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1. Company Snapshot

1.a. Company Description

SI-BONE, Inc., a medical device company, develops implantable devices used to solve musculoskeletal disorders of the sacropelvic anatomy in the United States and internationally.It offers iFuse, a minimally invasive surgical implant system to address sacroiliac joint dysfunction and degeneration, adult deformity, and pelvic ring traumatic fractures.The company also provides iFuse-3D, a titanium implant that combines the triangular cross-section of the iFuse implant with the proprietary 3D-printed porous surface and fenestrated design; and iFuse-TORQ, a set of 3D-printed threaded implants designed to treat fractures of the pelvis and for minimally invasive sacroiliac joint fusion.


It markets its products primarily with a direct sales force, as well as through distributors.The company was incorporated in 2008 and is headquartered in Santa Clara, California.

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1.b. Last Insights on SIBN

Recent positive drivers behind SI-BONE, Inc.'s performance include: * Strong earnings estimate revisions, indicating a potential upside of 64.7% to 83.6% as per Wall Street analysts' consensus price targets (Source: Wall Street Analysts). * Positive trend in earnings estimate revisions, which could translate into an upside in the stock (Source: Wall Street Analysts). * Management's guidance update, which may reflect the company's growth prospects (Source: SI-BONE, Inc.). * Upcoming conference call, which will provide insights into the company's performance and future outlook (Source: SI-BONE, Inc.).

1.c. Company Highlights

2. SI-BONE Delivers Record Performance with 20% Revenue Growth

SI-BONE reported a strong fourth quarter 2025, with worldwide revenue growing 15% to a record $56.3 million, and U.S. revenue reaching $53.5 million, representing 13.9% growth. For the full year 2025, the company generated worldwide revenue of $200.9 million, reflecting 20.2% growth, and U.S. revenue grew 20.6% to $191.1 million. The company's adjusted EBITDA margin was 9.1% in the fourth quarter, highlighting the scalability of its infrastructure. The earnings per share (EPS) came in at -$0.04, beating estimates of -$0.13.

Publication Date: Mar -08

📋 Highlights
  • Record Revenue Growth:: Generated $200.9M in 2025 revenue (20.2% YoY), with Q4 revenue hitting $56.3M (+15% YoY).
  • Profitability Milestone:: Achieved first full year of positive adjusted EBITDA ($5.1M in Q4, 9.1% margin), improving 176.2% YoY.
  • Product Innovation:: Launched INTRA Ti in Q4 2025 and plans a 2026 breakthrough device, with 22,000 procedures performed by 2,400 U.S. physicians in 2025.
  • Strategic Partnership:: Partnered with Smith & Nephew to expand trauma solutions, targeting Level 1/2 centers, with reps launching iFuse TORQ/TNT in Q2 2026.
  • Liquidity & Guidance:: Ended 2025 with $147.8M cash, $0.5M net free cash flow in Q4, and guided $228.5–232.5M revenue for 2026 (14–16% YoY growth).

Financial Performance Highlights

The company's financial performance was marked by significant achievements, including its first full year of positive adjusted EBITDA and a 9% adjusted EBITDA margin in the fourth quarter. As Anshul Maheshwari noted, "We delivered positive adjusted EBITDA of $5.1 million in the quarter, a 176.2% improvement over the prior year." The company's robust liquidity position, consistent profitability, and recent cash flow inflection position it to self-fund revenue-accelerating investments in platform technologies targeting new addressable markets.

Guidance and Outlook

SI-BONE guided 2026 worldwide revenue to be between $228.5 million and $232.5 million, implying year-over-year growth of 14% to 16%, driven by high teens growth in U.S. procedure volume. The company expects 2026 annual gross margin to be approximately 78% and annual operating expenses to grow 12.5% at the midpoint of the revenue range. Analysts estimate next year's revenue growth at 14.9%.

Valuation Metrics

To understand what's priced in, we can look at SI-BONE's valuation metrics. The company's Price-to-Sales Ratio is 3.04, and its EV/EBITDA is -67.29. Given the company's growth prospects, these metrics suggest that the market is pricing in a significant growth trajectory. With a ROE of -11.0% and a Net Debt / EBITDA of 4.86, the company's financial health is a concern.

Operational Highlights

The company made substantial progress on two highly compelling new products, including the launch of INTRA Ti and the expected commercialization of its next breakthrough device in late 2026. The company's hybrid sales model, combining a direct sales force with over 300 third-party agents, has been instrumental in driving productivity and enabling the company to achieve strong operating leverage.

Partnership with Smith & Nephew

The company's partnership with Smith & Nephew is expected to drive growth, with Smith & Nephew reps starting to carry TORQ and TNT in the second quarter. This partnership will allow SI-BONE to reach more trauma surgeons and treat more patients with sacral insufficiency fractures, driving growth for both companies.

