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TransMedics Group Inc (TMDX)
NASDAQ:TMDX
US Market
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TransMedics Group (TMDX) AI Stock Analysis

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TMDX

TransMedics Group

(NASDAQ:TMDX)

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Neutral 66 (OpenAI - 5.2)
Rating:66Neutral
Price Target:
$79.00
▼(-31.82% Downside)
Action:ReiteratedDate:05/07/26
The score is driven primarily by strong financial performance (rapid revenue scaling, sharply improved profitability, and positive free cash flow) and supportive earnings-call guidance for continued growth. These positives are meaningfully tempered by very bearish technicals (price far below key moving averages with negative momentum) and a high P/E valuation, which increase downside risk if growth or margins disappoint.
Positive Factors
Revenue & Profitability Turnaround
Rapid multi-year revenue scaling with a large margin inflection demonstrates the business reached profitable scale. Durable demand for OCS plus rising transplant volumes enabled operating leverage and a structural profit improvement that supports reinvestment and longer-term free cash flow generation.
Negative Factors
Sizable Absolute Debt
Although leverage improved materially, absolute debt remains substantial for a company that only recently achieved sustained profitability. High nominal debt increases interest and refinancing risk and could constrain capital allocation if cash generation weakens or clinical timing slips.
Read all positive and negative factors
Positive Factors
Negative Factors
Revenue & Profitability Turnaround
Rapid multi-year revenue scaling with a large margin inflection demonstrates the business reached profitable scale. Durable demand for OCS plus rising transplant volumes enabled operating leverage and a structural profit improvement that supports reinvestment and longer-term free cash flow generation.
Read all positive factors

TransMedics Group (TMDX) vs. SPDR S&P 500 ETF (SPY)

TransMedics Group Business Overview & Revenue Model

Company Description
TransMedics Group, Inc., a commercial-stage medical technology company, engages in transforming organ transplant therapy for end-stage organ failure patients in the United States and internationally. The company offers Organ Care System (OCS), a p...
How the Company Makes Money
TransMedics primarily makes money by selling and supporting its organ preservation technology and related services used by transplant centers and organ procurement stakeholders. Key revenue streams include: (1) Product-related revenue tied to use ...

TransMedics Group Key Performance Indicators (KPIs)

Any
Any
Revenue by Geography
Revenue by Geography
Breaks down revenue across different regions, revealing where the company is strongest and where it may face risk or growth potential due to local economic conditions or market share shifts.
Chart InsightsTransMedics Group's U.S. revenue has shown remarkable growth, reflecting a 32% year-over-year increase in transplant revenue, despite a seasonal slowdown in Q3. International revenue remains modest but is poised for growth with strategic expansions in Europe, including the launch of the OUS NOP program in Italy. While there was a sequential decline in both U.S. and international revenues, the company's strong cash position and improved operating margins underscore its resilience and capacity for future growth.
Data provided by:The Fly

TransMedics Group Earnings Call Summary

Earnings Call Date:May 05, 2026
(Q1-2026)
|
% Change Since: |
Next Earnings Date:Jul 30, 2026
Earnings Call Sentiment Positive
The call communicates solid top-line growth (21% YoY) and a strong cash position (~$462M), supported by clear, multi-year growth initiatives (CHOPS, OCS Kidney Gen 3.0, Gen 3.0 upgrades, and European NOP expansion) and reiterated full‑year guidance (20%–25% revenue growth). Near term, the company is absorbing deliberate, sizeable investments that compress gross and operating margins (gross margin down ~331 bps YoY; adjusted operating expenses up ~42% YoY), while donor-volume volatility and prior competitive-driven enrollment delays create execution and timing risk for clinical programs. Overall the call strikes a positive tone on growth and strategic direction but acknowledges tangible near-term margin and enrollment headwinds.
Positive Updates
Strong Top-Line Growth
Total revenue of $174.0M in 1Q2026, up ~21% year-over-year and ~8% sequentially, demonstrating continued demand for the OCS platform and NOP services.
Negative Updates
Gross Margin Pressure
Total gross margin ~58% in 1Q2026, down ~331 basis points YoY. The decline was attributed to internal supply chain activity to replenish inventory for DENOVO/ENHANCE, investments in NOP capabilities and certain one-time items; management expects some normalization over time but near-term pressure remains.
Read all updates
Q1-2026 Updates
Negative
Strong Top-Line Growth
Total revenue of $174.0M in 1Q2026, up ~21% year-over-year and ~8% sequentially, demonstrating continued demand for the OCS platform and NOP services.
Read all positive updates
Company Guidance
Management reiterated full‑year 2026 revenue guidance of $727–$757 million (up 20%–25% vs. 2025) while reporting a solid Q1: total revenue $174M (+21% YoY, +8% sequential), U.S. transplant revenue ~$167M (liver ~$139M, heart ~$26M, lung ~$2M), international revenue ~$5.6M, total product revenue ~$108M, service revenue ~$66M and transplant logistics services revenue ~$32M (NOP coverage ~82%; plan to maintain 22 U.S. aircraft in 2026). Q1 adjusted operating profit was roughly $18M (~10–10.4% adjusted operating margin), adjusted net income ~$11M (≈$0.30 diluted EPS), cash and equivalents ~$462M, gross margin ~58% (down ~331 bps YoY), and adjusted operating expenses ~$83M (up ~42% YoY) with adjusted R&D +45% and adjusted SG&A +41% as investments were front‑loaded; management reiterated a long‑term gross margin target of ~60%, expects near‑term margin pressure (operate up to ~250 bps below 2025 adjusted operating margin) and said guidance may be revisited as ENHANCE/DENOVO enrollment and U.S. transplant modernization dynamics unfold.

