Strong Overall Revenue and Positive Guidance
Core business total revenue up over 33% (factoring Ambry). Management guided 2026 revenue to $1.59 billion, consistent with a ~25% long-term growth expectation, and projected approximately $65 million of positive adjusted EBITDA.
Diagnostics: Oncology and Hereditary Unit Growth
Oncology unit growth of 29% in Q4 (accelerating throughout the year). Hereditary unit growth of 23% in Q4. Management expects Oncology to remain strong and core diagnostic growth to be in the ~30% range when excluding slower businesses.
MRD Traction and Upside
MRD tests ran ~4,700 in the quarter with quarter-over-quarter growth of 56%. Management stated the sales effort is highly constrained and estimated that if fully unblocked MRD volume could be up to ~20x higher, indicating substantial market opportunity pending reimbursement and go-to-market expansion.
Data Business Momentum and Contract Backlog
Data/licensing (Insights) revenue reported up 69% in the quarter when factoring a one-time AstraZeneca warrant impact, and management is projecting roughly 40% growth in the near quarter. Total contract value (TCV) is >$1.1 billion, and management emphasized bookings visibility for 2026 with strong in-year pipeline.
High Net Revenue Retention
Net revenue retention in the Data business was 126%, indicating existing customers are expanding spend and contributing to recurring revenue growth.
ASP Improvement and Path to Higher Pricing
Q4 average selling price (ASP) was approximately $1,640 (up ~$40 QoQ). Management outlined >$500 of potential upside to ASP over time driven primarily by migration from LDT xT to FDA-approved xT CDx (targeting majority of volume on FDA version by end of 2026) plus other product and payer improvements.
AI/Foundation Model Progress and Compute Investment
Foundation model deliverable for AstraZeneca hit internal benchmarks and was submitted for AZ testing. Tempus has deployed significant on-prem compute clusters (1000+ H200s for oncology model and an additional 500+ GB200s) and is scaling foundation-model work across radiology, pathology and other modalities to accelerate diagnostic and data product enhancements.
Product & Platform Enhancements
Launched Paige Predict (digitized pathology-derived predictive insights), developed Immune Profile Score, submitted xF (liquid biopsy) to the FDA, and announced a whole-genome heme offering going live this year—strengthening the multi-assay platform and multimodal data capture.