Xtant Medical Holdings (XTNT) AI Stock Analysis

• Market Cap: $81.48M
• Dividend Yield: N/A
• Average Volume (3M): 260.21K
• Price to Earnings (P/E): 57.1
• Beta (1Y): 1.26
• Revenue Growth: 16.88%
• EPS Growth: N/A
• Country: US
• Employees: 217
• Sector: Healthcare
• Sector Strength: 45
• Industry: Medical - Devices
• EPS (TTM): <0.01
• Shares Outstanding: 140,004,240
• 10 Day Avg. Volume: 318,290
• 30 Day Avg. Volume: 260,215
• PEG Ratio: <0.01
• Price to Book (P/B): 1.38
• Price to Sales (P/S): 0.50
• P/FCF Ratio: -3.70
• Enterprise Value/Market Cap: 1.04
• Enterprise Value/Revenue: 0.63
• Enterprise Value/Gross Profit: 1.02
• Enterprise Value/Ebitda: 7.75
• 1Y Price Target: $1.50
• Price Target Upside: 158.62% Upside
• Rating Consensus: Moderate Buy
• Number of Analyst Covering: 2
• EPS Forecast (FY): N/A
• Revenue Forecast (FY): N/A

• Rating: 66 Neutral
• Price Target: $0.64 ▲(10.17% Upside)

Xtant Medical Holdings shows a positive outlook with strong revenue growth and operational improvements, as highlighted in the earnings call. Technical indicators support a bullish trend. However, high valuation metrics and ongoing profitability challenges temper the overall score.

Positive Factors

Sustained Revenue Growth

Consistent double-digit revenue growth indicates strengthening product demand and commercial execution. Over a 2-6 month horizon this trend supports scale benefits, funds reinvestment in R&D and sales expansion, and reduces execution risk versus peers with stagnant top-line performance.

High Gross Margin

A sustained high gross margin reflects favorable product mix and manufacturing efficiency, giving durable room to invest in R&D and commercial initiatives. Strong gross margins help absorb SG&A variability and increase the probability of converting revenue gains into lasting profitability.

Reduced Leverage

Lower leverage materially improves financial flexibility and lowers interest burden, enabling strategic investments and cushioning against reimbursement or volume shocks. A healthier capital structure supports longer-term growth initiatives and reduces refinancing risk.

Negative Factors

Weak Free Cash Flow Generation

Negative free cash flow growth despite positive operating cash flow indicates capital spending or working capital needs outpacing cash generation. Over months this constrains self-funded growth, increases reliance on asset sales or financing, and limits reinvestment flexibility.

Net Margin Still Negative

Persistent negative net margins signal underlying profitability shortfalls despite gross margin gains. If operating leverage and SG&A reductions don't continue, sustainable net income remains uncertain, making long-term EPS durability vulnerable to demand or pricing shifts.

Product Mix Headwinds

Declining hardware sales and underwhelming biologics growth reduce revenue diversity and slow scale in the core biologics franchise. Coupled with recent hardware asset divestitures, the company risks concentrated exposure to slower-adopting products and execution risk in commercializing biologics.

