Xtant Medical (XTNT) Reports Q4 and Full-Year 2025 Financials: Returns to Profitability, Sharpens Focus on Biologics

Key Highlights

• Full-year 2025 revenue of \$133.9 million, up 14% year-over-year.
• Achieved profitability: Net income of \$5.0 million for 2025 compared to a \$16.5 million net loss in 2024.
• Adjusted EBITDA turnaround: \$16.3 million positive in 2025 vs. a \$2.3 million loss in 2024.
• Strong operating cash flow: \$12.5 million provided by operations, compared to \$11.9 million used in 2024.
• Divested non-core assets (Coflex®, CoFix, and international hardware businesses) for \$21.4 million in cash; \$10.5 million of proceeds received in early 2026.
• Launched two new products: nanOss Strata™ (innovative synthetic bone graft) and CollagenX™ (bovine collagen surgical wound closure product).
• 2026 Revenue Guidance: \$95–\$99 million, reflecting the loss of divested product lines and certain one-time license revenues.
• Management signals no need for additional capital, expects to be free cash flow positive in 2026.

Detailed Financial Review

Fourth Quarter 2025

• Revenue: \$32.4 million (up 3% from Q4 2024). Companion Spine transaction reduced quarterly revenue by an estimated \$2.0 million.
• Gross Margin: 54.9% (vs. 50.8% Q4 2024).
• Net Income: \$0.1 million (vs. \$3.2 million loss Q4 2024).
• Adjusted EBITDA: \$1.9 million (vs. \$0.4 million Q4 2024).

Full-Year 2025

• Revenue: \$134.0 million (up 14% from \$117.3 million in 2024).
• Gross Margin: 62.9% (vs. 58.2% in 2024).
• Net Income: \$5.0 million, or \$0.03 per diluted share (vs. \$16.5 million loss, or \$0.12 per share loss in 2024).
• Adjusted EBITDA: \$16.3 million (vs. \$2.3 million loss in 2024).
• Net Operating Cash Flow: \$12.5 million (vs. \$11.9 million used in 2024).
• Cash Position: \$17.3 million as of December 31, 2025; increased to over \$22 million after Companion Spine note repayment in February 2026. Term loan balance reduced to \$11.2 million.

Strategic Highlights and Shareholder-Relevant Developments

• Divestiture of Non-Core Assets:
  The completed sale of Coflex®, CoFix, and international hardware businesses to Companion Spine for \$21.4 million in cash is a major strategic shift. This transaction enables Xtant to focus resources on its core, higher-margin biologics business and product innovation. The sale also strengthened the balance sheet, directly impacting cash flow and reducing the need for external capital.
• Product Launches:
  Xtant announced the commercial launch of nanOss Strata™ (a hydroxycarbonapatite-based synthetic bone graft) and CollagenX™ (a bovine collagen particulate for surgical wound closure). These launches demonstrate Xtant’s commitment to innovation and expanding its biologics portfolio.
• Profitability & Cash Flow:
  After several years of losses, Xtant achieved profitability and strong cash flow in 2025, a significant milestone. The company’s management emphasized that, with a stronger financial position, no further capital raises are anticipated, and Xtant expects to be free cash flow positive in 2026.
• 2026 Outlook:
  Full-year 2026 revenue is expected to be \$95–\$99 million. This forecast reflects organic growth in the core biologics business, but also the anticipated decline from divested product lines and the cessation of one-time license revenues related to Q-Code and amniotic membrane agreements.
• Sales Force Expansion:
  Xtant began growing its field sales force in late 2025 and into 2026, aiming to leverage its contract portfolio and independent agent network to drive future growth.
• Balance Sheet Improvements:
  Cash and cash equivalents increased to \$17.3 million at year-end 2025 (\$22 million after Companion Spine note repayment). Debt was reduced significantly (term loan down to \$11.2 million from \$22.0 million). Inventory and accounts receivable were also reduced, improving working capital efficiency.

Important Shareholder Considerations and Potential Price-Sensitive Information

• Return to Profitability and Cash Flow: The company’s swing to profitability and positive cash flow after years of losses signals a potentially transformative period for Xtant, which could be positively received by investors.
• Divestiture Impact: The sale of non-core assets provides liquidity and focus but will result in a meaningful reduction in total revenues starting in 2026, as reflected in guidance. Investors should note that the core business is higher margin, which could support future profitability even at lower revenue levels.
• No Additional Capital Needs Forecasted: Management’s assertion that no further capital raising is anticipated reduces dilution risk and may be viewed favorably by the market.
• 2026 Guidance Lower Than 2025 Actuals: Revenue is forecasted to drop in 2026 due to the divestitures and the wind-down of certain license revenues. The market may react to this guidance, so close attention is warranted.
• Continued Investment in Biologics and Sales Team: The company’s focus on high-margin biologics and expanding its sales force could drive future growth and margin improvement.
• Risk Factors: As always, shareholders should be aware of risks, including dependence on third-party manufacturers, risks from acquisitions/dispositions, possible impairment charges, product innovation and competition, reimbursement environment, and macroeconomic factors.

Conference Call Details

Xtant Medical will host a webcast and conference call to discuss Q4 and full-year 2025 results at 8:30 AM ET on March 31, 2026.

Webcast: https://www.webcaster5.com/Webcast/Page/3039/53616
Conference Call: US: 888-506-0062; International: 973-528-0011 (Participant Access Code: 581090)

A replay will be available on the investor section of the company’s website for one year.

About Xtant Medical Holdings, Inc.

Xtant Medical Holdings, Inc. (NYSE American: XTNT) is a global medical technology company focused on orthobiologics for spinal and other orthopedic conditions, surgical wound care, and sports medicine. The company is committed to honoring the gift of donation and improving patient outcomes.

Disclaimer

This article is for informational purposes only and does not constitute investment advice or a recommendation to buy or sell any security. All investments carry risks, and readers should conduct their own due diligence and consult with their financial advisor before making investment decisions. The information contained herein is derived from company disclosures and is believed to be accurate as of the date of publication but is subject to change without notice.

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