Xtant Medical Reports Fourth Quarter and Full Year 2024 Financial Results

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Xtant Medical's Q4 and full year 2024 results reveal a company in transition with 28% annual revenue growth to $117.3 million but continued profitability challenges. The 12% Q4 revenue growth was entirely organic, showing the company has moved beyond acquisition-dependent expansion. However, gross margins declined significantly to 50.8% in Q4 (from 61.0%) and 58.2% for the full year (from 60.8%).

The $16.4 million annual net loss requires context - 2023's $660,000 profit included an $11.7 million one-time bargain purchase gain. More revealing is Q4's operational improvement with reduced net loss of $3.2 million (vs. $4.3 million) and positive adjusted EBITDA of $438,000, a meaningful swing from the prior year's EBITDA loss.

The $5 million expense reduction (approximately 6% of annual operating expenses) primarily from Surgalign integration efficiencies has already begun materializing in Q4's reduced operating expenses. Management's projection of free cash flow generation in 2H 2025 without additional capital would mark a critical inflection point.

While the 7-11% projected revenue growth represents a deceleration, the SimpliGraft licensing agreement with $1.5 million upfront payment demonstrates intellectual property monetization beyond direct sales. The company appears to be transitioning from an integration phase to optimization phase, with improving operational metrics despite continued challenges.

Xtant's financial results reflect the complex dynamics of integrating the Surgalign acquisition while maintaining organic growth in the competitive spinal disorder treatment market. The company has successfully maintained revenue momentum with 12% organic growth in Q4, but the significant gross margin compression to 50.8% indicates substantial integration challenges affecting manufacturing efficiency.

The streamlining of their product portfolio and internalization of production represents a strategic pivot toward vertical integration - a common evolution for medical device companies seeking greater control over quality and margins. However, the inventory write-offs associated with the Surgalign acquisition suggest potential miscalculations in product line rationalization.

While operating expenses decreased quarter-over-quarter, the $80.3 million annual figure represents a substantial increase from $65.6 million in 2023. This reflects the reality of operating a larger organization with expanded sales compensation, higher amortization from acquired intangible assets, and increased R&D investments.

The anticipated free cash flow generation in 2H 2025 would be transformative for Xtant's financial health, eliminating dependency on capital markets. The license agreement for SimpliGraft suggests management is exploring asset-light growth strategies alongside traditional direct sales approaches. The 7-11% projected organic growth rate aligns with typical mid-stage medical technology companies post-major acquisition, where focus shifts from growth-at-all-costs to sustainable profitability.

03/06/2025 - 04:05 PM

Full Year 2024 Revenue Growth of 28%

Expects 2025 Revenue of $126 Million to $130 Million Without Need for Additional Capital

BELGRADE, MT / ACCESS Newswire / March 6, 2025 / Xtant Medical Holdings, Inc. (NYSE American:XTNT), a global medical technology company focused on surgical solutions for the treatment of spinal disorders, today reported financial and operating results for the fourth quarter and year ended December 31, 2024 and provided full year revenue guidance for 2025.

Fourth Quarter 2024 Financial Highlights

Revenue of $31.5 million, up 12%, compared to the prior year quarter
Gross margin of 50.8% compared to 61.0% for the prior year quarter
Net loss of $3.2 million compared to a net loss of $4.3 million in the prior year quarter
Adjusted EBITDA of $438,000 compared to Adjusted EBITDA loss of $695,000 in the prior year quarter

Full Year 2024 Financial Highlights

Revenue of $117.3 million, up 28%, compared to the prior year
Gross margin of 58.2% compared to 60.8% for the prior year
Net loss of $16.4 million compared to net income of $660,000 in the prior year, which included a $11.7 million bargain purchase gain related to the acquisition of Surgalign Holdings
Adjusted EBITDA loss of $2.3 million compared to an Adjusted EBITDA loss of $1.4 million in the prior year

Recent Business Highlights

Subsequent to year end, in the first quarter of 2025, entered into a two-year manufacture and license agreement with automatic renewals with a distributor granting the right to manufacture and supply Xtant's SimpliGraft^® product that provides for an upfront payment of $1.5 million and minimum purchase obligations
Reduced operating expenses by more than $5 million on an annualized basis since third quarter of 2024. A portion of the savings will be reinvested to drive future growth.

