SI-BONE: Q1 Sales +25%, Loses $7.5 million

SI-BONE, Inc. reported a strong 25% sales increase year-over-year (YOY) to $47.3 million and lost $7.5 million, which is down from the $12 million SI-BONE lost in the same quarter a year ago. Overall, SI-BONE beat Wall Street’s expectations.

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Turning a Profit on a $194 Million Run Rate Is Hard

Company CEO Laura Francis and CFO Anshul Maheshwari gave analysts an update on first quarter 2025 revenue in a recent earnings call.

Francis reported that their worldwide revenue for the quarter was $47.3 million, which represented almost 25% growth. U.S revenue was $44.8 million. For the full year, Wall Street expects that SI-BONE will report approximately $194 million in sales.

“We’re experiencing broad-based demand for our existing technologies and rapid adoption of our new solutions launched last year. With an active pipeline of novel technologies under development, we believe our procedure volume growth will be amplified as we launch these new solutions over the next 12 to 18 months,” she explained.

“Our innovative platform is driving deeper engagement and market penetration as we add physicians at a record pace. Additionally, a growing number of physicians are performing multiple types of procedures, driving end user density. These are both positive leading indicators for demand.”

Maheshwari touched on the potential impact of tariffs, saying “All our implants and virtually all our instruments are manufactured domestically. The majority of the raw materials for our instruments is sourced from the U.S. And the titanium powder used in our implants is sourced from Canada under the 2020 USMCA Agreement with supply already secured through 2026. As such, we currently do not anticipate any material impact on gross margins or our supply chain from the proposed tariffs.”

He added that the current economic uncertainty hasn’t impacted procedure volumes at this time either.

“It is important to note that given the debilitating pain and physical disability experienced by our patients, our procedures are less likely to be deferred. We have a track record of sustained growth even through periods of extreme stress as demonstrated during COVID.”

SI-BONE is updating the full year revenue guidance to range between $193.5 million to $197.5 million, with year-over-year growth of approximately 16% to 18% compared to the previous guidance of approximately 16% to 17%.

“The $2 million increase at the upper end of the guidance incorporates the strong first quarter results and our conviction in the demand for our solutions,” Maheshwari said.

Analysts Wonder If This Growth Is Sustainable

Dave Turkaly of Citizens asked whether the company thought a 20% growth could be something to push for, considering the strong start to the year.

Francis said, “So, you’re right, we had a very strong start to the year and showed particularly strong execution during what’s typically a seasonally lighter quarter. So, it’s really laying the foundation for the rest of the year. With revenue growth and procedure volume growing 27%, you can see that we’re benefiting from demand and accelerating adoption of our products, especially those that were launched in 2024.”

She said that this does highlight the long-term leverage potential they have.

Maheshwari added, “Obviously, I’m not going to be providing long-term guidance at this point. But we’re really confident about the growth potential of the business, not just in 2025, but even beyond that.”

Young Li with Jeffries asked for more information on the addition of new surgeons.

Francis responded saying that SI-BONE added about 300 physicians in the first quarter and that this was the largest year-over-year increase ever.

She added, “The increase wasn’t concentrated in any particular call point. It was really broad-based, and we had a record number of users across ortho, neuro spine, trauma as well as interventional.”

In addition, more surgeons are doing more procedure types with the company, she added. They had an almost 45% increase in the number of physicians performing multiple procedure types. Francis said that they expect that number to continue to grow.