Xtant Medical Q2 2026 Earnings Report

Xtant Medical EPS Results

• Actual EPS: -$0.07
• Consensus EPS: -$0.02
• Beat/Miss: Missed by -$0.05
• One Year Ago EPS: N/A

Xtant Medical Revenue Results

• Actual Revenue: $23.03 million
• Expected Revenue: $24.88 million
• Beat/Miss: Missed by -$1.85 million
• YoY Revenue Growth: N/A

Xtant Medical Announcement Details

• Quarter: Q2 2026
• Date: 8/11/2026
• Time: Before Market Opens
• Conference Call Date: Tuesday, August 11, 2026
• Conference Call Time: 8:30AM ET

Xtant Medical (NYSEAMERICAN:XTNT), Inc. is a medical technology company focused on the development, manufacturing and distribution of bone graft, spine biologics and related implantable medical devices. The company’s product portfolio is designed to address critical needs in spinal fusion, orthopedics and trauma surgery by providing a range of solutions that promote bone growth, structural support and patient recovery.

The company’s offerings include an array of bone graft substitutes – such as demineralized bone matrix putties and fibers – interbody fusion devices, spinal fixation systems and biologic agents. Xtant Medical leverages proprietary technologies to optimize handling characteristics and osteoinductive potential, with products that are used by surgeons in hospital operating rooms and outpatient surgical centers. The company also provides custom solutions through its product design and contract manufacturing services.

Headquartered in Carlsbad, California, Xtant Medical serves customers primarily across North America, with distribution partnerships extending to select international markets. Under the leadership of President and Chief Executive Officer Shawn Ainsworth, the company continues to expand its research and development capabilities and advance its regenerative medicine pipeline. Xtant Medical is dedicated to improving patient outcomes by delivering innovative, clinically driven solutions for spinal and orthopedic care.

Xtant Medical Q2 2026 Earnings Call Transcript

Key Takeaways

• Negative Sentiment: Revenue and guidance declined: Q2 revenue fell to $23.0 million from $24.8 million on a pro forma basis, primarily due to weakness in legacy orthobiologics and amnio products. Xtant reduced full-year revenue guidance to $99 million–$103 million from $101 million–$105 million.
• Negative Sentiment: Profitability weakened materially: Gross margin fell to 57.9% from 68.6%, while the company reported a $9.4 million net loss and a $2.7 million adjusted EBITDA loss, partly reflecting the $5 million Dilon fee, lower production efficiency, and inventory charges.
• Positive Sentiment: HEMOBLAST® integration is progressing: The company recognized approximately $1.5 million of Q2 HEMOBLAST® revenue and expects transactional volume to exceed $1 million per month on a gross basis, with substantially all future sales expected to flow through Xtant’s contracts and distribution network.
• Positive Sentiment: Expanded commercial reach and new products support future growth: Xtant integrated 17 Dilon salespeople and expanded its broader commercial team to more than 25 representatives, while reporting strong early traction for Trivium™ Shaped. Management expects these investments and cross-selling opportunities to accelerate biologics growth in the second half of 2026.

Presentation

[Operator]

Good morning, everyone, and welcome to the Xtant Medical Second Quarter 2026 Financial Results Conference Call. At this time, all participants are in a listen-only mode, and the floor will be open for questions following the presentation. Please note that this conference is being recorded. I will now turn the conference over to your host, Kevin Gardner of LifeSci Advisors. Please go ahead.

[Kevin Gardner, Managing Director at LifeSci Advisors]

Thank you, operator, and welcome to Xtant Medical's Second Quarter 2026 Financial Results Call. Joining me today are Sean Browne, President and Chief Executive Officer, and Scott Neils, Chief Financial Officer. Today's call is being webcast and will be posted on the company's website for playback. During the course of this call, management may make certain forward-looking statements regarding future events and the company's expected future performance. These forward-looking statements reflect Xtant's current perspective on existing trends and information and can be identified by such words as "expect," "plan," "will," "may," "anticipate," "believe," "should," "intends," and other words with similar meaning. Such forward-looking statements are not guarantees of future performance and involve risks and uncertainties, including those noted in the Risk Factor section of the company's annual report on Form 10-K filed with the SEC and in subsequent SEC reports and press releases. Actual results may differ materially.