Sean Browne, President and CEO of Xtant Medical, stated, "2024 was a year of significant accomplishments. We delivered total revenue of $117.3 million, representing growth of 28% and in-line with our guidance, launched multiple new offerings and began capturing the operational and financial benefits of internally producing our own products. Fourth quarter 2024 revenue growth was 12% year-over-year, and importantly, it was all organic growth."

Browne continued, "The work we completed in 2024 to streamline our product portfolio and increase reliance on our own supply chain has enhanced product quality, reduced costs and, importantly, strengthened our business for sustainable, profitable growth. During the course of the fourth quarter of 2024, we identified over $5 million of expenses for removal, which will benefit our 2025 financial position. Most of these cost reductions were tied to the integration of the Surgalign business into Xtant."

Brown concluded, "Today, we are providing full year 2025 revenue guidance of $126 million to $130 million. Notably, we expect to begin generating free cash flow in the second half of 2025, enabling us to support our expected organic growth without the need for additional external capital."

Fourth Quarter and Full Year 2024 Financial Results

Fourth quarter 2024 revenue grew 12% to $31.5 million, compared to $28.1 million for the same quarter in 2023. Full year 2024 revenue grew 28% to $117.3 million, compared to $91.3 million for 2023. The revenue increase compared to the prior year quarter is due primarily to growth within our biologics product family and upfront revenue generated from a licensing agreement. The year- over-year revenue increase also included additional sales resulting from the acquisition of the Surgalign Holdings' hardware and biologics business.

Gross margin for the fourth quarter of 2024 was 50.8%, compared to 61.0% for the same period in 2023 and 58.2% for the full year 2024, compared to 60.8% for the full year 2023. These decreases were primarily attributable to reduced production throughput and charges for the write-off of inventory associated with the acquisition of Surgalign Holdings' hardware and biologics business.

Operating expenses for the fourth quarter of 2024 totaled $17.9 million, compared to $20.9 million for the fourth quarter of 2023, and were $80.3 million for the full year 2024 compared to $65.6 million for the full year 2023. The reduction in fourth quarter 2024 operating expenses compared to the prior year quarter is primarily attributable to reductions in various compensation plans and reduced professional fees. The increase in operating expenses year over year was primarily due to additional independent agent sales commissions and higher employee compensation expenses, amortization of intangible assets associated with the Coflex and CoFix product lines, and increased research and development expenses.

Fourth quarter 2024 net loss totaled $3.2 million, or $(0.02) per share, compared to a net loss in the fourth quarter 2023 of $4.3 million, or $(0.03) per share. Net loss for 2024 was $16.4 million, or $(0.12) per share, compared to net income of $660,000, inclusive of a $11.7 million bargain purchase gain related to the acquisition of Surgalign Holdings, or $0.01 per share, for 2023.

Non-GAAP adjusted EBITDA for the fourth quarter of 2024 totaled $438,000, compared to Adjusted EBITDA loss of $695,000 for the same period in 2023. Non-GAAP adjusted EBITDA for 2024 was a loss of $2.3 million, compared to an adjusted EBITDA loss of $1.4 million for 2023. Beginning in the fourth quarter of 2024, phasing of the bargain purchase gain on sell through of inventory acquired as part of the purchase of Surgalign Holdings' hardware and biologics business is no longer included in acquisition-related fair value adjustments in the non-GAAP adjusted EBITDA calculation and prior period calculations as presented herein have been recast to conform to the current presentation and calculation. The Company defines adjusted EBITDA as net income/loss from operations before depreciation, amortization and interest expense and provision for income tax/benefit, and as further adjusted to add back in or exclude, as applicable, separation related expenses, legal settlements, non-cash compensation, acquisition-related expense, acquisition-related fair value adjustments, gain on bargain purchase and unrealized foreign currency translation gain or loss. A calculation and reconciliation of adjusted EBITDA to net loss can be found in the attached financial tables.

