PROCEPT BioRobotics® Reports Fourth Quarter and Full Year 2024 Results

Rhea-AI Summary

PROCEPT BioRobotics (PRCT) reported strong Q4 2024 financial results with total revenue of $68.2 million, up 57% year-over-year. The company sold 60 new robotic systems in the US at an average price of $460,000. U.S. system revenue reached $27.6 million (+67%), while handpiece revenue grew to $29.3 million (+36%).

Full-year 2024 revenue was $224.5 million, representing 65% growth from 2023. The company achieved significant milestones including FDA 510(k) clearance for the HYDROS Robotic System and FDA-IDE approval for the WATER IV PCa prostate cancer study.

For 2025, PROCEPT projects revenue of approximately $320 million (+42% YoY) with an expected gross margin of 64.5%. Q4 2024 saw challenges with an acute saline shortage affecting 10-20% of Aquablation procedures.

Positive

• Revenue grew 57% YoY to $68.2M in Q4 2024
• U.S. system revenue increased 67% to $27.6M
• International revenue up 137% to $7.8M
• Gross margin improved to 64% from 49% YoY
• Full year revenue up 65% to $224.5M
• Installed base reached 505 systems in U.S.
• FDA clearance received for HYDROS Robotic System

Negative

• Net loss of $18.9M in Q4 2024
• Operating expenses increased to $63.4M from $50.8M
• Saline shortage impacted 10-20% of procedures
• Full year net loss of $91.4M
• Projected $35M Adjusted EBITDA loss for 2025

Insights

Financial Analyst

PROCEPT BioRobotics delivered exceptional growth in Q4 and full-year 2024, demonstrating strong commercial momentum in the robotic urology space. Q4 revenue reached $68.2 million (57% YoY growth), while full-year revenue hit $224.5 million (65% YoY growth). The company's 2025 revenue guidance of $320 million suggests continued robust expansion at 42% growth.

The company's capital equipment business showed particular strength with 60 new US system placements in Q4 at an ASP of $460,000, bringing the total US installed base to 505 systems. This represents significant market penetration in the BPH surgical robotics space, though still with substantial runway considering there are approximately 4,000 hospitals performing BPH procedures in the US alone.

The recurring revenue component - handpieces and consumables - grew 36% YoY to $29.3 million in Q4, which is notable but fell short of system revenue growth. Management disclosed that a Q4 saline shortage impacted 10-20% of Aquablation procedures, creating a temporary headwind for utilization. This situation bears monitoring, as recurring revenue growth is important for long-term profitability.

Gross margin expansion was particularly impressive, reaching 64% in Q4 (up from 49% YoY) and 61% for the full year. This 15 percentage point improvement reflects:

• Increased manufacturing scale efficiencies
• Higher system ASPs
• Improved overhead absorption

With 2025 gross margin guidance of 64.5%, the company appears to be stabilizing at these higher levels, which significantly improves the path to profitability.

The company's operating metrics show improving leverage, with operating expenses growing at 30% YoY while revenue grew 65%. This positive divergence resulted in narrowing losses, with Adjusted EBITDA loss improving to $61.1 million for 2024 from $86.5 million in 2023. The 2025 guidance of $35 million Adjusted EBITDA loss suggests continued progress toward breakeven.

Strategically, two developments stand out as potential catalysts for future growth:

• FDA clearance of the next-generation HYDROS Robotic System, representing the first major platform advancement
• FDA-IDE approval for the WATER IV PCa pivotal study in prostate cancer, potentially expanding the addressable market beyond BPH

With $333.7 million in cash and a quarterly cash burn rate that appears to be decreasing (based on improving EBITDA loss), PROCEPT has substantial runway to execute its growth strategy while progressing toward profitability. The Q1 2025 revenue guidance of $65.5 million represents a slight sequential decline from Q4, but this likely reflects typical capital equipment seasonality rather than deteriorating fundamentals.

