Q2 2026 SI-BONE Inc Earnings Call Transcript
Key Points
- SI-BONE Inc (SIBN) delivered strong second-quarter results with worldwide and U.S. revenues of $56 million and $53.2 million, respectively, both representing approximately 15% growth, and U.S. procedure volume grew nearly 15% with double-digit growth across all modalities.
- The company achieved significant operating leverage, with revenue growing nearly twice as fast as operating expenses, leading to a 178% improvement in adjusted EBITDA to $2.8 million.
- SI-BONE Inc (SIBN) submitted a 510(k) application for its third breakthrough device, a non-pelvic solution targeting a recognized failure point in complex spine procedures, with a phased commercial launch on track for Q4 2026.
- The company saw broad-based physician adoption, with 1,715 unique physicians performing procedures in Q2, a 19% increase year-over-year, and double-digit growth across all call points.
- Reimbursement tailwinds are strong, including a proposed ~$1,000 increase for SI joint fusion CPT code 27279, new OBL reimbursement of over $20,000, and new DRGs for complex spinal fusion that could increase hospital payments by up to $50,000 per procedure.
- SI-BONE Inc (SIBN) raised the low end of its 2026 revenue guidance to $231 million-$233 million, reflecting 15%-16% growth, and maintained its gross margin guidance at 79%.
- The company's updated 2026 revenue guidance implies a slight deceleration in U.S. revenue growth in the back half of the year, with management citing typical Q3 seasonality and a measured approach to new product and reimbursement catalysts.
- SI-BONE Inc (SIBN) expects higher-than-normal cash flow variability in the next two quarters due to timing of payments for its new headquarters build-out and investments in surgical capacity for the upcoming product launch.
- The company is intentionally increasing R&D investment in the back half of the year to advance longer-term programs, which could temper near-term profitability expansion despite first-half outperformance.
- Gross margin is expected to remain flat at 79% for the full year, as the company anticipates depreciation on new surgical capacity assets to begin before associated revenue ramps up.
- The commercial partnership with Smith & Nephew is still in early stages, with a typical onboarding cycle of around six months for new physicians, meaning meaningful contribution from this channel may not materialize until late 2026 or 2027.
- The company's guidance assumes low single-digit ASP degradation, partly due to growth in interventional and trauma procedures that use fewer implants per case.
Good afternoon, and welcome to SI BONE's Second Quarter 2026 Earnings Conference Call. (Operator Instructions) As a reminder, this call is being recorded for replay purposes. I would now like to turn the call over to Saqib Iqbal, Vice President, FP&A and Investor Relations at SI BONE. Please go ahead.
Earlier today, SIBOM released financial results for the quarter ended June 30, 2026. A copy of the press release is available on the company's website. Before we begin, I'd like to remind you that management's remarks today may include forward-looking statements within the meaning of federal securities laws, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1,995.
These forward-looking statements are subject to a number of risks and uncertainties, including those set forth in our SEC filings, such as our most recent Form 10-K and actual results may differ materially from any forward-looking
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