Quarterly Revenue Stabilization
Q4 total revenue of $82.4M, down 1.3% year-over-year — a meaningful improvement from the double-digit decline seen in Q3, signaling stabilization in topline performance.
Consumables Revenue Growth and Recurring Model Strength
Q4 consumables revenue $57.7M, up 1.7% year-over-year; full-year consumables were $212.7M. Management emphasized the resiliency of recurring consumables as the company’s margin engine.
Material Margin Expansion
Adjusted gross margin expanded to 67.4% and GAAP gross margin expanded to 64.4% in Q4. For the full year, adjusted gross margin moved from ~62% to over 68% and GAAP gross margin improved from 54.5% to 65.3% — driven by favorable mix shift toward consumables and lower inventory charges.
Large Increase in Adjusted EBITDA and Profitability Progress
Adjusted EBITDA was $15.0M in Q4 versus $9.0M in the prior-year quarter (~700 bps margin expansion). Full-year adjusted EBITDA grew to $45.1M from $12.3M — a 268% year-over-year increase, demonstrating strong operating leverage and expense discipline.
Installed Base Scale and Device Placements
Placed 1,032 delivery systems in Q4 and ended the year with an installed base of over 36,000 systems globally — a strategic asset that management plans to activate to drive future consumables and margin growth.
Operating Cash Generation and Balance Sheet Actions
Generated over $37M in operating cash flow for the year and completed repurchases/refinancing of convertible debt to strengthen the capital structure (while changing cash balances).
Booster and Pricing Momentum
Booster revenue grew ~7% in Q4; boosters represent roughly 20% of treatments and are a growing attach-rate driver. Average spend per treatment in the U.S. increased ~10% year-over-year. A 5% consumables price increase implemented in Q3 was well received with minimal pushback.
Forward Guidance with Positive Adjusted EBITDA
2026 guidance: revenue $285M–$305M and positive adjusted EBITDA $35M–$45M. Q1 2026 guide: revenue $63M–$68M and positive adjusted EBITDA $3.5M–$5.5M. Management expects 2026 to be an execution year with momentum building into H2 and a return to growth in 2027.