The 137% international revenue growth, while from a smaller base, indicates significant global expansion potential as the company scales beyond its primary US market. This geographic diversification provides additional growth vectors beyond US market penetration.

Medical Device Expert

PROCEPT BioRobotics continues to demonstrate exceptional market traction with its Aquablation therapy platform, which represents a significant advancement in BPH treatment technology. The company's 57% Q4 revenue growth and expansion to 505 US installed systems indicates strong clinical adoption of this robotically-controlled waterjet ablation technology.

From a clinical perspective, Aquablation's key advantages driving this adoption include:

• Consistent, reproducible results regardless of surgeon experience
• Preservation of sexual function (~0% reported rates of ejaculatory dysfunction compared to 30-65% with TURP/laser)
• Ability to treat prostates of all sizes and configurations
• Reduced learning curve compared to other advanced techniques
• Demonstrated durability of results in 5-year follow-up data

The Q4 placement of 60 new systems represents continued strong penetration in a US market of approximately 4,000 hospitals performing BPH procedures. With 505 systems installed, PROCEPT has penetrated roughly 12-13% of potential hospital accounts, indicating substantial remaining runway in their core market alone.

The reported saline shortage impacting 10-20% of Aquablation procedures is noteworthy but likely transient. Saline shortages periodically affect numerous surgical specialties and typically stem from manufacturing disruptions or supply chain bottlenecks at major fluid manufacturers. These shortages generally resolve within 1-2 quarters and hospitals typically prioritize allocation to procedural areas over general floor use. The impact on Aquablation (which requires continuous irrigation) demonstrates how supply chain vulnerabilities can temporarily affect even high-value procedures.

The FDA clearance of the HYDROS Robotic System represents a significant platform evolution. While specific enhancements weren't detailed, next-generation surgical robotic platforms typically deliver improvements in:

• Visualization technology and image processing
• User interface and surgeon control mechanisms
• Procedure time efficiency
• System footprint and OR workflow integration
• Service requirements and reliability

These advancements could accelerate adoption in both new accounts and drive upgrades within the existing installed base, particularly at high-volume centers seeking efficiency gains.

Perhaps most strategically significant is the FDA-IDE approval for the WATER IV PCa prostate cancer trial. This represents a potential paradigm shift in PROCEPT's addressable market. While Aquablation was initially optimized for BPH tissue removal with preservation of surrounding structures, adapting this technology for precise cancer treatment presents both challenges and opportunities:

The prostate cancer surgical market (approximately 80,000 radical prostatectomies annually in the US) represents a substantial expansion opportunity. If PROCEPT can demonstrate that robotically-controlled waterjet ablation can precisely target cancerous tissue while preserving surrounding neurovascular structures, it could potentially offer advantages over current focal therapy approaches like cryotherapy, HIFU, and focal laser ablation.

Reimbursement remains favorable for Aquablation with a Category 1 CPT code and facility payment rates that support hospital economics. The $29.3 million in Q4 handpiece revenue (36% YoY growth) suggests strong utilization per system, with the average installed system generating approximately $60,000 in annual recurring revenue - a figure likely to increase as programs mature and procedural volumes grow.

The international growth of 137% indicates PROCEPT is successfully navigating different regulatory and reimbursement environments globally, though international markets typically present longer adoption curves for advanced medical technologies due to more constrained capital budgets and varying reimbursement structures.

SAN JOSE, Calif., Feb. 25, 2025 (GLOBE NEWSWIRE) -- PROCEPT BioRobotics Corporation (Nasdaq: PRCT) (the “Company”), a surgical robotics company focused on advancing patient care by developing transformative solutions in urology, today reported financial results for the fourth quarter and year ended December 31, 2024.