As of December 31, 2024, the Company had $6.2 million of cash and cash equivalents compared to $5.7 million as of December 31, 2023.

2025 Financial Guidance

Xtant Medical initiated revenue guidance for the full year 2025 of $126 million to $130 million, representing organic growth of 7% to 11%.

Conference Call

Xtant Medical will host a webcast and conference call to discuss fourth quarter and full year 2024 financial results at 4:30 pm ET on Thursday, March 6, 2025.

To access the webcast, visit https://www.webcaster4.com/Webcast/Page/3039/52116.

To access the conference call, dial 888-506-0062 within the U.S. or 973-528-0011 outside the U.S. Conference Call Name: Xtant Medical Q4 and Year End 2024 Financial Results.

A replay of the call will be available on the Investor section of the Company's website at www.xtantmedical.com.

About Xtant Medical Holdings, Inc.

Xtant Medical's mission of honoring the gift of donation so that our patients can live as full and complete a life as possible, is the driving force behind our company. Xtant Medical Holdings, Inc. (www.xtantmedical.com) is a global medical technology company focused on the design, development, and commercialization of a comprehensive portfolio of orthobiologics and spinal implant systems to facilitate spinal fusion in complex spine, deformity and degenerative procedures. Xtant people are dedicated and talented, operating with the highest integrity to serve our customers.

The symbols ^™ and ^® denote trademarks and registered trademarks of Xtant Medical Holdings, Inc. or its affiliates, registered as indicated in the United States, and in other countries. All other trademarks and trade names referred to in this release are the property of their respective owners.

Non-GAAP Financial Measures

To supplement the Company's consolidated financial statements prepared in accordance with U.S. generally accepted accounting principles (GAAP), the Company uses certain non-GAAP financial measures in this release, including adjusted EBITDA. Reconciliations of the non-GAAP financial measures used in this release to the most comparable GAAP measures for the respective periods can be found in tables later in this release. The Company's management believes that the presentation of these measures provides useful information to investors. These measures may assist investors in evaluating the Company's operations, period over period. Management uses the non-GAAP measures in this release internally for evaluation of the performance of the business, including the allocation of resources. Investors should consider non-GAAP financial measures only as a supplement to, not as a substitute for or as superior to, measures of financial performance prepared in accordance with GAAP.

Cautionary Statement Regarding Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include statements that are predictive in nature, that depend upon or refer to future events or conditions, or that include words such as "intends," ‘‘expects,'' ‘‘anticipates,'' ‘‘plans,'' ‘‘believes,'' ‘‘estimates,'' "continue," "future," ‘‘will,'' "potential," "going forward," "guidance," similar expressions or the negative thereof, and the use of future dates. Forward-looking statements in this release include the Company's full year 2025 revenue guidance and the statement that it expects to begin generating free cash flow in the second half of 2025, enabling the Company to support expected organic growth without the need for additional external capital. The Company cautions that its forward-looking statements by their nature involve risks and uncertainties, and actual results may differ materially depending on a variety of important factors, including, among others: the Company's future operating results and financial performance; its ability to increase or maintain revenue; the Company's ability to become operationally self-sustaining and less reliant on third-party manufacturers and suppliers; risks associated with its acquisitions and the integration of those businesses; anticipated shortages of stem cells which will adversely affect future revenues; the ability to implement successfully its future growth initiatives and risks associated therewith; possible future impairment charges to long-lived assets and goodwill and write-downs of excess inventory; the ability to remain competitive; the ability to innovate, develop and introduce new products and the success of those products; the ability to engage and retain new and existing independent distributors and agents and qualified personnel and the Company's dependence on key independent agents for a significant portion of its revenue; the effect of labor and hospital staffing shortages on the Company's business, operating results and financial condition, especially when they affect key markets; the effect of inflation, increased interest rates and other recessionary factors and supply chain disruptions; the effect of product sales mix changes on the Company's financial results; government and third-party coverage and reimbursement for Company products; the ability to obtain and maintain regulatory approvals and comply with government regulations; the effect of product liability claims and other litigation to which the Company may be subject; the effect of product recalls and defects; the ability to license certain of the Company's intellectual property on commercially reasonable terms and to maintain any such licenses; the ability to obtain and protect Company intellectual property and proprietary rights and operate without infringing the rights of others; risks associated with the Company's clinical trials; international risks; the ability to service Company debt, comply with its debt covenants and access additional indebtedness; the ability to maintain sufficient liquidity to fund its operations and obtain financing on favorable terms or at all; and other factors. Additional risk factors are contained in the Company's Annual Report on Form 10-K for the year ended December 31, 2024 to be filed with the Securities and Exchange Commission (SEC) on March 6, 2025 and subsequent SEC filings by the Company, including without limitation its most recent Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2024 filed with the SEC on November 12, 2024. Investors are encouraged to read the Company's filings with the SEC, available at www.sec.gov, for a discussion of these and other risks and uncertainties. The Company undertakes no obligation to release publicly any revisions to any forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events, except as required by law. All forward-looking statements attributable to the Company or persons acting on its behalf are expressly qualified in their entirety by this cautionary statement.

