Q2 2026 Carlsmed Inc Earnings Call Transcript
Key Points
- Carlsmed Inc (CARL) delivered strong Q2 2026 revenue of $18.9 million, a 57% year-over-year increase, driven by robust surgeon adoption and procedure volume growth.
- The company's surgeon user base grew by more than 60% year-over-year, indicating strong market traction and expanding adoption of the aprevo platform.
- CMS issued a favorable final rule creating three new MS-DRG codes for aprevo lumbar procedures, simplifying coding and enhancing hospital reimbursement, which is expected to expand access.
- Gross margins expanded by 340 basis points year-over-year to 76.8%, reflecting operational efficiencies and a capital-light, digital-first business model.
- The company is on track for multiple product launches in Q4 2026, including the aprevo lumbar bilateral system and CORA cervical plating system, which are expected to drive further growth.
- Carlsmed Inc (CARL) raised its full-year 2026 revenue guidance to $74-$78 million, representing over 50% growth at the midpoint, reflecting strong first-half performance and confidence in the second half.
- The company reported a GAAP net loss of $10.5 million in Q2 2026, wider than the $6.8 million loss in the prior year, indicating increasing losses despite revenue growth.
- Total operating expenses increased significantly to $25.6 million in Q2 2026, up from $15.4 million in Q2 2025, driven by higher R&D, sales and marketing, and G&A costs.
- Adjusted EBITDA remained negative at -$8.6 million in Q2 2026, compared to -$6.2 million in the prior year, showing continued cash burn.
- The company's guidance implies a deceleration in revenue growth in the second half of 2026, with a midpoint growth rate of 45% versus the 57% achieved in Q2, suggesting potential headwinds or conservatism.
- The new CMS reimbursement ruling is not expected to have a material impact on second-half 2026 revenue, with benefits likely deferred to 2027, limiting near-term upside.
- The company faces increasing competition as competitors plan to introduce their own custom implants, which could pressure market share and pricing in the future.
Ladies and gentlemen, thank you for standing by and welcome to the Carlsmed second quarter 2026 earnings conference call. (Operator Instructions) I would now like to turn the conference over to your first speaker today, Stephanie Zhadkevich, Investor Relations. Please go ahead, Stephanie.
Thank you, Operator. Welcome to Carlsmed's second quarter 2026 earnings call. Joining me today are Mike Cordonnier, Chairman and Chief Executive Officer, and Leo Greensbank, Chief Financial Officer. Before we begin, I would like to caution that comments made during this call will include forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995.
All statements made on this call that do not relate to matters of historical fact should be considered forward-looking statements, including statements regarding the market in which Carlsmed operates, expectations and demand for Carlsmed's products, expectations with respect to reimbursement
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