Recent Highlights

• Total revenue of approximately $68.2 million for the fourth quarter of 2024, an increase of 57% compared to the prior year period
• U.S. system revenue of $27.6 million for the fourth quarter of 2024, an increase of 67% compared to the prior year period
• Sold 60 new robotic systems in the U.S. in the fourth quarter of 2024 at a blended average selling price of approximately $460,000
• U.S. handpiece and consumables revenue of $29.3 million for the fourth quarter of 2024, an increase of 36% compared to the prior year period
• Total revenue of $224.5 million for full year 2024, an increase of 65% compared to 2023
• Issued 2025 total revenue guidance of approximately $320 million, which would represent an increase of 42% compared to actual full year 2024 revenue

“In pursuit of our long-term vision to transform the global treatment of BPH and ultimately build a global urology company, 2024 was a productive year for PROCEPT in two key areas," said Reza Zadno, Chief Executive Officer. “First, in August, we received FDA 510(k) clearance of our next-generation platform – the HYDROS™ Robotic System. This was a pivotal moment for the Company as HYDROS represents the first significant technological advancement compared to the AquaBeam^® system. Second, we received FDA-IDE approval to initiate WATER IV PCa, a pivotal randomized clinical study for prostate cancer. As we enter 2025, we believe there are several positive factors that will enable us to continue to pursue our long-term growth strategy while continuing a disciplined approach on our path to profitability.”

Fourth Quarter 2024 Financial Results

Total revenue for the fourth quarter of 2024 was $68.2 million, an increase of 57% compared to the prior year period. The increase was primarily driven by increased system and handpiece sales, higher system average selling prices, and increased international revenue. U.S. system revenue was $27.6 million, an increase of 67% compared to the prior year period. As of December 31, 2024, the install base of AquaBeam and Hydros Robotic Systems in the U.S. was 505 systems. U.S. handpiece and consumable revenue for the quarter was $29.3 million, an increase of 36% compared to the prior year period. Due to an acute saline shortage in the fourth quarter of 2024, particularly in November 2024, the Company estimates reduced saline supply to hospital accounts resulted in a delay or cancellation of between 10 to 20 percent of Aquablation procedures - which ultimately impacted handpiece order patterns. International revenue was $7.8 million for the quarter, an increase of approximately 137% compared to the prior year period.

Gross margin for the fourth quarter 2024 was 64% compared to 49% in the prior year period. Gross margin improvement was primarily due to improved overhead absorption, increased revenues, and increased U.S. robotic system average selling prices.

Operating expenses in the fourth quarter of 2024 were $63.4 million, compared with $50.8 million in the prior year period. The increase in operating expenses was primarily due to expenses to expand the commercial organization, increased variable compensation expense and increased general and administrative expenses.

Interest expense in the fourth quarter of 2024 was $1.0 million. Interest and other income in the fourth quarter of 2024 was $1.8 million. Interest and other income in the quarter was offset by foreign exchange loss headwinds.

Net loss was $18.9 million for the fourth quarter of 2024, compared to a loss of $27.5 million in the prior year period. Adjusted EBITDA was a loss of $10.3 million for the fourth quarter of 2024, compared to a loss of $23.3 million in the prior year period.

Cash and cash equivalents as of December 31, 2024 totaled $333.7 million, while long-term borrowings totaled $52.0 million.

Full Year 2024 Financial Results

Revenue for the full year 2024 was $224.5 million, compared to $136.2 million for the full year 2023. The growth was primarily driven by increases in U.S. revenues attributable to system placements and increased handpieces sold.

Gross margin for full year 2024 was 61%, compared to 52% for the full year 2023. Gross margin improvement was primarily due to improved overhead absorption, increased revenues, and increased U.S. robotic system average selling prices.

Operating expenses were $233.7 million for the full year 2024, compared to $180.2 million for the full year 2023, an increase of 30%. The increase was driven by increased sales and marketing expenses primarily to expand the commercial organization, and increased research and development and general and administrative expenses.

