TransMedics Group (TMDX) AI Stock Analysis

• Market Cap: $4.71B
• Dividend Yield: N/A
• Average Volume (3M): 686.68K
• Price to Earnings (P/E): 27.1
• Beta (1Y): 1.05
• Revenue Growth: 41.20%
• EPS Growth: 173.53%
• Country: US
• Employees: 728
• Sector: Healthcare
• Sector Strength: 45
• Industry: Medical - Devices
• EPS (TTM): 2.62
• Shares Outstanding: 34,302,452
• 10 Day Avg. Volume: 616,345
• 30 Day Avg. Volume: 686,683
• PEG Ratio: 0.05
• Price to Book (P/B): 8.74
• Price to Sales (P/S): 6.83
• P/FCF Ratio: 30.96
• Enterprise Value/Market Cap: 0.95
• Enterprise Value/Revenue: 7.41
• Enterprise Value/Gross Profit: 12.37
• Enterprise Value/Ebitda: 30.22
• 1Y Price Target: $158.80
• Price Target Upside: 18.01% Upside
• Rating Consensus: Moderate Buy
• Number of Analyst Covering: 11
• EPS Forecast (FY): 2.89
• Revenue Forecast (FY): $724.50M

• Rating: 73 Outperform
• Price Target: $154.00 ▲(14.44% Upside)
• Action: Reiterated Date: 02/25/26
• Date: Action: Reiterated 02/25/26

The score is driven primarily by strong financial performance (rapid revenue scaling, improved profitability, and positive free cash flow) and constructive earnings-call outlook (20%–25% revenue growth guidance backed by solid cash). These positives are tempered by a high valuation (P/E ~55.7) and only moderate technical momentum, plus near-term margin pressure and execution risks highlighted on the call.

Positive Factors

Sustained revenue and margin expansion

TransMedics has shifted from prior losses to a durable profitability inflection with revenue scaling rapidly to $605.5M in 2025 and net margins near 31%. This demonstrates operating leverage and structural ability to convert increasing procedure volume into lasting profit expansion.

High recurring consumable & service revenue mix

A growing installed base and 5,139 U.S. OCS transplants in 2025 underpin recurring disposables and service revenue. Per-case consumables and logistics services create durable, high-margin annuity-like streams tied to transplant volumes rather than one-time device sales.

Strong cash generation and liquidity

Operating cash flow and positive FCF in 2025, plus ~$488M cash, provide durable financial optionality to fund R&D, international rollouts and logistics scale. Strong cash buffers materially reduce short-term refinancing risk and support multi-year execution.

Negative Factors

Elevated absolute debt levels

Although leverage improved, nearly $470M of absolute debt remains meaningful for a company that only recently achieved sustained profits. In a growth or clinical delay scenario, fixed obligations could constrain reinvestment and increase refinancing or interest-rate sensitivity.

Clinical trial and lung adoption risk

Key long-term growth hinges on expanding indications and lung adoption. ENHANCE Part B enrollment headwinds and just 88 lung cases in 2025 indicate trial and adoption risks that could delay new-market penetration and slow multi-organ revenue diversification.

Planned 2026 investment-driven margin pressure

Management plans stepped-up R&D, trials and Gen 3.0 investments in 2026 that will compress operating margins by ~250 bps near-term. These deliberate spend increases raise execution risk: benefits are multi-year, but near-term profitability and cash conversion will be pressured during scale-up.

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 portable organ perfusion, optimization, and monitoring system that utilizes its proprietary and customized technology to replicate near-physiologic conditions for donor organs outside of the human body. Its Organ Care System includes OCS LUNG for the preservation of standard criteria donor lungs for double-lung transplantation; OCS Heart, a technology for extracorporeal perfusion and preservation of donor hearts; and OCS Liver for the preservation of donor livers. The company was founded in 1998 and is headquartered in Andover, Massachusetts.

How the Company Makes Money

TransMedics generates revenue primarily through the sale and rental of its Organ Care Systems and related services. The company earns money through the direct sale of OCS devices to hospitals and transplant centers, as well as through leasing agreements that allow medical facilities to utilize the technology on a per-case basis. Additionally, TMDX may derive revenue from the sale of consumables and accessories used in conjunction with its devices. Significant partnerships with transplant centers, hospitals, and healthcare organizations enhance its reach and capability, contributing to its revenue streams by facilitating more organ transplants and expanding the adoption of its technology.

TransMedics Group Financial Statement Overview

Summary

Strong top-line growth and a major profitability inflection (revenue $241.6M in 2023 to $605.5M in 2025; net margin ~31% in 2025) supported by improving cash generation (2025 FCF $133.6M). Offsets include meaningful absolute debt, historical free-cash-flow volatility, and a 2025 net income boost that warrants earnings-quality monitoring.

Income Statement

Results show a sharp profitability inflection alongside strong scale. Annual revenue expanded from $241.6M (2023) to $441.5M (2024) and $605.5M (2025), with 2025 gross margin holding near ~60%. Profitability improved materially: net margin rose from ~8.0% (2024) to ~31.4% (2025), and the business moved from losses in 2021–2023 to strong profits in 2024–2025. Key watch-outs are that earnings quality should be monitored given the very large jump in net income in 2025, and one provided operating margin datapoint appears inconsistent (EBIT margin shown as 0.0% in 2025 despite positive EBIT).