[Kevin Gardner, Managing Director at LifeSci Advisors]

The company's financial results press release and today's discussion include certain non-GAAP financial measures. Please refer to the non-GAAP to GAAP reconciliations, which appear in our press release and are otherwise available on our website. Note that the Form 8-K that we file with our financial results press releases provide detailed narratives that describe our use of such measures. For the benefit of those of you who may be listening to a replay of this call, it was held and recorded on August 11th, 2026, at approximately 8:30 A.M. Eastern Time. The company declines any obligation to update its forward-looking statements except as required by applicable law. Now I'd like to turn the call over to Sean Browne, CEO. Sean?

[Sean Browne, President and CEO at Xtant Medical]

Thank you, Kevin, and good morning, everyone. Thank you for joining our second quarter update call. As has been our practice, I will begin with a few prepared remarks about our operations, and Scott will provide a deeper dive into the financials. We will then open the call to your questions. Okay. During the second quarter, we achieved meaningful progress across several aspects of our business. We integrated the new Dilon sales reps into our own commercial organization, and we addressed a significant unmet need among surgeons with the launch of Trivium Shaped.

[Sean Browne, President and CEO at Xtant Medical]

While our reported revenue continues to face challenging year-over-year comps due to the sale of certain assets and businesses to Companion Spine last year, as well as the cessation of certain license revenue due to changes in reimbursements that took effect January 1, we are building a solid, resilient foundation that we believe will support sustained, predictable, and profitable growth in the future. Turning to the Dilon Technologies distribution agreement that we announced in April. Recall that through this agreement, we acquired exclusive U.S. distribution rights to Dilon's HEMOBLAST Bellows product for high-performance hemostasis following certain surgical procedures. This agreement adds a highly complementary hemostatic technology to our portfolio and gives us entry into an estimated $1 billion global addressable market for hemostatic products.

[Sean Browne, President and CEO at Xtant Medical]

As part of that agreement, we hired Dilon's U.S. team of 17 salespeople and two their regional managers that have been integrated into our own commercial organization and are being trained on our entire portfolio. This is in addition to our own investments that we have been making in our commercial organization, including, as we stated previously, doubling the number of regional sales reps in the field. In 2026, we've been adding significant resources to our marketing and national accounts teams, and these professionals have had an immediate impact driving institutional adoption of our portfolio at scale across hospital systems and large practice groups. As a side note, the training and integration of these new reps consumed a significant amount of our time and resources and played a role in our soft Q2 sales.

[Sean Browne, President and CEO at Xtant Medical]

However, I'm more than excited than ever about Xtant's future with this significantly larger commercial team. As for HEMOBLAST, HEMOBLAST orders during the quarter were in line with our expectations, but our recognition of this revenue from sales is lower than we expected since we didn't transition purchase orders for HEMOBLAST to Xtant until after the end of the second quarter, and our transition of certain customers to Xtant contracts remains ongoing. Accordingly, we are unable to fully recognize the revenue on orders submitted to Dilon during the quarter. As we look out into the remainder of the year, we see significant sales synergies as our legacy commercial organization and the new specialty reps share very few overlapping call points in the field.

[Sean Browne, President and CEO at Xtant Medical]

As the specialty reps continue to get comfortable selling our other product lines, we anticipate that this will translate into accelerating biologics growth in Q3 and beyond. At this point, while we are very pleased with the speed with which they are coming up the learning curve, we see significant untapped potential that we expect to penetrate once these additional sales resources are fully deployed. We view the newly integrated sales force as a foundational part of our future commercial strategy. Turning to Trivium Shaped. We are seeing strong early sales traction since the product's launch in May, joining CollagenX and OsteoFactor Pro as recent product launches that are key drivers to our overall biologics growth. Trivium Shaped is an extension of our Trivium bone graft portfolio, available in pre-shaped configurations designed to support handling, preparation, and placement across a range of surgical applications.

[Sean Browne, President and CEO at Xtant Medical]

Trivium is a composite allograft that combines cortical fibers, cancellous bone, and demineralized bone matrix into a single connected bone graft matrix. Trivium Shaped builds on the Trivium's sculptable format, which we launched in 2025, by offering surgeons ready-to-use graft forms, including boats and strips that are designed to improve consistency and handling in the operating room. Surgeons tell us that these pre-shaped formats reduce preparation time and support more predictable placement, and that feedback is translating directly into the sales momentum we are seeing since launch. Innovations such as Trivium Shaped, a demineralized bone matrix, together with our amnio and CollagenX product lines, also position us to move into adjacent high-value markets, including chronic wound care and surgical repair, a combined TAM of approximately $6.5 billion.

