- Q4 2025 Procedure Growth: 12,200 procedures completed, reflecting 69% annual growth.
- 2026 Revenue Guidance: $390M–$410M total revenue, representing 27%–33% annual growth.
- Handpiece Model Shift: 1:1 ratio with procedure volume, replacing prior 108-115% model, driven by price increases and inventory normalization.
- System Sales Performance: 65 systems sold in Q4 at $425,000 ASP, with 2026 system placements expected to be flat to slightly up.
- 2026 Procedure Outlook: 60,000–64,000 U.S. procedures, representing 39%–48% growth, driven by new launches and installed base expansion.
Operational Highlights
The company completed 12,200 procedures in Q4 2025, reflecting 69% annual growth. The company sold 65 systems in Q4 at a $425,000 ASP, which doesn't reflect softness in capital sales. The company has adjusted its business model for handpiece sales, now modeling it at a 1:1 ratio with procedure volume, a significant change from previous modeling at 108-115% of procedure volume.
Guidance and Outlook
For 2026, the company expects total revenue to be in the range of $390 million to $410 million, representing annual growth of 27% to 33%. The company expects 2026 total U.S. procedures to be in the range of 60,000 to 64,000, representing growth of approximately 39% to 48%. Gross margin for 2026 is expected to be approximately 65%. Analysts estimate next year's revenue growth at 24.2%, slightly below the company's guidance.
Valuation Metrics
Using the current valuation metrics, the company's P/S Ratio is 4.12, and EV/EBITDA is -12.1. ROE is -25.13%, and ROIC is -23.48%. These metrics indicate that the market is pricing in significant growth, but the company's current financial performance is not yet profitable. The negative EPS and EBITDA loss are expected to continue in the short term, as indicated by the guidance for Q1 EBITDA loss of around $20 million.
Future Plans
The company plans to drive growth through procedure volume, not customer ordering or stocking patterns. The sales force realignment is complete, with new account targets, quotas, and incentive plans in place. The company aims to target men with BPH through education programs and increase awareness and adoption of Aquablation therapy for BPH treatment. More details on these plans will be shared at the Analyst Day.