Carlsmed Raises 2026 Revenue Outlook After Faster Growth

The Tip Desk · November 12, 2026 · 2 min read

Third-quarter revenue reached $21.6 million, up 65% from a year earlier, and the company lifted full-year 2026 guidance to $78 million to $80 million.

Carlsmed, Inc. (CARL), a medical technology company focused on AI-enabled personalized spine surgery, reported third-quarter 2026 revenue of $21.6 million, up 65% from $13.1 million a year earlier, after year-over-year growth slowed to 57% in the second quarter.

The sequential step-up from $18.9 million in the second quarter marked the third consecutive quarter of year-over-year expansion. Chairman and CEO Mike Cordonnier said the period represented strong execution against the company’s long-term strategy and that the surgeon user base grew by more than 60% over the prior year, matching the trained-surgeon growth cited in the second quarter.

Gross profit was $16.7 million, compared with $9.9 million a year earlier. Gross margin was 77.3%, after expanding 340 basis points year-over-year in the second quarter.

Operating expenses were $29.4 million, including $2.8 million of executive transition costs and expected resolution of certain legal matters. Sales and marketing expenses were $13.0 million. Research and development expenses were $6.4 million. General and administrative expenses were $10.0 million, after $7.6 million in the second quarter.

Net loss was $12.2 million, or $0.45 a share, compared with $8.5 million, or $0.40 a share, a year earlier. Adjusted EBITDA was a $7.3 million loss, improving from an $8.2 million loss a year earlier. The reconciliation added back $2.4 million of stock-based compensation, $2.4 million of executive transition costs and $0.5 million of legal settlements.

Cash and cash equivalents, restricted cash, short-term investments, and marketable securities were $80.3 million as of September 30, 2026, down from $89.3 million as of June 30.

The company raised full-year 2026 revenue guidance to $78 million to $80 million, representing growth of over 56% at the midpoint versus 2025, from prior guidance of $74 million to $78 million.

After quarter-end, the CMS Inpatient Prospective Payment System rule for fiscal year 2027 became effective October 1, 2026, with increased reimbursement for inpatient aprevo lumbar procedures. Carlsmed also launched aprevo Lumbar Bi-lateral Posterior System in October, which it estimates addresses approximately 30,000 U.S. lumbar fusion procedures annually.

Leadership changes included the promotion of Jeff Bertolini to chief operating officer, the appointment of Rich Heppenstall as chief financial officer, and the addition of Tony Jarc, Ph.D., as chief product and AI officer. Cordonnier said those moves, together with the reimbursement change and the capital-light model, reinforced the company’s foundation for sustainable, profitable long-term growth as it heads into 2027.