Investor Relations Contact:

Brett Maas
Managing Partner, Hayden IR
brett@haydenir.com
(646) 536-7331

XTANT MEDICAL HOLDINGS, INC.
CONSOLIDATED BALANCE SHEETS
(In thousands, except number of shares and par value)

	As of December 31, 2024			As of December 31, 2023

ASSETS
Current Assets:
Cash and cash-equivalents	$	6,199		$	5,715
Restricted cash		22			208
Trade accounts receivable, net of allowance for credit losses of $1,437 and $920, respectively		20,660			20,731
Inventories		38,634			36,885
Prepaid and other current assets		1,601			1,330
Total current assets		67,116			64,869

Property and equipment, net		10,131			8,692
Right of use asset, net		829			1,523
Goodwill		7,302			7,302
Intangible assets, net		8,356			10,085
Other assets		103			141
Total Assets	$	93,837		$	92,612

LIABILITIES & STOCKHOLDERS' EQUITY
Current Liabilities:
Accounts payable	$	7,918		$	7,054
Accrued liabilities		7,771			10,419
Current portion of lease liability		703			830
Current portion of finance lease obligations		69			65
Line of credit		12,120			4,622
Total current liabilities		28,581			22,990
Long-term Liabilities:
Lease liability, net		166			759
Financing lease obligations, net		47			116
Long-term debt, plus premium and less issuance costs		22,038			17,167
Accrued earnout liabilities		-			210
Deferred tax liability		42			21
Total Liabilities		50,874			41,263

Stockholders' Equity
Preferred stock, $0.000001 par value; 10,000,000 shares authorized; no shares issued and outstanding		-			-
Common stock, $0.000001 par value; 300,000,000 shares authorized; 139,045,664 shares issued and outstanding as of December 31, 2024 and 130,180,031 shares issued and outstanding as of December 31, 2023		-			-
Additional paid-in capital		302,738			294,330
Accumulated other comprehensive income		(316	)		29
Accumulated deficit		(259,459	)		(243,010	)
Total Stockholders' Equity		42,963			51,349

Total Liabilities & Stockholders' Equity	$	93,837		$	92,612

XTANT MEDICAL HOLDINGS, INC.
CONSOLIDATED STATEMENTS OF OPERATIONS
(In thousands, except number of shares and per share amounts)

	Three Months Ended December 31,						Twelve Months Ended December 31,
	2024			2023			2024			2023
Revenue
Product revenue	$	30,011		$	28,108		$	115,765		$	91,303
License revenue		1,502			-		$	1,502			-
Total Revenue	$	31,513		$	28,108		$	117,267		$	91,303