Net loss was $91.4 million for the full year 2024, compared to $105.9 million for the full year 2023. Adjusted EBITDA was a loss of $61.1 million for full year 2024, compared to a loss of $86.5 million for the full year 2023.

First Quarter of 2025 Financial Guidance

• The Company projects total revenue for the first quarter of 2025 to be approximately $65.5 million
• The Company projects U.S. system revenue for the first quarter of 2025 to be approximately $18.7 million
• The Company projects U.S. handpieces sold for the first quarter of 2025 to be approximately 10,750
• The Company projects first quarter of 2025 gross margin to be approximately 64%
• The Company projects first quarter of 2025 total operating expense of approximately $71.0 million
  

2025 Financial Guidance

• The Company projects revenue for the full year 2025 to be approximately $320 million, which would represent 42% growth over the Company’s prior year revenue
• The Company projects full year 2025 gross margin to be approximately 64.5%
• The Company projects full year 2025 total operating expense of approximately $300 million
• The Company projects full year 2025 Adjusted EBITDA loss to be approximately $35 million

Adjusted EBITDA is a financial measure that is not prepared in accordance with generally accepted accounting principles in the United States (GAAP). For more information about the Company’s use of non-GAAP financial measures, please see the section below titled “Use of Non-GAAP Financial Measures (Unaudited).”

Webcast and Conference Call Information

PROCEPT BioRobotics will host a conference call to discuss the fourth quarter 2024 financial results after the market close on Tuesday, February 25, 2025, at 1:30 p.m. Pacific Time / 4:30 p.m. Eastern Time

Investors interested in listening to the conference call may do so by following one of the below links:

• Webcast link for interested listeners:
  • https://edge.media-server.com/mmc/p/q33jvv92  
• Dial-in registration for sell-side research analysts:
  • https://register.vevent.com/register/BI96427501b8ee48bdb09e18cb484392b0    

Live audio of the webcast will be available on the “Investors” section of the company’s website at: https://ir.procept-biorobotics.com.

An archived recording will be available on the “Investors” section of the company’s website at: https://ir.procept-biorobotics.com. The webcasts will be available for replay for at least 90 days after the event.

About PROCEPT BioRobotics Corporation
PROCEPT BioRobotics is a surgical robotics company focused on advancing patient care by developing transformative solutions in urology. PROCEPT BioRobotics manufactures the AQUABEAM^® and HYDROS™ Robotic Systems. The HYDROS Robotic System is the only AI-Powered, robotic technology that delivers Aquablation therapy. PROCEPT BioRobotics designed Aquablation therapy to deliver effective, safe, and durable outcomes for males suffering from lower urinary tract symptoms or LUTS, due to BPH that are independent of prostate size and shape or surgeon experience. BPH is the most common prostate disease and impacts approximately 40 million men in the United States. The Company has developed a significant and growing body of clinical evidence with over 150 peer-reviewed publications, supporting the benefits and clinical advantages of Aquablation therapy.

Use of Non-GAAP Financial Measures (Unaudited)
This press release references Adjusted EBITDA, a financial measure that is not prepared in accordance with generally accepted accounting principles in the United States (GAAP). The Company defines Adjusted EBITDA as net income (loss) before interest expense, taxes, depreciation and amortization and stock-based compensation expense. Non-GAAP financial measures are not a substitute for or superior to measures of financial performance prepared in accordance with GAAP and should not be considered as an alternative to any other performance measures derived in accordance with GAAP.

The Company believes that presenting Adjusted EBITDA provides useful supplemental information to investors about the Company in understanding and evaluating its operating results, enhancing the overall understanding of its past performance and future prospects, and allowing for greater transparency with respect to key financial metrics used by its management in financial and operational decision making. However, there are a number of limitations related to the use of non-GAAP measures and their nearest GAAP equivalents. For example, other companies may calculate non-GAAP measures differently, or may use other measures to calculate their financial performance, and therefore any non-GAAP measures the Company uses may not be directly comparable to similarly titled measures of other companies.