Xtant Medical Holdings Business Overview & Revenue Model

Company Description

Xtant Medical Holdings, Inc. develops, manufactures, and markets regenerative medicine products and medical devices for orthopedic and neurological surgeons in the United States and internationally. Its biomaterial products include OsteoSponge that provides a natural scaffold for cellular in-growth and exposes bone-forming proteins to the healing environment; OsteoSponge SC that fills bony defects in the subchondral region of joints; OsteoSelect DBM Putty for osteoinductive bone growth; OsteoSelect PLUS DBM Putty for use as a bone void filler and bone graft substitute in the pelvis, extremities, and posterolateral spine; OsteoFactor, which contains various proteins and peptides that support bone formation and remodeling; OsteoWrap; and OsteoVive Plus, a growth factor enriched cellular bone matrix. The company also provides 3Demin, a family of allografts that maximizes osteoconductivity and the osteoinductive potential of human bone. In addition, it processes and distributes sports allografts for anterior and posterior cruciate ligament repairs, anterior cruciate ligament reconstruction, and meniscal repair; milled spinal allografts for cortical bone milled to desired shapes and dimensions; and traditional allografts for orthopedics, neurology, podiatry, oral/maxillofacial, genitourinary, and plastic/reconstructive applications. Further, the company offers Certex spinal fixation, Spider cervical plating, Axle interspinous fusion, Silex Sacroiliac joint fusion, Xpress minimally invasive pedicle screw, and Fortex Pedicle screw systems. Additionally, it provides Calix for cervical and thoracolumbar applications, Axle-X interspinous fusion system, Irix-C cervical integrated fusion system, and Irix-A Lumbar integrated fusion system. The company was formerly known as Bacterin International Holdings, Inc. and changed its name to Xtant Medical Holdings, Inc. in July 2015. Xtant Medical Holdings, Inc. is headquartered in Belgrade, Montana.

How the Company Makes Money

Xtant Medical generates revenue primarily through the sale of its surgical products and devices, which include allografts, spinal implants, and orthopedic instrumentation. The company’s revenue model is built on a combination of direct sales to hospitals and surgical centers, as well as partnerships with distributors and medical device companies that expand their market reach. Key revenue streams include the sales of their proprietary allograft products, which are essential for various surgical procedures, and recurring sales from spinal implant systems. Additionally, Xtant Medical benefits from collaborations with healthcare providers and research organizations that enhance its product offerings and market presence, contributing positively to its earnings.

Xtant Medical Holdings Financial Statement Overview

Summary

Xtant Medical Holdings is showing signs of recovery with positive revenue growth and operational improvements. The balance sheet is strengthening with reduced leverage, but profitability and cash flow generation remain concerns. Continued focus on cost management and cash flow improvement is crucial.

Income Statement

Xtant Medical Holdings has shown a positive trend in revenue growth, with a TTM revenue increase of 4.16%. The gross profit margin is strong at 60.16% for TTM, indicating efficient cost management. However, the net profit margin remains negative, albeit improving, reflecting ongoing challenges in achieving profitability. The EBIT and EBITDA margins have turned positive in TTM, suggesting operational improvements.

Balance Sheet

The company's debt-to-equity ratio has improved to 0.31 in TTM, indicating a healthier balance sheet with reduced leverage. The return on equity is still negative, but the trajectory shows improvement. The equity ratio is stable, suggesting a solid capital structure. Overall, the balance sheet reflects a strengthening financial position.

Cash Flow

Cash flow from operations has turned positive in TTM, a significant improvement from previous periods. However, free cash flow growth is negative, highlighting challenges in generating cash after capital expenditures. The operating cash flow to net income ratio is low, indicating limited cash generation relative to net income.

Breakdown	TTM	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020
Income Statement
Total Revenue	133.08M	117.27M	91.30M	57.97M	55.26M	53.34M
Gross Profit	82.54M	68.22M	55.47M	32.14M	32.49M	34.39M
EBITDA	10.90M	-7.88M	5.08M	-5.43M	-2.51M	1.33M
Net Income	1.75M	-16.45M	660.00K	-8.48M	-4.85M	-7.02M
Balance Sheet
Total Assets	106.32M	93.84M	92.61M	60.23M	54.69M	41.47M
Cash, Cash Equivalents and Short-Term Investments	10.40M	6.20M	5.71M	20.30M	18.24M	2.34M
Total Debt	15.08M	35.14M	23.56M	17.07M	16.84M	18.54M
Total Liabilities	55.94M	50.87M	41.26M	26.06M	23.81M	26.95M
Stockholders Equity	50.38M	42.96M	51.35M	34.17M	30.88M	14.51M
Cash Flow
Free Cash Flow	5.17M	-16.01M	-10.97M	-7.11M	-1.68M	-2.28M
Operating Cash Flow	7.83M	-11.90M	-9.52M	-5.34M	439.00K	-731.00K
Investing Cash Flow	2.65M	-3.73M	-24.78M	-1.56M	-1.89M	-1.30M
Financing Cash Flow	-6.88M	16.07M	19.69M	9.02M	17.50M	-861.00K