Cost of Sales		15,489			10,971			49,051			35,836
Gross Profit		16,024			17,137			68,216			55,467

Gross Profit %		50.8	%		61.0	%		58.2	%		60.8	%

Operating Expenses
General and administrative		5,700			8,867			28,691			25,850
Sales and marketing		11,684			11,584			49,214			38,439
Research and development		522			492			2,385			1,336
Total Operating Expenses		17,906			20,943			80,290			65,625

Loss from Operations		(1,882	)		(3,806	)		(12,074	)		(10,158	)

Other (Expense) Income
Interest expense		(1,134	)		(818	)		(4,160	)		(2,938	)
Interest income		-			16			-			149
Unrealized foreign currency translation gain		(101	)		265			5			265
Bargain purchase gain		-			666			-			11,694
Other expense		(27	)		(49	)		(33	)		(49	)
Total Other (Expense) Income		(1,262	)		80			(4,188	)		9,121
Net Loss from Operations Before Provision for Income Taxes		(3,144	)		(3,726	)		(16,262	)		(1,037	)

(Provision) Benefit for Income Taxes
Current and Deferred		(21	)		(577	)		(187	)		1,697
Net (Loss) Income	$	(3,165	)	$	(4,303	)	$	(16,449	)	$	660

Net (Loss) Income Per Share:
Basic	$	(0.02	)	$	(0.03	)	$	(0.12	)	$	0.01
Dilutive	$	(0.02	)	$	(0.03	)	$	(0.12	)	$	0.01

Shares used in the computation:
Basic		138,977,615			130,023,185			133,665,075			119,093,687
Dilutive		138,977,615			136,955,849			133,665,075			126,793,318

XTANT MEDICAL HOLDINGS, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)

	Twelve Months Ended December 31,
	2024			2023
Operating activities:
Net (loss) income	$	(16,449	)	$	660
Adjustments to reconcile net (loss) income to net cash used in operating activities:
Depreciation and amortization		4,224			3,174
Non-cash interest		522			386
Gain on sale of fixed assets		(264	)		(115	)
Stock-based compensation		4,117			2,739
Provision for reserve on accounts receivable		823			497
Provision for excess and obsolete inventory		485			357
Deferred income taxes		21			(1,901	)
Gain on bargain purchase		-			(11,694	)
Other		(26	)		16

Changes in operating assets and liabilities, net of effects of acquisitions:
Trade accounts receivable		(755	)		(8,736	)
Inventories		(2,494	)		(1,886	)
Prepaid and other assets		(218	)		220
Accounts payable		1,033			2,980
Accrued liabilities		(2,915	)		3,788
Net cash used in operating activities		(11,896	)		(9,515	)

Investing activities:
Purchases of property and equipment		(4,113	)		(1,456	)
Proceeds from sale of fixed assets		383			175
Acquisition of Surgalign SPV, Inc.		-			(17,000	)
Acquisition of Surgalign Holdings, Inc.'s hardware and biologics business, net of cash acquired		-			(4,503	)
Acquisition of nanOss Production Operations from RTI Surgical Inc.		-			(2,000	)
Net cash used in investing activities		(3,730	)		(24,784	)

Financing activities:
Borrowings on line of credit		112,640			78,219
Repayments on line of credit		(105,142	)		(76,976	)
Payments on financing leases		(65	)		(63	)
Proceeds from issuance of common stock, net of issuance costs		4,456			14,011
Proceeds from issuance of long term debt		5,000			5,000
Debt issuance costs		(651	)		(239	)
Payment of taxes from withholding of common stock on vesting of restricted stock units		(178	)		(261	)
Proceeds from exercise of stock-based compensation		13			-
Net cash provided by financing activities		16,073			19,691

Effect of exchange rate changes on cash and cash equivalents and restricted cash		(149	)		24

Net change in cash and cash equivalents and restricted cash		298			(14,584	)
Cash and cash equivalents and restricted cash at beginning of year		5,923			20,507
Cash and cash equivalents and restricted cash at end of year	$	6,221		$	5,923