Balance Sheet

Leverage remains meaningful, but improved significantly year-over-year. Total debt was $469.7M in 2025 versus $518.3M in 2024, while equity increased to $473.1M (from $228.6M), bringing debt-to-equity down from ~2.27x (2024) to ~0.99x (2025). Total assets rose to $1.07B, reflecting growth and balance sheet expansion. Strengths include the much healthier capital structure and strong return on equity in 2025 (~40%), while the main risk is that absolute debt is still sizable for a company that only recently reached sustained profitability.

Cash Flow

Cash generation strengthened materially in 2025. Operating cash flow improved to $192.8M (from $48.8M in 2024) and free cash flow turned positive to $133.6M (from -$80.9M), indicating better cash conversion and scaling benefits. Operating cash flow covered net income at ~2.16x in 2025, providing a cushion, though free cash flow was still below net income (about ~69% of net income), suggesting working capital/investment needs are still meaningful. Prior-year volatility (negative free cash flow in 2024 and deeper deficits in 2022–2023) remains a key risk factor to monitor.

Breakdown	Dec 2025	Dec 2024	Dec 2023	Dec 2022	Dec 2021
Income Statement
Total Revenue	605.49M	441.54M	241.62M	93.46M	30.26M
Gross Profit	362.81M	262.08M	154.09M	65.27M	21.16M
EBITDA	148.49M	69.95M	-7.70M	-28.96M	-38.49M
Net Income	190.29M	35.46M	-25.03M	-36.23M	-44.22M
Balance Sheet
Total Assets	1.07B	804.08M	706.05M	277.15M	134.89M
Cash, Cash Equivalents and Short-Term Investments	488.37M	336.65M	394.81M	201.18M	92.45M
Total Debt	469.69M	518.29M	515.95M	67.56M	43.80M
Total Liabilities	595.27M	575.47M	568.85M	89.77M	67.04M
Stockholders Equity	473.10M	228.60M	137.20M	187.38M	67.85M
Cash Flow
Free Cash Flow	133.59M	-80.94M	-192.09M	-57.72M	-32.38M
Operating Cash Flow	192.84M	48.80M	-13.03M	-45.82M	-28.86M
Investing Cash Flow	-59.25M	-129.30M	-193.95M	54.51M	29.27M
Financing Cash Flow	16.86M	22.87M	400.42M	167.93M	1.39M

TransMedics Group Technical Analysis

• Technical Analysis Sentiment: Positive
• Last Price: 134.57
• 50DMA: Positive
• 100DMA: Positive
• 200DMA: Positive
• MACD: Positive
• RSI: Neutral
• STOCH: Neutral

Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For TMDX, the sentiment is Positive. The current price of 134.57 is above the 20-day moving average (MA) of 134.01, above the 50-day MA of 132.85, and above the 200-day MA of 125.41, indicating a bullish trend. The MACD of -0.09 indicates Positive momentum. The RSI at 50.39 is Neutral, neither overbought nor oversold. The STOCH value of 48.32 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for TMDX.

TransMedics Group Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
TMDX	73 Outperform	$4.71B	27.15	54.24%	―	41.20%	173.53%
LIVN	68 Neutral	$3.77B	-15.72	-19.24%	―	8.97%	-1024.86%
INSP	66 Neutral	$1.65B	11.94	19.77%	―	16.81%	34.90%
ITGR	64 Neutral	$3.00B	30.15	6.11%	―	7.81%	-26.32%
GKOS	60 Neutral	$6.92B	-36.96	-26.38%	―	30.38%	47.64%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
ATEC	51 Neutral	$2.07B	-14.63	-630.66%	―	27.11%	17.66%

TransMedics Group Corporate Events

TransMedics Group Names New Commercial Leader

On February 1, 2026, TransMedics Group’s board appointed Giovanni Cecere as Chief Commercial Officer, effective February 2, 2026, succeeding long-serving commercial chief Tamer Khayal, M.D., who will shift into the role of Senior Vice President of International, signaling a greater strategic focus on global market development. The board also named Matthew Forsyth as Senior Vice President, General Counsel & Corporate Secretary, effective March 9, 2026 or his employment start date, with current legal head Anil Ranganath transitioning to a non-executive role and then to a consulting position through September 7, 2026 under a detailed transition package that preserves his compensation, bonus eligibility, and equity vesting, indicating a carefully managed leadership handover aimed at maintaining continuity in the company’s commercial and legal operations.

The most recent analyst rating on (TMDX) stock is a Buy with a $140.00 price target. To see the full list of analyst forecasts on TransMedics Group stock, see the TMDX Stock Forecast page.

TransMedics Group Expands Somerville Campus With Major Lease

On January 8, 2026, TransMedics Group entered into a long-term lease with BioMed Realty for approximately 498,286 square feet of space at 188 Assembly Park Drive in Somerville, Massachusetts, which will house the company’s future headquarters as well as research, laboratory, manufacturing, assembly, vivarium, and office operations. The facility is expected to become TransMedics’ new headquarters on or before January 1, 2028, with base rent beginning no later than February 1, 2028 at about $23.9 million annually, subject to 2% yearly increases, and the company assuming essentially all operating and tax expenses; the lease runs for an initial term of 192 months, backed by an $18 million letter-of-credit security deposit and multiple extension options, underscoring a significant, long-horizon infrastructure commitment. Also on January 8, 2026, the company purchased two adjacent Somerville parcels for $15 million each plus related costs, further consolidating its campus-style presence and signaling a substantial long-term expansion of its Massachusetts operational base.

The most recent analyst rating on (TMDX) stock is a Hold with a $115.00 price target. To see the full list of analyst forecasts on TransMedics Group stock, see the TMDX Stock Forecast page.