[Sean Browne, President and CEO at Xtant Medical]

Now with the addition of Hemostatic Biologic, we gain access to an additional $1 billion of TAM, and we are uniquely positioned to be a partner of choice that can address a very broad range of surgeon and hospital needs in regenerative medicine. We believe that breadth of our portfolio, together with the quality control that comes with in-house manufacturing, sets us apart from nearly everyone else in the field. Now, from a guidance perspective, reflecting lower than expected biologics revenue in the second quarter, as well as the ongoing headwinds related to our amnio product line directly tied to the advanced wound care market that are expected to persist through the back half of the year. We are today modestly reducing our full-year revenue guidance to a range of $99 million to $103 million, and that was from $101 million to $105 million previously.

[Sean Browne, President and CEO at Xtant Medical]

Notwithstanding this change, however, we continue to believe that our enhanced commercial presence and expanded product portfolio position us well to drive top-line growth throughout 2026 and beyond. With that, I'll turn the call over to Scott for a more detailed review of our financial results. Scott?

[Scott Neils, CFO at Xtant Medical]

Thank you, Sean, and good morning, everyone. Total revenue for the second quarter of 2026 was $23 million, compared to $35.4 million for the second quarter of 2025, or $24.8 million for the second quarter of 2025 on a pro forma basis, excluding the revenue from the non-core products and businesses that we sold to Companion Spine and non-recurring license revenue. Note that a reconciliation of actual to pro forma revenue results for each quarter of 2025 can be found on the company's website at www.xtantmedical.com. With respect to the Q2 comparison on a pro forma basis, headwinds related to our amnio product revenue directly tied to the advanced wound care market were the main driver for the decline in 2026 biologics revenue compared to the pro forma 2025 period.

[Scott Neils, CFO at Xtant Medical]

Although this was partially offset by approximately $1.5 million of HEMOBLAST sales, as well as higher than anticipated hardware revenue in the current year period, driven by sales of our Cortera spinal fixation system. Our second quarter revenue was also impacted by the time our legacy sales team spent getting up to speed on HEMOBLAST Bellows during the quarter, which created a modest additional headwind that we expect to abate in the second half of the year. Staying on the topic of HEMOBLAST, the $1.5 million of revenue that we recognized in the second quarter was accounted for primarily on a net basis, as it was shipped directly to customer sites from the Dilon Technologies facility under Dilon's customer agreements. We previously anticipated that significantly more of these transactions would be ordered from and shipped by Xtant, which would have increased reported revenue by approximately $600,000 to $700,000.

[Scott Neils, CFO at Xtant Medical]

Going forward, we believe that substantially all HEMOBLAST Bellows sales will be processed through our own customer agreements and distribution network and will therefore be recognized on a gross basis. As Sean mentioned a moment ago, new product introduction and the new measured investments we have made in our field sales force on both the regional and national basis should drive accelerating biologics growth on a sequential basis for the remainder of 2026 and beyond. Gross margin for the second quarter of 2026 was 57.9%, compared to 68.6% for the same period in 2025. The decrease is primarily attributable to the cessation of Q-Code license revenue from our amniotic membrane agreements that terminated at the end of 2025, together with reduced production efficiencies and increased charges for excess and obsolete inventory, partially offset by improvements in production mix.

[Scott Neils, CFO at Xtant Medical]

Second quarter 2026 operating expenses were $22.5 million, compared to $19.7 million for the second quarter of 2025. The increase was primarily due to a $5 million exclusive fee paid to Dilon Technologies in connection with their distribution agreement, which is recorded as an operating expense, partially offset by lower general and administrative and sales and marketing expenses following the sale of our non-core Coflex and CoFix assets and international hardware businesses to Companion Spine in December 2025. General and administrative expenses were $6.4 million for the three months ended June 30th, 2026, compared to $7.5 million for the same period in 2025. The decrease was driven primarily by the divestiture of assets and businesses to Companion Spine in December of last year. Sales and marketing expenses were $10.4 million for the three months ended June 30th, 2026, compared to $11.6 million for the same quarter last year.

[Scott Neils, CFO at Xtant Medical]

Approximately $2.4 million of the decrease resulted from the Companion Spine divestitures. The remaining change reflects $1.2 million of increased compensation expense related to headcount, a $0.3 million increase in independent agent commissions resulting from revenue mix, and a $0.3 million increase in travel-related expenses, partially offset by a $0.9 million reduction in consulting fees. Research and development expenses were $695,000 for the three months ended June 30th, 2026, an increase from $566,000 in the second quarter of 2025. Net loss for the second quarter of 2026 was $9.4 million, or $0.07 per basic and diluted share, compared to net income of $3.6 million for the second quarter of 2025, to $0.03 per basic share and $0.02 per diluted share. Adjusted EBITDA for the second quarter of 2026 was a loss of $2.7 million, compared to positive adjusted EBITDA of approximately $6.9 million for the second quarter of 2025.

