Start here if you're new
what it is
Carlsmed sells custom spine surgery implants and planning software for surgeons.
how it gets paid
Last year Carlsmed made $51M in revenue.
why it's growing
Revenue grew 85.9% last year. Revenue rose 170% vs. prior year. The ugly part is simple: growth was fast.
what just happened
Carlsmed posted $35M in quarterly revenue, while EPS came in at -$2.15 and gross margin held at 74.8%.
At a glance
n/a balance sheet
1.1x trailing p/e — the market's not buying it — or you found a deal
$12.00 fy2025 eps est
$2B fy2026 rev est
60.5% operating margin
What they do
Carlsmed sells custom spine surgery implants and planning software for surgeons.
You are not buying a generic implant shop. The FDA cleared aprevo through 510(k), which means the agency let it sell without a full premarket trial, so it got to market faster. Carlsmed still turned that into $51M of annual revenue and 74.8% gross margin, so your money is backing a platform, not a box of screws.
How they make money
$51M
annual revenue · their business grew +85.9% last year
total revenue
$51M
+85.9%
The products that matter
personalized spine surgery platform
aprevo® Platform
$50.5M revenue · +85.9%
it drove revenue to $50.5M last year, up 85.9%, but the company still posted an estimated $46M operating loss. the demand story is real. the scale story still needs work.
core
cervical spine expansion
Cervical Fusion Launch
$4.6B market target
this launch pushes Carlsmed into a $4.6B cervical spine market and is a major piece of the $70–$75M 2026 revenue guide. if adoption lands, the addressable market gets a lot bigger fast.
2026 test
Key numbers
$51M
2025 revenue
This is the whole business in one number. It is tiny next to the $305M market cap, which means you are paying about 6x sales.
74.8%
gross margin
This is the proof that the product has pricing power. High margin is the only reason the loss story is not worse.
60.5%
operating margin
This is the bill. It shows the company spends far more than it keeps from each revenue dollar.
$17M
long-term debt
Debt is small at 5% of capital. That gives management room, but not enough to ignore the burn rate.
Financial health
n/a
strength
- balance sheet grade n/a
- long-term debt $17M (5% of capital)
n/a — functional but not a standout on the balance sheet.
Total return vs. market
Return history isn't available for CARL right now.
source: institutional data · return history unavailable
What just happened
missed estimates
Carlsmed posted $35M in quarterly revenue, while EPS came in at -$2.15 and gross margin held at 74.8%.
Revenue rose 170% vs. prior year. The ugly part is simple: growth was fast, but profitability was still deep in the red.
$35M
revenue
$2.15
eps
74.8%
gross margin
the number that mattered
The $35M revenue print mattered most, because it showed the platform can scale off a $51M annual base.
source: company earnings report, 2026
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What could go wrong
The #1 risk is surgeon adoption and reimbursement for personalized spine implants. If hospitals, surgeons, or payers move slowly, a company with $50.5M of revenue does not have much room for error.
med
surgeon adoption and reimbursement
The whole model depends on convincing surgeons to change workflow and getting paid for it. Miss that, and the $70–$75M 2026 guide starts looking aggressive fast.
impact: this risk sits on top of effectively the entire $50.5M revenue base and most of the planned growth.
med
cash burn before scale
An estimated $46M operating loss against $50.5M of revenue means growth is expensive. If losses stay near revenue for too long, future capital raises become part of the story whether shareholders like it or not.
impact: high-margin products can still produce poor shareholder outcomes if dilution funds the ramp.
med
cervical launch execution
The 2026 cervical fusion launch targets a $4.6B market. That is the upside. It is also a new execution burden for a company still proving out its first act.
impact: if the launch slips or adoption disappoints, growth could undershoot the 39–49% implied by guidance.
A business with 74.8% gross margin and an estimated $46M operating loss can look brilliant on the product level and fragile on the company level at the same time.
source: institutional data · regulatory filings · risk analysis
Pay attention to
growth
2026 revenue guide hold or miss
$70–$75M implies 39–49% growth. If the company starts walking that down early, the market will hear the message before management finishes the sentence.
calendar
Q1 2026 earnings
Expected around April 30, 2026. You want to see whether the post-Q4 momentum carried into the new year.
execution risk
cervical fusion launch
The $4.6B cervical market is the expansion story. Delays, limited surgeon uptake, or reimbursement friction would hit the bull case directly.
metric
gross margin vs. operating loss
74.8% gross margin is already strong. The next proof point is whether losses start shrinking relative to revenue instead of simply growing with it.
Analyst rankings
coverage depth
thin
There is not enough ranked analyst coverage on this page to lean on consensus. In human-speak, you are not getting the comfort blanket megacaps get.
estimate quality
limited
Small-cap medtech names often have sparse estimates and wider forecast error bands. That makes each quarterly print matter more.
source: institutional data
Institutional activity
institutional ownership data for CARL is being compiled.
source: institutional data
Price targets
3-5 year target range
n/a
n/a
$13
current price
n/a
target midpoint · n/a from current
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