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Exagen (XGN)
NASDAQ:XGN
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Exagen (XGN) AI Stock Analysis

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XGN

Exagen

(NASDAQ:XGN)

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Neutral 48 (OpenAI - 5.2)
Rating:48Neutral
Price Target:
$5.00
▲(62.34% Upside)
Action:Reiterated
Date:05/28/26
The score is held down primarily by weak financial performance (ongoing losses and negative free cash flow despite improving revenue and margins). Technicals are supportive but stretched (overbought signals), while the earnings call was moderately positive due to reaffirmed guidance and improving operating metrics, tempered by reimbursement and cash-collection timing risks. Valuation remains constrained by negative earnings and no dividend data.
Positive Factors
Revenue & Volume Growth
Sustained top‑line momentum and rising test volumes signal durable clinical adoption of AVISE products. Consistent revenue and ordering growth supports scale economics, spreads fixed lab costs, and increases the likelihood management can convert growth into sustained margin gains over the next several quarters.
Negative Factors
Negative Cash Flow
Persistent negative operating and free cash flow forces reliance on external financing or equity dilution and constrains strategic flexibility. Until operations consistently generate positive cash, the company faces ongoing runway and capital‑structure risk that can limit investments and scale-up plans.
Read all positive and negative factors
Positive Factors
Negative Factors
Revenue & Volume Growth
Sustained top‑line momentum and rising test volumes signal durable clinical adoption of AVISE products. Consistent revenue and ordering growth supports scale economics, spreads fixed lab costs, and increases the likelihood management can convert growth into sustained margin gains over the next several quarters.
Read all positive factors

Exagen Key Performance Indicators (KPIs)

Any
Any
Revenue by Customer Category
Revenue by Customer Category
Breaks down revenue across customer types (e.g., clinical labs and hospitals, commercial lab partners and distributors, direct-to-patient testing, and research or licensing agreements). For Exagen (XGN), this reveals whether growth is driven by broad consumer demand or concentrated partner contracts, highlights margin and cash-flow differences between channels, and flags concentration or reimbursement risks that could quickly affect results. Points to which channels are scalable and where management should focus sales, pricing, and payer negotiations.
Chart InsightsCommercial has become the clear growth engine since 2023, effectively replacing the lost Janssen business and signaling broader commercial adoption of Exagen’s offerings; government revenue looks like a steadier, mid‑level contributor after a one‑time large contract, while client‑direct bill is growing but remains lumpy, suggesting demand is real but seasonal or cadence‑driven. For investors this means lower single‑customer concentration and higher upside if commercial momentum continues, but watch quarter‑to‑quarter variability and the need for sustained commercial wins to cement higher revenue baselines.
Data provided by:The Fly

Exagen (XGN) vs. SPDR S&P 500 ETF (SPY)

Exagen Business Overview & Revenue Model

Company Description
Exagen Inc. develops and commercializes various testing products based on its cell-bound complement activation products technology under the AVISE brand in the United States. It enables rheumatologists to care for patients through the diagnosis, p...
How the Company Makes Money
Exagen makes money primarily by performing its proprietary autoimmune diagnostic tests as a clinical laboratory service and recognizing revenue when those tests are ordered by healthcare providers and processed by Exagen. The core revenue stream i...

Exagen Earnings Call Summary

Earnings Call Date:May 11, 2026
(Q1-2026)
|
% Change Since: |
Next Earnings Date:Aug 10, 2026
Earnings Call Sentiment Positive
The call conveyed meaningful operational and commercial progress: record revenue (+12% YoY), double‑digit volume growth (+10% YoY), consistent ASP expansion (+6% YoY TTM) and improved adjusted EBITDA (14% improvement). The company also highlighted a growing pharma services backlog (> $5M), ongoing innovation (myositis target early 2027) and a healthy cash balance (~$22M). Offsetting risks include weather‑related volume loss in Q1, continued GAAP operating losses, reliance on lumpy prior‑period collections for ASP upside, an unresolved LCD timing risk, and the earlier loss of a client‑bill account. On balance the positives—organic growth, commercial momentum, ASP gains and pipeline advancement—outweigh the near‑term headwinds and uncertainties.
Positive Updates
Record First Quarter Revenue and Year‑over‑Year Growth
Reported record Q1 revenue of $17.3 million, a 12% increase versus prior year, and management reaffirmed full‑year 2026 revenue guidance of $70.0M to $73.0M.
Negative Updates
Weather‑Driven Volume Disruption
Severe winter storms in late January/early February reduced patient access and physician office days; management estimates losing ~1/3 of volume across two weeks (a couple thousand tests), a negative impact on Q1 volume that is not recoverable/catch‑up.
Read all updates
Q1-2026 Updates
Negative
Record First Quarter Revenue and Year‑over‑Year Growth
Reported record Q1 revenue of $17.3 million, a 12% increase versus prior year, and management reaffirmed full‑year 2026 revenue guidance of $70.0M to $73.0M.
Read all positive updates
Company Guidance
Management reaffirmed full‑year 2026 revenue guidance of $70.0–$73.0 million (midpoint assumes high‑single‑digit volume growth and low‑single‑digit ASP growth versus Q4‑2025 in‑period ASP of ≈$430), citing a strong Q1 that supports the outlook: Q1 revenue $17.3M (+12% YoY), test volume +10% YoY (mid‑30,000 quarterly run rate), trailing 12‑month ASP $444 (+6% YoY, +$25), gross margin 59% (up 360 bps sequentially), adjusted EBITDA loss $2.2M (14% improvement YoY), cash just under $22M, pharma services revenue ≈$300k with >$5M backlog, and >$900k collected on claims >360 days; they expect ASP to expand toward at least 50% of Medicare reimbursement (≈$600–$650) and gross margin to progress to the mid‑60s over time, while noting prior‑period collections and seasonality/RCM timing can be lumpy and AR‑driven cash use should normalize in H2.