[Scott Neils, CFO at Xtant Medical]

As of June 30th, 2026, we had $9.9 million of cash and cash equivalents, total indebtedness of $23 million, and availability under a revolving credit facility of $0.7 million. This compares to $17.3 million of cash and cash equivalents, total indebtedness of $25.4 million, and availability under a revolving credit facility of $3.8 million as of December 31st, 2025. That concludes the financial overview. Operator, you may now open the line for questions.

[Operator]

Certainly. The floor is now open for questions. If you have any questions or comments, please press star one on your phone at this time. We ask that while posing your question, you please pick up your handset if listening on a speakerphone to provide optimum sound quality. Please hold for just a moment while we pull for questions. Your first question is coming from Chase Knickerbocker with Craig-Hallum. Please pose your question. Your line is live.

[Analyst at Craig-Hallum]

Morning, everyone. This is Jake in for Chase. Thanks for taking the questions.

[Scott Neils, CFO at Xtant Medical]

Hey, Jake. How are you?

[Analyst at Craig-Hallum]

I'm good, Scott. Good to hear from you. I'm just wondering, can you peel apart the layers of Orthobiologics for us, please? What's kind of underperforming relative to expectations that you guys had earlier in the year when guidance was initially issued?

[Sean Browne, President and CEO at Xtant Medical]

Scott, I'll start this, and then if you want to add any color to it. I'd say there's a couple of key areas. One of the big areas has been our old line, like our OsteoSelect, OsteoSponge, 3Demin product lines, which have been the workhorses of our product line, and they're older product lines. Those have been down more than we expected. The other area, too, that's been down, of course, has been the amnio side, which we mentioned, which has been due and was somewhat expected. We did think that there would start to see green shoots of growth in that world, in the amnio world. But those would be the key areas that I would say that we have seen much more softness than we originally expected. Scott, I don't know if you want to add anything to that.

[Scott Neils, CFO at Xtant Medical]

No, I think you covered it with those two, Sean.

[Analyst at Craig-Hallum]

Thanks for that color. Maybe just for my follow-up, turning to HEMOBLAST. Could you further talk about the cross-selling opportunities that are presenting themselves from the addition of the reps associated with HEMOBLAST? What does your guidance assume for HEMOBLAST from this year, and how does that compare to your expectations upon the acquisition?

[Sean Browne, President and CEO at Xtant Medical]

Okay. I'll start off with where do we see the synergies of these guys. First and foremost, this is a group that when you look at the hemostasis business, they're in areas that we're typically not in. However, we have products that fit perfectly within what they do, specifically our CollagenX products as well as our amnio products. At a minimum, we've got these guys now carrying these products into these other areas that are really non-orthobiologics in their normal space. Additionally, our current HEMOBLAST guys do have some business within the spine world. The spine world actually turns out to be a very, very good market for the hemostasis world. We do have some new independent agents that have been tied into that.

[Sean Browne, President and CEO at Xtant Medical]

However, one of the big things that we see with this group is that they are going to help us extend our reach, not only with what we can do in way of managing our current independent agent network, which even though we've doubled the size of our sales force, the core Xtant group went from four guys last year to we have roughly eight people selling it on our core side. We now have 17 more people actually having it in their bag and carrying and managing some of our smaller, if not even guys that aren't doing that much business with our independent agent network.

[Sean Browne, President and CEO at Xtant Medical]

We see this as a great extension for us because the other piece to this too is that they have really great relationships within the not only in these areas outside the hospital or outside of where we normally go, but they also have a pretty strong relationship within the materials management world, which again, is certainly something that we've not had in years past. When you have a biologics portfolio as broad as ours is,

[Sean Browne, President and CEO at Xtant Medical]

We want to make sure that the hospital knows that we're not just a spine company, that we can actually touch several other areas within a hospital. This group is really a nice little addition to us as we start to get our name out and make sure that at least as hospitals go, we become a much bigger player, especially as you start looking at, as contracts start coming up and other things like that, we become somebody that they look to as potentially that one-stop shop. That's how I'd answer that. As for the HEMOBLAST guides, what I'd like to do on that is maybe, Scott, I think what I'd like to do is just kick the can a little bit or kick the ball on the. Maybe I'll let you comment on that, Scott, if that doesn't make sense.