Reconciliation of cash and cash equivalents and restricted cash reported in the consolidated balance sheets
Cash and cash equivalents		6,199			5,715
Restricted cash		22			208
Total cash and restricted cash reported in the consolidated balance sheets	$	6,221		$	5,923

XTANT MEDICAL HOLDINGS, INC.
CALCULATION OF NON-GAAP CONSOLIDATED EBITDA AND ADJUSTED EBITDA
(In thousands)

	Three Months Ended December 31,						Twelve Months Ended December 31,
	2024			2023			2024			2023

Net (Loss) Income	$	(3,165	)	$	(4,303	)	$	(16,449	)	$	660

Depreciation and amortization		1,148			1,017			4,224			3,174
Interest expense		1,134			802			4,160			2,789
Tax expense (benefit)		21			577			187			(1,697	)
Non-GAAP EBITDA		(862	)		(1,907	)		(7,878	)		4,926

Non-GAAP EBITDA/Total revenue		-2.7	%		-6.8	%		-6.7	%		5.4	%

NON-GAAP ADJUSTED EBITDA CALCULATION
Separation related expenses		192			-			682			-
Legal settlements		-			-			-			140
Non-cash compensation		840			938			4,117			2,739
Acquisition-related expense		-			929			338			2,255
Acquisition-related fair value adjustments (1)		167			276			415			541
Gain on bargain purchase		-			(666	)		-			(11,694	)
Unrealized foreign currency translation (gain) loss		101			(265	)		(5	)		(265	)
Non-GAAP Adjusted EBITDA	$	438		$	(695	)	$	(2,331	)	$	(1,358	)

Non-GAAP Adjusted EBITDA/Total revenue		1.5	%		-2.5	%		-2.0	%		-1.5	%

(1) Beginning in the fourth quarter of 2024, phasing of the bargain purchase gain on sell through of inventory acquired as part of the purchase of Surgalign Holdings' hardware and biologics business is no longer included in acquisition-related fair value adjustments in the non-GAAP adjusted EBITDA calculation and prior period calculations as presented herein have been recast to conform to the current presentation and calculation. The related effect on adjusted EBITDA was a reduction of $1.4 million for the fourth quarter of 2023, and a reduction of $2.3 million for the year ended December 31, 2023 to arrive at recast amounts.

SOURCE: Xtant Medical Holdings, Inc.

View the original press release on ACCESS Newswire

FAQ

What is Xtant Medical's revenue guidance for 2025?

Xtant Medical (XTNT) projects 2025 revenue between $126-130 million, representing organic growth of 7-11%.

How much did Xtant Medical's revenue grow in Q4 2024?

XTNT's Q4 2024 revenue grew 12% to $31.5 million compared to $28.1 million in Q4 2023.

What cost reduction measures has XTNT implemented?

Xtant reduced operating expenses by over $5 million annually since Q3 2024, mainly from integrating the Surgalign business.

What was Xtant Medical's gross margin in Q4 2024?

XTNT's gross margin was 50.8% in Q4 2024, down from 61.0% in Q4 2023.

When does XTNT expect to generate free cash flow?

The company expects to begin generating free cash flow in the second half of 2025.

Xtant Medical Reports Fourth Quarter and Full Year 2024 Financial Results

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What is Xtant Medical's revenue guidance for 2025?

How much did Xtant Medical's revenue grow in Q4 2024?

What cost reduction measures has XTNT implemented?

What was Xtant Medical's gross margin in Q4 2024?

When does XTNT expect to generate free cash flow?

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Xtant Medical Reports Fourth Quarter and Full Year 2024 Financial Results

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FAQ

What is Xtant Medical's revenue guidance for 2025?

How much did Xtant Medical's revenue grow in Q4 2024?

What cost reduction measures has XTNT implemented?

What was Xtant Medical's gross margin in Q4 2024?

When does XTNT expect to generate free cash flow?

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