Forward Looking Statements
This release contains forward‐looking statements within the meaning of federal securities laws, including with respect to the Company’s projected financial performance for full year 2024,   statements regarding the potential utilities, values, benefits and advantages of Aquablation^® therapy performed using PROCEPT BioRobotics’ products, including AquaBeam^® Robotic System, which involve risks and uncertainties that could cause the actual results to differ materially from the anticipated results and expectations expressed in these forward-looking statements. You are cautioned not to place undue reliance on these forward-looking statements. Forward-looking statements are only predictions based on the Company’s current expectations, estimates, and assumptions, valid only as of the date they are made, and subject to risks and uncertainties, some of which the Company is not currently aware.   Forward-looking statements may include statements regarding financial guidance, market opportunity and penetration, clinical trial outcomes, the Company’s possible or assumed future results of operations, including descriptions of the Company’s revenues, gross margin, profitability, operating expenses, installed base growth, commercial momentum and overall business strategy. Forward‐looking statements should not be read as a guarantee of future performance or results and may not necessarily be accurate indications of the times at, or by, which such performance or results will be achieved. These forward‐looking statements are based on the Company’s current expectations and inherently involve significant risks and uncertainties. Actual results and the timing of events could differ materially from those anticipated in such forward‐looking statements as a result of these risks and uncertainties. These risks and uncertainties are described more fully in the section titled “Risk Factors” in the Company’s filings with the Securities and Exchange Commission (the “SEC”), including the Company’s annual report on Form 10-K filed with the SEC on February 28, 2023 and subsequent quarterly reports on Form 10-Q and, when available, the Company’s annual report on Form 10-K for the year ended December 31, 2024. PROCEPT BioRobotics does not undertake any obligation to update forward‐looking statements and expressly disclaims any obligation or undertaking to release publicly any updates or revisions to any forward‐looking statements contained herein. These forward-looking statements should not be relied upon as representing PROCEPT BioRobotics’ views as of any date subsequent to the date of this press release.

Important Safety Information
All surgical treatments have inherent and associated side effects. For a list of potential side effects visit https://aquablation.com/safety-information/

Investor Contact:
Matt Bacso
VP, Investor Relations and Business Operations
m.bacso@procept-biorobotics.com

PROCEPT BioRobotics Corporation CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited, in thousands, except per share data)
		Three Months Ended December 31,								Twelve Months Ended December 31,
			2024				2023				2024				2023
Revenue		$	68,236			$	43,581			$	224,498			$	136,191
Cost of sales			24,564				22,326				87,399				65,142
Gross profit			43,672				21,255				137,099				71,049
Operating expenses:
Research and development			15,066				14,496				62,298				48,446
Selling, general and administrative			48,316				36,316				171,415				131,773
Total operating expenses			63,382				50,812				233,713				180,219
Loss from operations			(19,710	)			(29,557	)			(96,614	)			(109,170	)
Interest expense			(969	)			(1,125	)			(4,184	)			(3,995	)
Interest and other income, net			1,823				3,178				9,385				7,268
Net loss		$	(18,856	)		$	(27,504	)		$	(91,413	)		$	(105,897	)
Net loss per share, basic and diluted		$	(0.35	)		$	(0.54	)		$	(1.75	)		$	(2.24	)
Weighted-average common shares used to
Compute net loss per share attributable to
Common shareholders, basic and diluted			53,838				50,589				52,125				47,255

PROCEPT BioRobotics Corporation RECONCILIATION OF GAAP NET LOSS TO ADJUSTED EBITDA (Unaudited, in thousands)
		Three Months Ended December 31,								Twelve Months Ended December 31,
			2024				2023				2024				2023
Net loss		$	(18,856	)		$	(27,504	)		$	(91,413	)		$	(105,897	)
Depreciation and amortization expense			1,453				1,318				5,234				3,807
Stock-based compensation expense			9,085				4,981				31,840				19,134
Interest (income) and interest expense, net			(2,017	)			(2,079	)			(6,711	)			(3,556	)
Adjusted EBITDA		$	(10,335	)		$	(23,284	)		$	(61,050	)		$	(86,512	)

