Carlsmed, Inc. (CARL) AI Stock Analysis

• Market Cap: $357.41M
• Dividend Yield: N/A
• Average Volume (3M): 120.41K
• Price to Earnings (P/E): ―
• Beta (1Y): 3.02
• Revenue Growth: 102.57%
• EPS Growth: -5.76%
• Country: US
• Employees: 100
• Sector: Healthcare
• Sector Strength: 45
• Industry: Medical - Healthcare Information Services
• EPS (TTM): -0.32
• Shares Outstanding: 26,731,993
• 10 Day Avg. Volume: 188,500
• 30 Day Avg. Volume: 120,408
• PEG Ratio: -0.14
• Price to Book (P/B): 1.78
• Price to Sales (P/S): 3.48
• P/FCF Ratio: -5.93
• Enterprise Value/Market Cap: 0.79
• Enterprise Value/Revenue: 5.59
• Enterprise Value/Gross Profit: 7.42
• Enterprise Value/Ebitda: -8.33
• 1Y Price Target: $19.75
• Price Target Upside: 47.72% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 4
• EPS Forecast (FY): -1.64
• Revenue Forecast (FY): $70.30M

• Rating: 57 Neutral
• Price Target: $14.00 ▲(4.71% Upside)
• Action: Reiterated Date: 03/03/26
• Date: Action: Reiterated 03/03/26

The score is held back primarily by ongoing losses and sustained cash burn despite strong gross margins. Offsetting this, the latest earnings call provided strong 2026 growth guidance and a credible narrative toward operating leverage, while technicals show generally positive momentum. Valuation remains constrained by negative earnings and no dividend.

Positive Factors

Accelerating Revenue Growth

Sustained, large topline acceleration demonstrates strong market demand and adoption of Carlsmed’s patient-specific spine solutions. Durable double-digit growth at scale supports operating leverage potential, expands addressable market share, and underpins multi-quarter revenue visibility for commercialization investments.

High and Stable Gross Margins

Mid-70s gross margins indicate strong unit economics for personalized implants and justify ongoing commercialization spend. High, stable margins provide structural capacity to absorb SG&A and R&D while preserving potential path to profitability once volume scales and fixed-cost dilution continues over multiple quarters.

Strong Cash Position / Runway

A sizeable cash balance from the IPO provides meaningful runway to fund commercialization, product launches, and R&D without immediate dilution. This financial flexibility reduces near-term refinancing risk and allows the company to execute multi-quarter growth and clinical initiatives critical to durable market penetration.

Negative Factors

Rising Operating Expenses

Rapid OpEx expansion to support sales, marketing and R&D can outpace revenue benefits and delay operating leverage. If revenue growth slows or per-surgeon utilization ramps more slowly than expected, elevated fixed and semi-fixed costs will prolong the timeline to adjusted EBITDA and cash‑flow breakeven.

Persistent Cash Burn / Negative Operating Cash Flow

Consistent negative operating cash flows signal funding dependency beyond internal cash generation. Continued burn at current levels increases the probability the company will need additional capital before reaching sustained profitability, which can pressure strategic flexibility and prolong reliance on external financing.

Early-Stage Utilization per Surgeon

Adoption breadth is promising but depth is immature: low utilization per surgeon means revenue from new users will be gradual. Durable revenue expansion depends on converting new users into frequent adopters; execution risk in training, reimbursement navigation, and clinical workflow integration could slow sustainable per-surgeon revenue growth.

Carlsmed, Inc. Business Overview & Revenue Model

Company Description

Carlsmed, Inc. develops and operates a surgical platform for the treatment of complex adult spinal deformities that enables surgeons to harness clinical intelligence, advanced image recognition, and 3D printing technologies. Its product includes aprevo, a medical platform that makes surgical plans and devices tailored to the precise medical situation of every individual patient. It provides New Technology Add-On Payment (NTAP) reimbursement. The company was incorporated in 2018 and is based in Carlsbad, California.

How the Company Makes Money

Carlsmed generates revenue primarily through the sale of its surgical products, including customized spinal implants and surgical guides. The company's revenue model is based on direct sales to hospitals and surgical centers, where its products are utilized in orthopedic surgeries. Additionally, Carlsmed may engage in partnerships with healthcare providers and surgical device distributors, which can enhance market reach and facilitate sales. The company could also explore licensing agreements or collaborations for joint product development, contributing to its income streams. Overall, the combination of product sales and strategic partnerships is key to Carlsmed's financial performance.

Carlsmed, Inc. Financial Statement Overview

Summary

Strong acceleration in revenue and consistently high gross margins are positives, but they are outweighed by widening net losses and persistent, increasing operating/free-cash-flow burn, indicating the business has not yet proven operating leverage.

Income Statement

Revenue growth accelerated sharply in 2025 (up ~12.9% vs. ~1.0% in 2024), and gross margins remained strong and stable (~72–75%), suggesting solid unit economics. However, the company is still deeply unprofitable: net losses widened in dollars (about -$30.2M in 2025 vs. -$24.3M in 2024) and net margins remain meaningfully negative (about -59.8% in 2025). Overall, growth and gross profitability are positives, but operating cost structure is still too heavy to support earnings.

Balance Sheet

Leverage appears modest in 2025 with debt at ~$17.4M against ~$98.9M of equity (debt-to-equity ~0.18), providing balance sheet flexibility. A key risk is the sharp swing in equity: equity was negative in 2023–2024 and turned positive in 2025, which may reflect significant financing or balance sheet changes rather than steady retained profitability. Returns remain weak given ongoing losses (2025 return on equity is negative).

Cash Flow

Cash burn remains heavy and persistent, with operating cash flow negative across all periods (about -$29.0M in 2025, -$25.5M in 2024, -$17.5M in 2023) and free cash flow also negative (about -$29.6M in 2025). While cash outflows have generally tracked reported losses (free cash flow roughly in line with net income), the absolute burn increased in 2025, implying continued reliance on external funding until profitability improves.

Breakdown	Dec 2025	Dec 2024	Dec 2023
Income Statement
Total Revenue	50.51M	27.16M	13.78M
Gross Profit	38.04M	20.05M	9.90M
EBITDA	-28.51M	-22.79M	-18.12M
Net Income	-30.22M	-24.26M	-18.90M
Balance Sheet
Total Assets	130.12M	51.82M	14.02M
Cash, Cash Equivalents and Short-Term Investments	109.79M	40.13M	7.22M
Total Debt	17.41M	17.18M	11.39M
Total Liabilities	31.25M	122.45M	60.15M
Stockholders Equity	98.87M	-70.63M	-46.13M
Cash Flow
Free Cash Flow	-29.62M	-25.65M	-17.61M
Operating Cash Flow	-28.98M	-25.47M	-17.48M
Investing Cash Flow	-25.48M	-180.00K	-135.00K
Financing Cash Flow	100.13M	58.50M	3.18M

Carlsmed, Inc. Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
DOCS	71 Outperform	$4.75B	21.58	23.82%	―	20.21%	44.14%
CARL	57 Neutral	$357.41M	-11.67	-47.62%	―	102.57%	-5.76%
TDOC	53 Neutral	$920.53M	-4.52	-13.93%	―	-2.37%	77.85%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
AMWL	46 Neutral	$87.72M	-0.89	-35.42%	―	4.33%	50.50%
BEAT	43 Neutral	$61.38M	-2.30	-792.01%	―	―	4.31%