3. NewsRoom

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SI-BONE To Report First-Quarter 2026 Financial Results on May 11, 2026

Apr -20

Source: globenewswire.com

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SiBone (NASDAQ:SIBN) Shares Down 6.8% – What’s Next?

Apr -12

Source: defenseworld.net

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SiBone $SIBN Stake Lowered by JPMorgan Chase & Co.

Apr -06

Source: defenseworld.net

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SiBone (NASDAQ:SIBN) Sets New 52-Week Low – Here’s What Happened

Mar -29

Source: defenseworld.net

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Si-Bone (SIBN) Reports Q4 Loss, Tops Revenue Estimates

Feb -24

Source: zacks.com

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SI-BONE, Inc. (SIBN) Q4 2025 Earnings Call Transcript

Feb -24

Source: seekingalpha.com

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SI-BONE, Inc. Reports Record Financial Results for the Fourth Quarter 2025 and Issues 2026 Guidance

Feb -23

Source: globenewswire.com

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SI-BONE To Present at TD Cowen 46th Annual Health Care Conference on March 2, 2026

Feb -17

Source: globenewswire.com

4. Business Breakdown

4.a. Revenues by Country

4.b. Revenues by Segment

5. Expected revenues mid-term growth (9.27%)

6. Segments

Surgical Implant System

Expected Growth: 9.27%

Strong demand for minimally invasive spine procedures, increasing adoption of SI-BONE's iFuse Implant System, expansion into new markets, and growing awareness of sacroiliac joint dysfunction treatment options drive the 9.27% growth. Additionally, investments in sales and marketing efforts, and strategic partnerships contribute to the company's rapid expansion.

7. Detailed Products

iFuse Implant System

A minimally invasive surgical system for sacroiliac joint fusion

iFuse Bedrock Granite System

A minimally invasive surgical system for sacroiliac joint fusion in patients with advanced osteoporosis or bone fragility

iFuse-3D Implant System

A 3D-printed, porous titanium implant for sacroiliac joint fusion

8. SI-BONE, Inc.'s Porter Forces

Forces Ranking

Threat Of Substitutes

SI-BONE, Inc. has a unique product portfolio, and the threat of substitutes is low due to the lack of similar products in the market.

Bargaining Power Of Customers

SI-BONE, Inc. has a diverse customer base, and the bargaining power of customers is medium due to the availability of alternative products.

Bargaining Power Of Suppliers

SI-BONE, Inc. has a strong supply chain management system, and the bargaining power of suppliers is low due to the company's ability to negotiate prices.

Threat Of New Entrants

The medical device industry is highly competitive, and the threat of new entrants is high due to the potential for new companies to enter the market.

Intensity Of Rivalry

The medical device industry is highly competitive, and the intensity of rivalry is high due to the presence of established companies and new entrants.

9. SWOT Analysis

Strength

Weaknesses

Opportunities

Threats

10. Capital Structure

10.a. Balance Sheet

10.b. Weighted Average Cost of capital

Value
Debt Weight 18.12%
Debt Cost 8.88%
Equity Weight 81.88%
Equity Cost 10.15%
WACC 9.92%
Leverage 22.13%

11. Quality Control: SI-BONE, Inc. passed 3 out of 9 key points

12.a Historical Valuation

12.b Price/Earnings Ratio

12.c Margin Valuation

12.d Peers Valuation

Peers Group Analysis

Stock-Card
SI-BONE

A-Score: 5.1/10

Value: 6.8

Growth: 5.8

Quality: 5.6

Yield: 0.0

Momentum: 9.0

Volatility: 3.7

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908 Devices

A-Score: 4.5/10

Value: 7.9

Growth: 2.9

Quality: 5.0

Yield: 0.0

Momentum: 10.0

Volatility: 1.0

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Silk Road Medical

A-Score: 4.0/10

Value: 6.4

Growth: 5.6

Quality: 4.8

Yield: 0.0

Momentum: 6.0

Volatility: 1.0

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Avanos Medical

A-Score: 3.7/10

Value: 9.1

Growth: 2.3

Quality: 4.2

Yield: 0.0

Momentum: 1.0

Volatility: 5.7

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Orthofix Medical

A-Score: 3.6/10

Value: 8.9

Growth: 1.3

Quality: 3.8

Yield: 0.0

Momentum: 2.5

Volatility: 5.0

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TELA Bio

A-Score: 3.1/10

Value: 7.8

Growth: 5.7

Quality: 3.6

Yield: 0.0

Momentum: 0.0

Volatility: 1.7

1-Year Total Return ->

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Peers Metrics

12.e Scoring Insights

12.f DCF BETA

Parameters

Short Term Growth

Short term Time

Long-Term Growth

WACC

Target Price

14.32$

Current Price

14.32$

Potential

-0.00%

Expected Cash-Flows