PROCEPT BioRobotics Corporation RECONCILIATION OF GAAP NET LOSS TO ADJUSTED 2025 EBITDA Guidance (Unaudited, in thousands)
			2025
Net loss		$	(80,000	)
Depreciation and amortization expense			6,800
Stock-based compensation expense			51,200
Interest (income) expense and other (income) expense, net			(13,000	)
Adjusted EBITDA		$	(35,000	)

PROCEPT BioRobotics Corporation CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited, in thousands)
		December 31,				December 31,
			2024				2023
Assets
Current assets:
Cash and cash equivalents		$	333,725			$	257,222
Restricted cash, current			—				—
Accounts receivable, net			83,496				48,376
Inventory			56,168				39,756
Prepaid expenses and other current assets			8,453				5,213
Total current assets			481,842				350,567
Restricted cash, non-current			3,038				3,038
Property and equipment, net			26,709				28,748
Operating lease right-of-use assets, net			18,941				20,241
Intangible assets, net			932				1,204
Other assets			2,555				919
Total assets		$	534,017			$	404,717
Liabilities and Stockholders' Equity
Current liabilities:
Accounts payable		$	10,032			$	13,499
Accrued compensation			21,537				16,885
Deferred revenue			9,565				5,656
Operating leases, current			1,910				1,683
Loan facility derivative liability			2,000				1,886
Other current liabilities			8,089				6,318
Total current liabilities			53,133				45,927
Long-term debt			51,472				51,339
Operating lease , non-current			26,868				26,182
Other non-current liabilities			324				517
Total liabilities			131,797				123,965
Stockholders’ equity:
Additional paid-in capital			948,091				735,240
Accumulated other comprehensive loss			114				84
Accumulated deficit			(545,985	)			(454,572	)
Total stockholders’ equity			402,220				280,752
Total liabilities and stockholders’ equity		$	534,017			$	404,717

PROCEPT BioRobotics Corporation REVENUE BY TYPE AND GEOGRAPHY (Unaudited, in thousands)
		Three Months Ended						Twelve Months Ended
		December 31,						December 31,
		2024			2023			2024			2023
U.S.
System sales and rentals		$	27,636		$	16,561		$	78,614		$	53,626
Handpieces and other consumables			29,325			21,633			110,542			64,051
Service			3,428			2,075			11,316			6,620
Total U.S. revenue			60,389			40,269			200,472			124,297
Outside of U.S.
System sales and rentals			3,711			1,398			11,685			5,294
Handpieces and other consumables			3,689			1,645			10,914			5,471
Service			447			269			1,427			1,129
Total outside of U.S. revenue			7,847			3,312			24,026			11,894
Total revenue		$	68,236		$	43,581		$	224,498		$	136,191

FAQ

What was PRCT's revenue growth in Q4 2024?

PRCT's revenue grew 57% year-over-year to $68.2 million in Q4 2024.

How many robotic systems did PRCT install in the US by end of 2024?

PRCT had an installed base of 505 AquaBeam and Hydros Robotic Systems in the U.S. as of December 31, 2024.

What is PRCT's revenue guidance for 2025?

PRCT projects 2025 revenue of approximately $320 million, representing 42% growth over 2024.

How did the saline shortage affect PRCT's Q4 2024 performance?

The saline shortage caused delays or cancellations of 10-20% of Aquablation procedures, impacting handpiece order patterns.

What major regulatory approvals did PRCT receive in 2024?

PRCT received FDA 510(k) clearance for the HYDROS Robotic System and FDA-IDE approval for the WATER IV PCa prostate cancer study.