[Sean Browne, President and CEO at Xtant Medical]

But I'd feel a lot better knowing that we had a lot more of that product going through our own Xtant POs versus the Dilon. Again, a lot of this is just the transition, these large hospital systems. Hospital systems that quite frankly, before we got in with HEMOBLAST/Dilon, we weren't in. Places like Cleveland Clinic and Massachusetts General Hospital and a number of really big institutions. So these are behemoths to get into, and so we're just thrilled that we're getting some business, and we're hoping to pull through other contracts that go along with that. Scott, I'll let you add any color to that.

[Scott Neils, CFO at Xtant Medical]

I think what I'd add to that is we haven't backed off of our expectation around transactional volume, which would be over $1 million per month on a gross basis. But I think what you're getting at, Sean, is the extent to which we're able to fully recognize that really depends on the extent to which we're able to ship all that. We've made considerable progress towards that end, but we've left a little bit of a buffer to accommodate anything that would continue to ship out of Dilon during the course of Q3.

[Analyst at Craig-Hallum]

Got it. Thank you for all the detail, Sean and Scott. That was helpful.

[Operator]

Your next question is coming from Naz Rahman with Maxim Group. Please pose your question. Your line is live.

[Sean Browne, President and CEO at Xtant Medical]

Hey, Naz. How are you?

[Naz Rahman, Analyst at Maxim Group]

Hi, everyone. I'm doing well. You're doing great. Thanks for taking my questions. I just have a couple. Regarding the Dilon sales force and just your overall sales force, exactly when in the quarter did they start or restart promoting products following training? Also, I know you talked a little bit about expanding their bag. But in terms of their additional products in the bag, did you give them access to, I guess, all of Xtant's prior products outside of HEMOBLAST? Or was it just a limited few products, like you said, CollagenX and amnio, or are you going to roll that out to the sales force over time? Thanks.

[Sean Browne, President and CEO at Xtant Medical]

Yeah, great question because that timing is important. We closed the deal on April, I guess it was 13th is the official announcement of the day. So, right as the quarter got going. In the first couple of weeks, it was literally just the integration of these guys into our payroll system, our human resources elements, all those things. Then we quickly put in their bag our CollagenX and our Amnio products. Those do take some time to understand and explain how they can fit into the different worlds. Like for instance, we've got a really nice business within the OBGYN world. How does an Amnio product fit into that, right? It does. It's got a really nice place in it.

[Sean Browne, President and CEO at Xtant Medical]

We spent a good part of the first, let's say, actually almost the entirety of the quarter just getting them up and comfortable with those two product lines. Then at the flip of the really after June, we then started giving them the entire bag. They are now, as we speak, coming up to speed on all of our orthobiologics. At the same time, we're now starting to give to them, this group of 17, some of our lesser-covered independent agents that are part of our world today. We have some 650 agreements. However, we do a lot of business with the top 200 to, say, 250. So there's another 400 that are out there that are transactional at best. Part of what we want to do is actually start getting touches to those other guys.

[Sean Browne, President and CEO at Xtant Medical]

That is what this 17 is now being tasked with. They are also, at the same time, getting comfortable with our orthobiologics product lines. It is a work in progress, and as you can see, just as I lay out for you can see where organizationally, we, in some respects, took a step back to sharpen the saw, so to speak, where you are saying, "Okay, these 17 people are really going to help us as we move forward." However, it is going to take some time to train them. We lost a little bit of our sales momentum that was going into the second quarter because we were spending time working with these guys on a regional basis and also getting the word out about HEMOBLAST. So, yes. There has been a fair amount of time and energy devoted to bring this group up.

[Sean Browne, President and CEO at Xtant Medical]

But I think the long run, this is going to be a huge win for the business overall. If you think about, again, our commercial footprint from a year ago to where we are today, it is almost like night and day. I mean, we have four regional vice presidents, a national accounts guy, and whatever. Just a very small commercial footprint a year ago. Today, that number is over 25 reps and a couple of regional managers. We got three, I am soon to have four national accounts people. Our foot is fully on the accelerator when it comes to our commercial presence, and I think you will start to see that here in the second half start to take hold.

[Naz Rahman, Analyst at Maxim Group]

Got it. That was very helpful. Thanks for taking my questions.

[Operator]

There appear to be no further questions in queue. This does conclude today's conference call. You may disconnect your phone lines at this time, and have a wonderful day. Thank you for your participation.

Participants

Executives

• Sean Browne, President and CEO
• Scott Neils, CFO

Analysts

• Kevin Gardner, Managing Director at LifeSci Advisors
• Analyst at Craig-Hallum
• Naz Rahman, Analyst at Maxim Group