Carlsmed, Inc. (CARL)
NASDAQ:CARL
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Carlsmed, Inc.
(NASDAQ:CARL)
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Rating:49Neutral
Price Target:
$10.00
▲(0.00% Upside)
Action:ReiteratedDate:03/21/26
The score is held back primarily by weak financial performance (large losses and sustained cash burn) and bearish technical signals (below key averages with negative MACD). The earnings call improves the outlook with strong 2026 growth guidance and a credible path toward cash-flow breakeven, while valuation is constrained by negative earnings and no dividend support.
Positive Factors
Rapid Revenue Growth
Sharp, sustained top-line acceleration demonstrates durable commercial adoption of Carlsmed’s personalized spine solutions. Rapid revenue growth supports scaling of fixed-cost R&D and manufacturing infrastructure, improving the odds that operating leverage will materialize over the next several quarters if growth sustains.
Negative Factors
Persistent Cash Burn
Operating cash flow has been consistently negative and increased in 2025, indicating continued reliance on financing until adjusted EBITDA and operating cash flow turn positive. Sustained negative free cash flow elevates execution and refinancing risk if growth or margin improvements slow.
Read all positive and negative factors
Positive Factors
Negative Factors
Rapid Revenue Growth
Sharp, sustained top-line acceleration demonstrates durable commercial adoption of Carlsmed’s personalized spine solutions. Rapid revenue growth supports scaling of fixed-cost R&D and manufacturing infrastructure, improving the odds that operating leverage will materialize over the next several quarters if growth sustains.
Read all positive factors
Carlsmed, Inc. (CARL) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$267.19M
Dividend YieldN/A
Average Volume (3M)144.08K
Price to Earnings (P/E)―
Beta (1Y)3.01
Revenue Growth102.57%
EPS Growth-5.76%
CountryUS
Employees100
SectorHealthcare
Sector Strength45
IndustryMedical - Healthcare Information Services
Share Statistics
EPS (TTM)-0.32
Shares Outstanding26,731,993
10 Day Avg. Volume71,957
30 Day Avg. Volume144,080
Financial Highlights & Ratios
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 Cap0.74
Enterprise Value/Revenue3.94
Enterprise Value/Gross Profit5.23
Enterprise Value/Ebitda-5.87
Forecast
1Y Price Target
$19.50Price Target Upside95.00% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
EPS Forecast (FY)-1.64
Revenue Forecast (FY)$72.81M
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 a...
How the Company Makes Money
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Carlsmed, Inc. Earnings Call Summary
Earnings Call Date:Feb 25, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:Apr 30, 2026
Earnings Call Sentiment Positive
The call presents a largely positive growth narrative: rapid top-line acceleration (86% YoY), strong mid-70s gross margins, validated clinical outcomes (74% reduction in reoperations), a successful IPO and a strong cash position, plus meaningful operational improvements (6-day lead time) and reimbursement wins (NTAP). Offsetting these positives are sizable increases in operating expenses, widening GAAP net losses and negative adjusted EBITDA as the company invests heavily in R&D, sales/marketing and commercialization of new indications. Given the company’s solid cash runway, clear product momentum, and confident 2026 guidance, the highlights materially outweigh the lowlights for a growth-stage, innovation-driven medical device company.Positive Updates
Strong Revenue Growth
Full-year 2025 revenue of $50.5M, up 86% year-over-year from $27.2M in 2024; Q4 2025 revenue of $15.2M, up 61% year-over-year from $9.4M.
Negative Updates
Rising Operating Expenses
Total operating expenses increased to $68.6M in 2025 from $44.2M in 2024; Q4 operating expenses were $20.9M vs $11.7M in Q4 2024 driven by higher R&D, sales and marketing, and G&A as the company scales.
Read all updates
Q4-2025 Updates
Positive
Negative
Strong Revenue Growth
Full-year 2025 revenue of $50.5M, up 86% year-over-year from $27.2M in 2024; Q4 2025 revenue of $15.2M, up 61% year-over-year from $9.4M.
Read all positive updates
Company Guidance
For 2026 management guided revenue of $70.0–$75.0 million (about 44% growth at the midpoint versus 2025 revenue of $50.5 million), expecting the business mix to remain lumbar‑weighted with average revenue per procedure in the mid‑ to high‑$20,000s and a modestly lower ARP versus 2025 as cervical contribution grows; gross margins are expected to stay in the mid‑70% range (2025 gross margin 75.3%, Q4 2025 76.5%), and the company expects continued improvement in adjusted EBITDA and a clear path toward cash‑flow breakeven as operating leverage from R&D and sales & marketing investments materializes. Operational metrics supporting the plan include a 6‑business‑day lead time (down 25% from 8 days in Q3 and from 20 days a year earlier), 101 new surgeon users added in 2025 (with ~10% trained on cervical), and a favorable reimbursement backdrop including a cervical NTAP up to $21,125 per procedure; Carlsmed finished 2025 with $109.9 million in cash and investments and $15.6 million outstanding under a $50 million debt facility.Carlsmed, Inc. Financial Statement Overview
Summary
Income Statement
34
Negative
Balance Sheet
52
Neutral
Cash Flow
28
Negative
| 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. Risk Analysis
Carlsmed, Inc. disclosed 78 risk factors in its most recent earnings report. Carlsmed, Inc. reported the most risks in the "Tech & Innovation" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Carlsmed, Inc. Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
71 Outperform | $4.04B | 33.71 | 22.89% | ― | 20.21% | 44.14% | |
52 Neutral | $940.15M | -6.16 | -14.24% | ― | -2.37% | 77.85% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
49 Neutral | $267.19M | -5.81 | -263.64% | ― | 102.57% | -5.76% | |
46 Neutral | $94.51M | -0.82 | -35.88% | ― | 4.33% | 50.50% | |
44 Neutral | $48.89M | -3.85 | -571.06% | ― | ― | 4.31% |
* Healthcare Sector Average
CARL
Carlsmed, Inc.
10.00
-4.46
-30.83%
TDOC
Teladoc
5.27
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-27.21%
AMWL
American Well
5.71
-1.54
-21.24%
DOCS
Doximity
21.86
-29.71
-57.61%
BEAT
HeartBeam
1.19
-0.44
-26.99%
EUDA
EUDA Health Holdings
7.00
-66.00
-90.41%
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
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