TransMedics Group Financial Statement Overview

Summary
Strong operating turnaround with rapid revenue growth ($241.6M in 2023 to $605.5M in 2025) and a major profitability step-up (net margin ~31% in 2025) plus sharply improved cash generation (2025 FCF $133.6M). Offsets include historically volatile free cash flow, sizable absolute debt despite improved leverage (debt-to-equity ~0.99x in 2025), and a noted data inconsistency around 2025 EBIT margin that warrants monitoring of earnings quality.
Income Statement
86
Very Positive
Balance Sheet
62
Positive
Cash Flow
74
Positive
BreakdownDec 2025Dec 2024Dec 2023Dec 2022Dec 2021
Income Statement
Total Revenue605.49M441.54M241.62M93.46M30.26M
Gross Profit362.81M262.08M154.09M65.27M21.16M
EBITDA148.49M69.95M-7.70M-28.96M-38.49M
Net Income190.29M35.46M-25.03M-36.23M-44.22M
Balance Sheet
Total Assets1.07B804.08M706.05M277.15M134.89M
Cash, Cash Equivalents and Short-Term Investments488.37M336.65M394.81M201.18M92.45M
Total Debt469.69M518.29M515.95M67.56M43.80M
Total Liabilities595.27M575.47M568.85M89.77M67.04M
Stockholders Equity473.10M228.60M137.20M187.38M67.85M
Cash Flow
Free Cash Flow133.59M-80.94M-192.09M-57.72M-32.38M
Operating Cash Flow192.84M48.80M-13.03M-45.82M-28.86M
Investing Cash Flow-59.25M-129.30M-193.95M54.51M29.27M
Financing Cash Flow16.86M22.87M400.42M167.93M1.39M

TransMedics Group Technical Analysis

Technical Analysis Sentiment
Neutral
Last Price115.87
Price Trends
50DMA
122.63
Negative
100DMA
128.40
Negative
200DMA
123.33
Negative
Market Momentum
MACD
-2.14
Negative
RSI
52.44
Neutral
STOCH
71.13
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For TMDX, the sentiment is Neutral. The current price of 115.87 is above the 20-day moving average (MA) of 107.55, below the 50-day MA of 122.63, and below the 200-day MA of 123.33, indicating a neutral trend. The MACD of -2.14 indicates Negative momentum. The RSI at 52.44 is Neutral, neither overbought nor oversold. The STOCH value of 71.13 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for TMDX.

TransMedics Group Risk Analysis

TransMedics Group disclosed 75 risk factors in its most recent earnings report. TransMedics Group reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks

TransMedics Group Peers Comparison

Overall Rating
UnderperformOutperform
Sector (51)
Financial Indicators
Name
Overall Rating
Market Cap
P/E Ratio
ROE
Dividend Yield
Revenue Growth
EPS Growth
66
Neutral
$2.52B116.8241.92%30.24%244.83%
65
Neutral
$3.62B38.989.13%11.08%-485.09%
63
Neutral
$7.94B-78.94-26.46%36.30%-42.48%
62
Neutral
$2.93B45.098.23%5.48%77.43%
60
Neutral
$1.32B-32.7717.98%8.94%102.92%
51
Neutral
$7.86B-0.30-43.30%2.27%22.53%-2.21%
51
Neutral
$1.07B-12.36-141.88%22.55%27.87%
* Healthcare Sector Average
Performance Comparison
Ticker
Company Name
Price
Change
% Change
TMDX
TransMedics Group
72.92
-20.28
-21.76%
ATEC
Alphatec Holdings
6.99
-5.75
-45.13%
ITGR
Integer Holdings
86.29
-33.23
-27.80%
GKOS
Glaukos
135.27
44.73
49.40%
LIVN
LivaNova
66.26
22.19
50.35%
INSP
Inspire Medical Systems
45.70
-107.09
-70.09%
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.

Disclaimer

This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.Date of analysis: May 07, 2026