MiMedx Group Q1 Earnings Call Highlights

Key Points

• MiMedx reported Q1 consolidated net sales of $59 million (down 33% y/y) with surgical sales rising to $36 million (+13%) while wound care plunged to $23 million (-60%), producing a GAAP net loss of $11 million.
• Management blamed the wound-care collapse on Medicare’s shift to fixed-price reimbursement and the WISeR prior-authorization rollout, which slowed claims processing (including one MAC that largely stopped processing) and contributed to a 24% drop in wound volume.
• MiMedx announced a restructuring to deliver about $40 million in annualized savings including a 15% reduction in force, cut 2026 revenue guidance to $260–$290 million, expects adjusted EBITDA roughly breakeven for the year, and plans to resume up to $100 million in share repurchases over two years.

MiMedx Group NASDAQ: MDXG reported first-quarter 2026 results showing sharp divergence between its wound care and surgical businesses as the company worked through what executives described as significant disruption tied to a new Medicare reimbursement framework for skin substitutes.

On the company’s earnings call, CEO Joe Capper said MiMedx entered 2026 expecting some turbulence following the January 1 reimbursement reset, but he argued the rollout has created “a whole new set of challenges” and contributed to a larger-than-anticipated market contraction. CFO Doug Rice said the quarter marked the first time in recent company history that surgical revenue exceeded wound revenue.

Quarterly results: surgical growth offsets wound care decline

MiMedx posted first-quarter consolidated net sales of $59 million, down 33% from the prior-year period, according to Rice. Surgical sales were $36 million, up 13% year over year, while wound care sales were $23 million, down 60%.

Capper said adjusted gross profit margin was 72% and adjusted EBITDA was a loss of $12 million. Rice reported GAAP gross margin of 71% versus 81% a year ago, and said the decline reflected lower wound care average selling prices under Medicare’s new price cap, as well as higher production costs and product mix. MiMedx reported a GAAP net loss of $11 million, or $0.07 per share, compared to GAAP net income of $7 million, or $0.05 per share, in the prior-year quarter. Adjusted net loss was $7 million, or $0.05 per share.

MiMedx ended the quarter with $160 million of cash and cash equivalents as of March 31, 2026, and Rice said net cash balance was about $142 million, down from $148 million last quarter. First-quarter free cash flow was $1 million.

Medicare changes and WISeR model drive wound care disruption

Capper spent much of his prepared remarks detailing the operational impact of Medicare reimbursement reform, saying CMS moved from an ASP-based methodology to a fixed-price system for skin substitutes and, “at the very last minute,” did not implement new local coverage determinations (LCDs) that would have required proof of efficacy for reimbursement. He also pointed to the WISeR model rollout in six states, which adds prior authorization requirements.

According to Capper, claims processing slowed significantly, and he said at least one Medicare administrative contractor (MAC) did not process Medicare claims for most of the first quarter. In that MAC region, he said MiMedx’s year-over-year first-quarter wound revenue fell 72%. In one WISeR state, he said wound revenue was down 84%.

Rice added that the 60% wound sales decline included a 24% drop in volume, with pressure concentrated in “private office and associated care settings” that previously were reimbursed under ASP plus 6%. He said wound care center and hospital outpatient settings also experienced some confusion and reluctance to use amniotic skin substitutes, though he characterized the impact as smaller.

During Q&A, Capper told analysts MiMedx did not see the month-to-month wound volume pickup it typically expects, describing March as flat versus January and February. He added that April “has looked about the same” as the company continued to face market issues.

Capper said MiMedx recovered relatively quickly in wound care centers and that the bulk of the volume impairment came from outpatient settings such as “private office, home, mobile, nursing home, et cetera.” He said the company expects patients to migrate into other care settings over time, but described the pace as slow.

Cost reductions and profitability path

In response to the slower-than-anticipated market adjustment, MiMedx announced a restructuring and cost reduction initiative expected to deliver approximately $40 million in annualized savings. Rice said the initiative includes a 15% reduction in force, additional cost actions, and executive officer pay reductions. He said the company expects a one-time charge of about $4 million in the second quarter.

Rice said MiMedx expects adjusted EBITDA to be roughly break-even for the full year with sequential improvement each quarter, even as it anticipates an adjusted EBITDA loss in the first half and a return to profitability beginning in the third quarter as sales improve and cost savings take hold.

Asked whether more cuts may be needed if the wound recovery lags, Rice said management is “always looking to make the business as efficient as possible,” but called it “way too early” to discuss additional actions beyond the current initiative.

Surgical portfolio expansion, evidence generation, and regulatory plans

Management highlighted continued momentum in surgery as a central component of MiMedx’s longer-term strategy. Capper said the company has generated 50% top-line growth in its surgical business over the past three years as it invested in commercial resources, new products, and clinical evidence.

In the quarter, MiMedx launched AMNIOFIX Thyroid Shields, a variant of AmnioFix designed as a protective barrier during thyroidectomy procedures, which Capper said is “off to a terrific start.” MiMedx also began a limited market release of two licensed 510(k) products:

• G4Derm Plus, described as a flowable peptide matrix engineered for rapid protected wound closure
• Hydrelix Collagen Matrix, described as a sterile Type 1 collagen powder made from soluble modified bovine collagen

Rice said two flagship products, AmnioFix and AMNIOEFFECT, delivered strong double-digit surgical growth, and he said surgical revenue also benefited from late-quarter launch and early adoption of G4Derm Plus and HydroLix. Capper also pointed to MiMedx’s focus on scientific research, citing publications discussed on prior calls and emphasizing the company’s claim that it has “the number 1 most studied amniotic tissue.”

Looking ahead, Capper said MiMedx expects to submit its first two 510(k) applications for placental-derived products “in the next few months,” as the company advocates for placental allografts to move from a 361 designation to 510(k) clearance.

Updated outlook and capital allocation

Rice said MiMedx revised its top-line expectations for 2026, projecting revenue in the range of $260 million to $290 million, citing the slower-than-expected wound care market recovery. He said the company expects surgical to continue delivering double-digit growth over the year, supported by the organic portfolio and new products. For wound care, Rice said MiMedx anticipates sequential volume recovery each quarter, but expects the full-year year-over-year decline to be “in line with the decline that we saw during the first quarter on a relative basis,” reflecting continued ASP pressure under the new Medicare rules.

Capper also reiterated that MiMedx intends to move forward with its previously authorized up to $100 million share repurchase program over a two-year period. He said restructuring activity had temporarily precluded repurchases, but that the company is now able to proceed, while still prioritizing investments that meet its criteria.

In Q&A, Capper said competitor “dumping” of inventory at discounted prices remains “a meaningful headwind,” and he expects it to continue through at least the first half of the year.

About MiMedx Group NASDAQ: MDXG

MiMedx Group, Inc is a biopharmaceutical company focused on the development, manufacture and marketing of regenerative biomaterial products derived from human placental tissues. The company's core mission centers on harnessing the extracellular matrix and growth factors within amniotic and chorionic membranes to support wound healing and surgical applications. MiMedx's product line leverages proprietary purification processes designed to retain native tissue properties while ensuring sterility and safety.

MiMedx's principal offerings include amnion/chorion allografts branded under names such as EpiFix® and AmnioFix®, which are indicated for the treatment of acute and chronic wounds—including diabetic foot ulcers, venous leg ulcers and surgical site repair.

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