PROCEPT BioRobotics Q3 Earnings Call Highlights

Key Points

• Q3 revenue rose 18% to $98.3 million, supported by consumables and international growth, while the net loss widened to $26.5 million and adjusted EBITDA loss increased to $9.8 million.
• HYDROS adoption is reshaping the business: procedure volume at HYDROS accounts was more than 35% above AquaBeam accounts, and PROCEPT shipped 62 systems. New-account placements came in below expectations, but the company maintained its 2026 outlook.
• PROCEPT kept its 2026 revenue forecast at $390 million to $410 million and expects positive adjusted EBITDA in Q4. Management’s initial 2027 planning assumption is about 20% revenue growth; it also expects key WATER IV prostate cancer trial results in May 2027.

PROCEPT BioRobotics NASDAQ: PRCT reported 18% revenue growth in the third quarter of 2026 as demand for its HYDROS systems and procedure-related products helped offset slower-than-expected placements at new U.S. accounts.

The company maintained its full-year revenue outlook and said it expects to reach positive adjusted EBITDA in the fourth quarter. Management also offered an initial 2027 planning assumption of approximately 20% revenue growth, while emphasizing that formal guidance will come later.

Third-quarter revenue rose to $98.3 million, while the net loss widened to $26.5 million from $21.4 million a year earlier. U.S. procedures increased approximately 22% to more than 13,400.

HYDROS transition drives strategy

CEO Larry Wood said procedure volume at HYDROS accounts was more than 35% higher than at accounts using the older AquaBeam system. He attributed weakness in AquaBeam utilization primarily to surgeons choosing HYDROS when they have access to both platforms, sometimes deferring cases to use the newer system.

Wood cited HYDROS features including enhanced imaging, AI-driven planning and a more efficient workflow. He said the company did not yet have enough experience with replacement systems to provide meaningful metrics on how individual account upgrades affect utilization.

PROCEPT shipped 62 HYDROS systems in the quarter, including 20 replacements, bringing its year-to-date replacement total to 36. The company now expects 50 to 60 replacement sales for 2026 at an average selling price of approximately $315,000. Wood said the company had initially expected five to 10 replacements for the full year.

Placements at new, or greenfield, accounts fell short of third-quarter expectations. Wood said the shortfall was largely a matter of timing and that the company remained confident in capital demand. CFO Kevin Waters said the company’s updated outlook still implies around 210 greenfield placements for the year.

Approximately 70% of systems placed during the quarter were supported by PROCEPT’s dedicated launch team. Wood said the company remains on track to have the capacity to launch all systems with the team by year-end. Management said launch-team systems have reached their first cases sooner and shown higher utilization than historical levels.

Financial results and outlook

U.S. revenue increased 16% to $85.8 million. Handpiece and other consumable revenue rose 21% to $53.9 million, while U.S. system revenue was flat at $24.7 million. International revenue climbed 32% to a record $12.5 million.

New U.S. HYDROS system placements had an average selling price of approximately $495,000, unchanged from the second quarter and up from $435,000 in the year-earlier quarter. Handpiece pricing was approximately $3,570.

Of the 62 systems shipped, two were under operating leases and revenue recognition for three was deferred pending payment. Waters said the company expects to receive those payments and recognize the associated revenue in the fourth quarter.

Gross margin improved to 66% from 65% a year earlier. Operating expenses rose to $92.5 million from $77.2 million, reflecting investment in areas including product development, clinical studies and sales and marketing. Adjusted EBITDA was a loss of $9.8 million, compared with a $7.4 million loss a year earlier.

PROCEPT maintained its 2026 revenue forecast of $390 million to $410 million, representing growth of approximately 27% to 33%. It expects around 54,000 U.S. procedures for the year, at the low end of its prior range of 54,000 to 56,000. Wood pointed to a stronger September and typical fourth-quarter seasonality as reasons for confidence in the forecast.

The company expects full-year operating expenses of $359 million to $363 million and maintained its adjusted EBITDA loss outlook of $30 million to $35 million. Waters said that guidance implies fourth-quarter adjusted EBITDA of positive $3 million to $9 million.

2027 planning and clinical studies

Management described approximately 20% revenue growth in 2027 as a base case rather than formal guidance. Wood said the assumption contemplates capital activity similar to 2026 and does not include a contribution from prostate cancer. Waters said it does not rely on incremental benefits from patient activation or launch-team initiatives.

PROCEPT expects to present primary endpoint results in May 2027 from WATER IV, a fully enrolled trial comparing Aquablation with radical prostatectomy in 280 patients with prostate cancer. The company is also advancing a separate trial comparing Aquablation with active surveillance in up to 333 men.

Wood said the company would be able to provide more detail on the prostate cancer opportunity after reviewing the data and engaging with the Food and Drug Administration.

About PROCEPT BioRobotics (NASDAQ:PRCT)

PROCEPT BioRobotics Corporation is a medical technology company focused on developing and commercializing robotic solutions for the treatment of benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate that can cause urinary symptoms. The company's technology is designed to provide a minimally invasive alternative to conventional surgical procedures.

Its primary product is the AquaBeam Robotic System, which uses image guidance, robotic assistance and a high-velocity waterjet to remove targeted prostate tissue.

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