Exagen Financial Statement Overview

Summary
Revenue growth and stable high-50% gross margin are positives, and leverage has improved, but the business remains deeply unprofitable with persistent negative operating results and ongoing cash burn (negative operating and free cash flow), which meaningfully constrains the financial profile.
Income Statement
38
Negative
Balance Sheet
57
Neutral
Cash Flow
32
Negative
BreakdownTTMDec 2025Dec 2024Dec 2023Dec 2022Dec 2021
Income Statement
Total Revenue68.38M66.58M55.64M52.55M45.56M48.30M
Gross Profit39.88M38.80M33.11M29.46M21.35M27.71M
EBITDA-15.90M-11.95M-11.14M-19.15M-43.66M-23.10M
Net Income-20.17M-19.95M-15.12M-23.69M-47.39M-26.85M
Balance Sheet
Total Assets51.96M58.02M44.69M56.94M86.22M123.44M
Cash, Cash Equivalents and Short-Term Investments21.51M32.22M22.04M36.49M62.39M99.44M
Total Debt4.86M5.40M23.00M23.23M35.20M28.07M
Total Liabilities37.52M40.57M35.15M34.25M43.76M38.51M
Stockholders Equity14.43M17.45M9.54M22.69M42.46M84.94M
Cash Flow
Free Cash Flow-14.13M-14.27M-13.79M-15.29M-36.46M-22.64M
Operating Cash Flow-13.37M-13.63M-13.28M-14.46M-32.14M-20.27M
Investing Cash Flow-747.00K-626.00K-515.00K-804.00K-4.32M-2.42M
Financing Cash Flow24.44M24.43M-663.00K-10.63M-489.00K64.68M

Exagen Technical Analysis

Technical Analysis Sentiment
Positive
Last Price3.08
Price Trends
50DMA
3.27
Positive
100DMA
3.62
Positive
200DMA
6.46
Negative
Market Momentum
MACD
0.48
Negative
RSI
73.72
Negative
STOCH
92.16
Negative
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For XGN, the sentiment is Positive. The current price of 3.08 is below the 20-day moving average (MA) of 3.81, below the 50-day MA of 3.27, and below the 200-day MA of 6.46, indicating a neutral trend. The MACD of 0.48 indicates Negative momentum. The RSI at 73.72 is Negative, neither overbought nor oversold. The STOCH value of 92.16 is Negative, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for XGN.

Exagen Risk Analysis

Exagen disclosed 73 risk factors in its most recent earnings report. Exagen 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

Exagen Peers Comparison

Overall Rating
UnderperformOutperform
Sector (51)
Financial Indicators
Name
Overall Rating
Market Cap
P/E Ratio
ROE
Dividend Yield
Revenue Growth
EPS Growth
55
Neutral
$355.08M-5.80-36.02%201.72%-11.02%
54
Neutral
$635.47M-8.41-55.89%-52.94%59.88%
51
Neutral
$7.86B-0.30-43.30%2.27%22.53%-2.21%
48
Neutral
$120.32M-5.89-113.53%20.55%-4.63%
44
Neutral
$107.17M-2.89-164.68%69.52%58.15%
44
Neutral
$84.58M-3.38-41.02%-50.43%30.93%
41
Neutral
$39.03M-1.45402.97%17.42%42.75%
* Healthcare Sector Average
Performance Comparison
Ticker
Company Name
Price
Change
% Change
XGN
Exagen
4.98
-2.16
-30.25%
ACRS
Aclaris Therapeutics
4.55
3.11
215.97%
MDXH
MDxHealth
0.76
-1.44
-65.50%
STIM
Neuronetics
1.54
-2.27
-59.58%
PRE
Prenetics Group
21.10
11.90
129.35%
SERA
Sera Prognostics
2.16
0.58
36.71%

Exagen Corporate Events

Executive/Board Changes
Exagen Announces Board Resignation and Committee Restructuring
Neutral
Apr 23, 2026
On April 17, 2026, Exagen Inc. announced that director Ana Hooker resigned from the Board and all its committees, including her role as chair of the Nominating and Corporate Governance Committee and member of the Audit Committee, effective the sam...
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 28, 2026