SI-BONE Reaffirms 2026 Revenue Guidance After Procedure Mix

The Tip Desk · November 10, 2026 · 3 min read

Worldwide revenue was $55.7 million in the third quarter, up 14.5%, as U.S. procedure volume rose about 19.5% and the company kept 2026 sales guidance at $231 million to $233 million.

SI-BONE, Inc. (SIBN), the developer of procedural solutions for compromised bone, reported worldwide revenue of $55.7 million for the quarter ended September 30, 2026, a 14.5% increase from $48.7 million a year earlier.

That year-over-year growth rate slowed from 15.2% in the second quarter. U.S. revenue was $52.8 million, up 13.9% from $46.4 million a year earlier.

The company said U.S. revenue growth benefited from approximately 19.5% growth in procedure volume, a faster pace than the 14.9% volume increase it cited in the second quarter. Average selling price was lower, the company said, due to procedure mix and growing interventional spine physician demand for the INTRA platform in office-based and ambulatory surgery center sites.

International revenue was $2.9 million, a 27.0% increase from $2.3 million a year earlier. The company attributed the increase to increasing adoption of iFuse TORQ and iFuse TORQ TNT.

Gross profit was $44.2 million. Gross margin was 79.3%, compared with 79.8% a year earlier; the company said the decline was driven by procedure and site-of-care mix.

Operating expenses were $48.5 million, up 9.7% from $44.2 million a year earlier. The company said the increase was primarily driven by higher sales commissions on increased revenue, marketing to support new product launches and continued investment in research and development. Operating loss improved 19.2% to $4.4 million from $5.4 million a year earlier.

Net loss was $3.6 million, or $0.08 a share, compared with a net loss of $4.6 million, or $0.11 a share, a year earlier. Adjusted EBITDA was $3.0 million, compared with $2.3 million a year earlier.

Cash from operations was $5.9 million. Cash and equivalents were $146.3 million as of September 30, 2026.

Active U.S. physicians were 1,770, which the company said represented growth of about 16% from a year earlier.

In September, SI-BONE received 510(k) clearance for iFuse Granite Onyx, an FDA breakthrough device targeting failures in spine fusion procedures, with an estimated total addressable market of about $1.5 billion annually. In October, new MS-DRGs took effect for complex spinal fusion procedures incorporating iFuse Bedrock Granite, increasing average hospital inpatient payments by up to about $50,000 per qualifying procedure.

Chief Executive Officer Laura Francis said the company entered the fourth quarter with a record number of active physicians, favorable DRG changes and early uptake in an alpha launch of iFuse Granite Onyx, which she said expands the company’s estimated total addressable market to approximately $5 billion.

SI-BONE reaffirmed its previously issued 2026 worldwide revenue guidance of $231 million to $233 million, or about 15% to 16% growth, and gross margin guidance of about 79.0%. Based on year-to-date operating expense trend, the company is reducing its operating expense growth expectation at the revenue midpoint to about 10.5% from about 12.0%. Adjusted EBITDA for the full year remains expected to be positive.