SI-BONE Surges on Strong Q1, Raises Guidance Amid Innovation Push

SANTA CLARA, CA – May 11, 2026 – SI-BONE, Inc. (Nasdaq: SIBN) today reported robust first-quarter financial results that surpassed analyst expectations, prompting the medical device maker to raise its full-year guidance as its strategic initiatives in product innovation and market expansion gain significant traction. The company's performance, marked by double-digit revenue growth and a dramatic improvement in profitability metrics, signals growing confidence in its spinopelvic solutions and solidifies its position as a leader in a competitive healthcare sector.

For the quarter ending March 31, 2026, the company posted worldwide revenue of $52.6 million, an 11.2% increase over the same period last year and ahead of the consensus analyst estimate of $51.16 million. The positive results sent the company's stock up 1.79% in after-hours trading, reflecting investor optimism about its growth trajectory.

"The first quarter demonstrated the strength and durability of our platform, with record physician engagement and double-digit growth across all key metrics," said Laura Francis, Chief Executive Officer of SI-BONE, in a statement. "With growing commercial scale and our third breakthrough device on track for launch later this year, we are well positioned to accelerate revenue growth through 2026 and into 2027."

A Clearer Path to Profitability

Beyond the top-line growth, SI-BONE's first-quarter report revealed substantial progress on its path toward sustained profitability. Adjusted EBITDA—a non-GAAP measure of operating performance—skyrocketed by over 440% to $2.5 million, a significant leap from the $0.5 million reported in the first quarter of 2025. This marks the second consecutive quarter of positive adjusted EBITDA for the company, a crucial milestone that suggests its operational strategies are yielding tangible financial returns.

The company also made significant strides in managing its bottom line. Net loss for the quarter was $4.3 million, or $0.10 per share, a 33.8% improvement from the $6.5 million net loss recorded in the prior-year period. This performance handily beat the Zacks Consensus Estimate of a $0.17 loss per share.

In response to this strong start to the year, SI-BONE raised its full-year 2026 financial guidance. The company now expects worldwide revenue to be in the range of $230 million to $233 million, implying year-over-year growth of approximately 14% to 16%. It also increased its gross margin guidance by 100 basis points to around 79%, further underscoring its confidence in operational efficiency and financial discipline.

Innovation and Partnerships Fueling Growth

The quarter's success was not merely financial; it was built on a foundation of strategic execution. A key driver was the successful rollout of new products and the expansion into new markets. The company’s international revenue surged by an impressive 33.9% year-over-year, largely propelled by the strong European and Australian demand for its recently launched iFuse TORQ and iFuse TORQ TNT implants.

In the United States, which accounts for the majority of its business, revenue grew 10% to $49.3 million. This growth was attributed to the expanded adoption of its entire product portfolio, including the U.S. launch of INTRA Ti, a new device that expands the company’s procedural solutions.

A pivotal strategic move highlighted in the quarter was the new distribution agreement with medical technology giant Smith + Nephew. Finalized in February 2026, the partnership focuses on distributing SI-BONE's iFuse TORQ portfolio for pelvic fracture fixation. This collaboration acts as a force multiplier, leveraging Smith + Nephew's extensive commercial platform to introduce SI-BONE's innovative technology into Level 1 and Level 2 trauma centers across the nation, significantly expanding its market reach.

Favorable Reimbursement Winds Bolster Outlook

Perhaps one of the most significant long-term catalysts for SI-BONE is the increasingly favorable reimbursement landscape for its key technologies. The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule for fiscal year 2027 that includes the creation of a new, higher-paying diagnostic category (MS-DRG) for complex spinal fusion procedures that incorporate SI-BONE's iFuse Bedrock Granite implant.

While this proposal points to future tailwinds, the company is already benefiting from powerful reimbursement mechanisms. The iFuse Bedrock Granite system currently holds a Transitional Pass-Through (TPT) payment status from CMS, which became effective at the start of 2025. This status provides an additional, separate payment to healthcare facilities for the device, crucially without reducing the standard payment for the primary spinal fusion surgery, thereby removing a significant financial barrier to adoption for hospitals.

Furthermore, the iFuse TORQ TNT implant, which received FDA Breakthrough Device Designation, is eligible for a Medicare New Technology Add-on Payment (NTAP). This can provide hospitals with up to $4,136 in extra reimbursement per procedure. These payment structures are critical differentiators that incentivize the use of SI-BONE's advanced technologies over older, less-reimbursed alternatives and are expected to accelerate clinical adoption.

Expanding Clinical Footprint and Market Position

The financial and strategic wins are translating into a wider clinical footprint. SI-BONE reported a 17% year-over-year increase in active U.S. physicians, now numbering over 1,650. This growing base of surgeons choosing SI-BONE's products underscores increasing confidence in the clinical efficacy and benefits of its procedural solutions for compromised bone.

While SI-BONE faces competition from major orthopedic players like Medtronic and Globus Medical in the sacroiliac joint fusion space, its position is fortified by a unique combination of factors. The company boasts the only SI joint fusion system with Premarket Approval (PMA) from the FDA, supported by a deep body of clinical evidence including over 185 peer-reviewed publications. This robust clinical backing, combined with an innovative product pipeline and an advantageous reimbursement environment, positions SI-BONE to not only defend but also expand its market leadership. With a healthy cash reserve of $144.7 million, the company is well-capitalized to continue investing in the research, development, and commercial infrastructure needed to drive its next phase of growth.