP financial measures used by Carlsmed may not be the same or calculated in the same manner as those used and calculated by other companies. Non-GAAP financial measures have limitations as analytical tools and should not be considered in isolation or as a substitute for Carlsmed’s financial results prepared and reported in accordance with GAAP. This non-GAAP measure has limitations as an analytical tool and should not be construed as an inference that the Company’s future results will be unaffected by unusual or non-recurring items. We urge investors to review the reconciliation of these non-GAAP financial measures to the comparable GAAP financial measures included in this press release, and not to rely on any single financial measure to evaluate our business. A reconciliation of Adjusted EBITDA reported in this press release to the most comparable GAAP measure for the respective periods appears in the table captioned “Reconciliation of GAAP Net Income (Loss) to Adjusted EBITDA” later in this release. Within the accompanying financial tables presented, certain columns and rows may not add due to the use of rounded numbers.
About Carlsmed
Carlsmed is a medical technology company pioneering AI-enabled personalized spine surgery solutions with a mission to improve outcomes and decrease the cost of healthcare for spine surgery and beyond.
Forward Looking Statement
Any statements in this press release about future expectations, plans and prospects, including statements about the Carlsmed’s ability to scale the impact of its aprevo® technology platform and advance its personalized spine surgery platform to transform patient outcomes and drive long-term growth, Carlsmed’s current expectation of commercially launching aprevo® cervical in
Investor Relations
IR@Carlsmed.com
Media
Senior Director Brand Marketing
LBurton@Carlsmed.com
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| Three Months Ended | Six Months Ended | |||||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||||
| Revenue | $ | 12,083 | $ | 6,081 | $ | 22,272 | $ | 11,167 | ||||||||
| Cost of sales | 3,214 | 1,519 | 5,767 | 2,941 | ||||||||||||
| Gross profit | 8,869 | 4,562 | 16,505 | 8,226 | ||||||||||||
| Operating expenses: | ||||||||||||||||
| Research and development | 4,160 | 3,998 | 7,310 | 7,254 | ||||||||||||
| Sales and marketing | 7,869 | 4,873 | 14,608 | 8,470 | ||||||||||||
| General and administrative | 3,342 | 2,010 | 6,808 | 4,150 | ||||||||||||
| Total operating expenses | 15,371 | 10,881 | 28,726 | 19,874 | ||||||||||||
| Loss from operations | (6,502 | ) | (6,319 | ) | (12,221 | ) | (11,648 | ) | ||||||||
| Other income (expense): | ||||||||||||||||
| Interest expense | (363 | ) | (325 | ) | (720 | ) | (541 | ) | ||||||||
| Interest income | 336 | 428 | 716 | 526 | ||||||||||||
| Change in fair value of warrant liabilities | (237 | ) | (61 | ) | (270 | ) | (61 | ) | ||||||||
| Total other income (expense), net | (264 | ) | 42 | (274 | ) | (76 | ) | |||||||||
| Net loss and comprehensive loss | (6,766 | ) | (6,277 | ) | (12,495 | ) | (11,724 | ) | ||||||||
| Deemed dividend to preferred stockholders | — | — | (584 | ) | — | |||||||||||
| Net loss attributable to common stockholders | $ | (6,766 | ) | $ | (6,277 | ) | $ | (13,079 | ) | $ | (11,724 | ) | ||||
| Net loss per share attributable to common stockholders, basic and diluted | $ | (1.47 | ) | $ | (1.55 | ) | $ | (2.94 | ) | $ | (2.91 | ) | ||||
| Weighted-average number of common shares used to compute basic and diluted net loss per share | 4,589,717 | 4,053,063 | 4,445,384 | 4,024,815 | ||||||||||||
