Xtant Medical Holdings (XTNT) AI Stock Analysis

• Market Cap: $99.62M
• Dividend Yield: N/A
• Average Volume (3M): 72.58K
• Price to Earnings (P/E): ―
• Beta (1Y): 1.15
• Revenue Growth: 20.81%
• EPS Growth: -498.66%
• Country: US
• Employees: 217
• Sector: Healthcare
• Sector Strength: 47
• Industry: Medical - Devices
• EPS (TTM): 0.28
• Shares Outstanding: 139,323,170
• 10 Day Avg. Volume: 108,247
• 30 Day Avg. Volume: 72,584
• PEG Ratio: -0.30
• Price to Book (P/B): 2.04
• Price to Sales (P/S): 0.00
• P/FCF Ratio: -9.94
• Enterprise Value/Market Cap: 1.01
• Enterprise Value/Revenue: 0.22
• Enterprise Value/Gross Profit: 1.41
• Enterprise Value/Ebitda: -3.49
• 1Y Price Target: $2.00
• Price Target Upside: 189.86% Upside
• Rating Consensus: Moderate Buy
• Number of Analyst Covering: 2

• Rating: 59 Neutral
• Price Target: $1.00 ▲(44.93%Upside)

The overall stock score is driven primarily by strong technical indicators and positive earnings call insights that highlight strategic advancements and revenue growth. However, the stock's valuation is severely impacted by its negative P/E ratio and lack of dividends, reflecting profitability challenges. Financial performance remains a concern due to persistent issues with profitability and cash flow.

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 through the sale of its medical devices and biologics to hospitals, healthcare providers, and distributors. The company's key revenue streams include direct sales of its proprietary spinal implants and biologics used in orthopedic surgeries. Additionally, Xtant leverages partnerships with healthcare facilities and distributors to expand its market reach. These partnerships, along with a focus on research and development for new and improved products, contribute significantly to its earnings. The company also benefits from recurring revenue through the continued use of its products in medical procedures.

Xtant Medical Holdings Financial Statement Overview

Summary

Xtant Medical Holdings demonstrates strong revenue growth, which is promising. However, persistent challenges with profitability and cash flows highlight financial instability. While the balance sheet shows improvement in leverage and equity, the company's inability to turn revenue growth into positive net income and cash flow poses risks. Focus on operational efficiency and cost management is crucial for enhancing financial health.

Income Statement

The company's revenue has shown a consistent growth trend, increasing from $53.3M in 2020 to $122.3M in TTM 2025, reflecting a strong top-line trajectory. However, profitability remains a challenge, with negative net income and EBIT margins across the periods. The gross profit margin has been relatively stable around 58% to 60%, indicating some efficiency in production, but the net profit margin remains negative, which is a significant concern.

Balance Sheet

The balance sheet shows a mixed picture. The debt-to-equity ratio has improved to 0.28 in TTM 2025 from higher levels in previous years, reflecting reduced leverage. Stockholders' equity has grown, contributing to a healthier equity ratio of approximately 45.8%. However, the company still faces significant liabilities, and the negative net income impacts return on equity, which remains unfavorable.

Cash Flow

Cash flow analysis indicates persistent struggles with negative operating cash flows and free cash flows, although free cash flow was slightly less negative in TTM 2025 compared to 2024. The company has not yet achieved positive cash flow from operations, which is crucial for long-term sustainability. The reliance on financing activities to cover cash outflows remains a risk.

Breakdown	TTM	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020
Income Statement
Total Revenue	122.30M	117.27M	91.30M	57.97M	55.26M	53.34M
Gross Profit	71.16M	68.22M	55.47M	32.14M	32.49M	34.39M
EBITDA	-3.25M	-7.88M	5.08M	-5.43M	-2.51M	1.33M
Net Income	-11.99M	-16.45M	660.00K	-8.48M	-5.84M	-7.02M
Balance Sheet
Total Assets	92.61M	93.84M	92.61M	60.23M	54.69M	41.47M
Cash, Cash Equivalents and Short-Term Investments	5.92M	6.20M	5.71M	20.30M	18.24M	2.34M
Total Debt	23.56M	35.14M	23.56M	17.07M	16.84M	18.54M
Total Liabilities	41.26M	50.87M	41.26M	26.06M	23.81M	26.95M
Stockholders Equity	51.35M	42.96M	51.35M	34.17M	30.88M	14.51M
Cash Flow
Free Cash Flow	-9.39M	-16.01M	-10.97M	-7.11M	-1.68M	-2.28M
Operating Cash Flow	-4.86M	-11.90M	-9.52M	-5.34M	439.00K	-731.00K
Investing Cash Flow	-4.20M	-3.73M	-24.78M	-1.56M	-1.89M	-1.30M
Financing Cash Flow	9.97M	16.07M	19.69M	9.02M	17.50M	-861.00K

Xtant Medical Holdings Technical Analysis

• Technical Analysis Sentiment: Positive
• Last Price: 0.69
• 50DMA: Positive
• 100DMA: Positive
• 200DMA: Positive
• MACD: Negative
• RSI: Neutral
• STOCH: Neutral

Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For XTNT, the sentiment is Positive. The current price of 0.69 is above the 20-day moving average (MA) of 0.65, above the 50-day MA of 0.61, and above the 200-day MA of 0.53, indicating a bullish trend. The MACD of 0.02 indicates Negative momentum. The RSI at 56.98 is Neutral, neither overbought nor oversold. The STOCH value of 69.73 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for XTNT.

Xtant Medical Holdings Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
XGN	62 Neutral	$152.81M	―	-117.50%	―	1.78%	22.46%
XTNT	59 Neutral	$99.62M	―	-26.20%	―	20.81%	-498.66%
Sector *	51 Neutral	$7.55B	0.30	-61.90%	2.27%	17.11%	1.58%
DOMH		$77.32M	―	-92.68%	―	―	―
CRBP	43 Neutral	$87.62M	―	-44.89%	―	―	64.71%
CBUS	39 Underperform	$74.65M	―	-157.73%	―	104.78%	40.41%
ACET	27 Underperform	$50.54M	―	-55.83%	―	―	59.75%

Xtant Medical Holdings Corporate Events

Xtant Medical Ends Investor Agreement After Share Sale

On April 15, 2025, Xtant Medical Holdings terminated its Investor Rights Agreement with ROS Acquisition and ORO II following a secondary private sale of 73.1 million shares by OrbiMed to Nantahala Capital Management and other investors. This transaction provides Xtant with greater strategic flexibility and aligns it with long-term healthcare-focused investors. Xtant plans to prioritize profitability and self-sustainability by shifting towards higher-margin orthobiologics and leveraging its Montana manufacturing facility. The company anticipates revenue growth of 18% to 19% for the first quarter of 2025, driven by orthobiologics and licensing revenue.