Xtant Medical Holdings Technical Analysis

• Technical Analysis Sentiment: Negative
• Last Price: 0.58
• 50DMA: Negative
• 100DMA: Negative
• 200DMA: Negative
• MACD: Positive
• RSI: Neutral
• STOCH: Neutral

Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For XTNT, the sentiment is Negative. The current price of 0.58 is below the 20-day moving average (MA) of 0.64, below the 50-day MA of 0.68, and below the 200-day MA of 0.66, indicating a bearish trend. The MACD of -0.03 indicates Positive momentum. The RSI at 34.04 is Neutral, neither overbought nor oversold. The STOCH value of 23.19 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for XTNT.

Xtant Medical Holdings Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
XTNT	66 Neutral	$81.48M	57.06	3.64%	―	16.88%	―
FONR	66 Neutral	$116.86M	16.74	4.34%	―	3.36%	-21.15%
APYX	60 Neutral	$162.89M	-10.89	-172.18%	―	-1.32%	55.62%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
VANI	50 Neutral	$96.30M	-2.99	-265.02%	―	―	-0.27%
TELA	44 Neutral	$37.41M	-0.95	―	―	12.24%	47.45%
NVNO	42 Neutral	$6.16M	-0.24	-57.19%	―	―	18.94%

Xtant Medical Holdings Corporate Events

Xtant Medical Extends Note Maturity After Asset Divestitures

On December 1, 2025, Xtant Medical Holdings and its subsidiary Surgalign SPV completed the divestiture of certain assets related to its Coflex and CoFix spinal products to Companion Spine for $17.5 million, part of which was paid via an $8.2 million unsecured promissory note initially maturing on January 15, 2026, and simultaneously sold its foreign hardware business subsidiary, Paradigm Spine GmbH, to Companion Spine SAS for $1.7 million, both deals subject to purchase price adjustments that could reduce the note’s principal. On January 15, 2026, Xtant and Companion Spine amended the promissory note to extend its maturity to January 31, 2026 and modified the Paradigm Spine purchase agreement to shift payment of an estimated $1,742,000 positive purchase price adjustment to January 31, 2026, clarifying timing of cash inflows and potentially affecting the company’s near-term liquidity profile following these portfolio-divesting transactions.

The most recent analyst rating on (XTNT) stock is a Buy with a $0.78 price target. To see the full list of analyst forecasts on Xtant Medical Holdings stock, see the XTNT Stock Forecast page.

Xtant Medical Sells Assets to Companion Spine

On December 1, 2025, Xtant Medical Holdings completed the sale of its Coflex and CoFix product assets and its shares in Paradigm Spine GmbH to Companion Spine, LLC, and Companion Spine SAS for a total of $19.2 million. This divestiture, which includes a mix of cash payments and an unsecured promissory note, is part of a strategic move to streamline operations and reduce debt, as $8 million of the proceeds were used to prepay a portion of the company’s term loan with MidCap Financial Trust.

The most recent analyst rating on (XTNT) stock is a Hold with a $0.62 price target. To see the full list of analyst forecasts on Xtant Medical Holdings stock, see the XTNT Stock Forecast page.

Xtant Medical Approves Equity Plan Amendment at Meeting

On November 7, 2025, Xtant Medical Holdings held its annual stockholders meeting, where an amendment to the 2023 Equity Incentive Plan was approved, increasing the number of shares by 12,300,000. This decision, alongside other proposals such as the election of directors and the ratification of Grant Thornton LLP as the accounting firm, reflects the company’s strategic moves to enhance its operational framework and shareholder engagement.

The most recent analyst rating on (XTNT) stock is a Hold with a $1.00 price target. To see the full list of analyst forecasts on Xtant Medical Holdings stock, see the XTNT Stock Forecast page.