| ||||||||
| Assets | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 33,472 | $ | 40,125 | ||||
| Restricted cash | 100 | 100 | ||||||
| Accounts receivable, net of allowances of | 9,711 | 6,766 | ||||||
| Inventory | 1,068 | 995 | ||||||
| Prepaid expenses and other current assets | 1,841 | 1,365 | ||||||
| Total current assets | 46,192 | 49,351 | ||||||
| Property and equipment, net | 972 | 260 | ||||||
| Operating lease right-of-use assets | 2,144 | 1,644 | ||||||
| Other assets | 3,962 | 569 | ||||||
| Total assets | $ | 53,270 | $ | 51,824 | ||||
| Liabilities, Convertible Preferred Stock, and Stockholders’ Deficit | ||||||||
| Current liabilities: | ||||||||
| Accounts payable | $ | 2,581 | $ | 2,412 | ||||
| Accrued liabilities | 3,219 | 2,687 | ||||||
| Accrued compensation | 3,113 | 3,270 | ||||||
| Short-term operating lease liabilities | 571 | 449 | ||||||
| Total current liabilities | 9,484 | 8,818 | ||||||
| Long-term portion of term loan, net | 15,431 | 15,414 | ||||||
| Long-term operating lease liabilities | 1,705 | 1,317 | ||||||
| Warrant liabilities | 727 | 457 | ||||||
| Other long-term liabilities | 267 | 222 | ||||||
| Total liabilities | 27,614 | 26,228 | ||||||
| Commitments and contingencies (Note 9) | ||||||||
| Series A convertible preferred stock, | 13,578 | 13,578 | ||||||
| Series B convertible preferred stock, | 29,801 | 29,801 | ||||||
| Series C convertible preferred stock, | 65,350 | 52,847 | ||||||
| Stockholders’ deficit: | ||||||||
| Common stock, | — | — | ||||||
| Additional paid-in capital | 593 | 541 | ||||||
| Accumulated deficit | (83,666 | ) | (71,171 | ) | ||||
| Total stockholders’ deficit | (83,073 | ) | (70,630 | ) | ||||
| Total liabilities, convertible preferred stock, and stockholders’ deficit | $ | 53,270 | $ | 51,824 | ||||
| RECONCILIATION OF GAAP NET LOSS TO ADJUSTED EBITDA (unaudited) | ||||||||||||||||||||
| Three Months Ended | $ | % | ||||||||||||||||||
| 2025 | 2024 | Change | Change | |||||||||||||||||
| (in thousands, except percentages) | ||||||||||||||||||||
| Net loss | $ | (6,766 | ) | $ | (6,277 | ) | $ | (489 | ) | 7.8 | % | |||||||||
| Interest (income) expense | 27 | (103 | ) | 130 | (126.2 | ) | % | |||||||||||||
| Income taxes | — | — | — | — | ||||||||||||||||
| Depreciation and amortization | 61 | 35 | 26 | 74.3 | % | |||||||||||||||
| EBITDA | (6,678 | ) | (6,345 | ) | (333 | ) | 5.2 | % | ||||||||||||
| Stock-based compensation | 258 | 52 | 206 | 396.2 | % | |||||||||||||||
| Change in fair value of warrant liabilities | 237 | 61 | 176 | 288.5 | % | |||||||||||||||
| Adjusted EBITDA | $ | (6,183 | ) | $ | (6,232 | ) | $ | 49 | (0.8 | ) | % | |||||||||
| Six Months Ended | $ | % | ||||||||||||||||||
| 2025 | 2024 | Change | Change | |||||||||||||||||
| (in thousands, except percentages) | ||||||||||||||||||||
| Net loss | $ | (12,495 | ) | $ | (11,724 | ) | $ | (771 | ) | 6.6 | % | |||||||||
| Interest (income) expense | 4 | 15 | (11 | ) | (73.3 | ) | % | |||||||||||||
| Income taxes | — | — | — | — | ||||||||||||||||
| Depreciation and amortization | 101 | 75 | 26 | 34.7 | % | |||||||||||||||
| EBITDA | (12,390 | ) | (11,634 | ) | (756 | ) | 6.5 | % | ||||||||||||
| Stock-based compensation | 433 | 87 | 346 | 397.7 | % | |||||||||||||||
| Change in fair value of warrant liabilities | 270 | 61 | 209 | 342.6 | % | |||||||||||||||
| Adjusted EBITDA | $ | (11,687 | ) | $ | (11,486 | ) | $ | (201 | ) | 1.7 | % | |||||||||
