SI-BONE, Inc. (SIBN) · Nov 2, 2026 · Earnings
Beat — EPS $(0.08) vs ~$0.13 loss consensus; revenue $55.7M vs ~$55.3M consensus
SI-BONE earnings slightly beat expectations, with positive adjusted EBITDA and lower operating-expense growth guidance supporting its new-product expansion.
SI-BONE is expanding from its established sacroiliac and pelvic-fixation business into a broader compromised-bone spine platform, with iFuse Granite Onyx extending the franchise beyond the pelvis. The company had already raised 2026 revenue guidance in August and flagged a third breakthrough-device launch, so the strategic direction was known before this report.
| Q3 2026 | Q3 2025 | Consensus | |
|---|---|---|---|
| Revenue (Financial Highlights) | $55.7M (+14.5%) | $48.7M | ~$55.3M |
| Gross margin (Financial Highlights) | 79.3% | 79.8% | |
| Net loss per share (Income Statement) | $(0.08) | $(0.11) | ~$(0.13) |
| Adjusted EBITDA (Adjusted EBITDA reconciliation) | $3.0M | $2.3M | |
| Free cash flow (Cash Flow data) | $(4.6M) | $(9.5M) |
The quarter modestly beat the operating bar. Revenue of $55.7 million was slightly above the published consensus near $55.3 million, while diluted loss per share of $0.08 was better than the roughly $0.13 loss expected. Revenue growth remained healthy, but it was driven more by procedure volume than pricing: U.S. procedure volume rose about 19.5%, while average selling price was pressured by mix and greater demand for the lower-priced INTRA setting.
Profitability is improving faster than the headline loss suggests. Operating expenses grew 9.7%, below revenue growth and below the prior 12% expense-growth assumption, lifting adjusted EBITDA to $3.0 million from $2.3 million. The company also generated $4.4 million from operations, although heavy equipment spending left free cash flow negative.
The guidance change is a quiet positive, not a growth reset. SI-BONE left 2026 revenue at $231–233 million, gross margin near 79%, and adjusted EBITDA positive, but lowered expected operating-expense growth to 10.5% from 12%. That improves the path toward profitability without requiring a higher sales forecast. 〔0〕
Onyx adds strategic upside, but its commercial contribution is still early. The FDA clearance was announced in September rather than discovered in this filing, so the approval itself is partly known; the new information is management's claim of early uptake and a roughly $5 billion total addressable market. The product broadens SI-BONE's addressable procedure set, but this quarter does not yet quantify meaningful Onyx revenue.
Bottom line: This is a modestly better-than-expected quarter that advances SI-BONE's profitable-growth transition, mainly through cost discipline and improving losses. The larger Onyx expansion remains a future growth opportunity rather than a material contributor to this quarter's numbers.
Q4 results, early 2027
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