SIBN

SI-BONE is executing a textbook med-device growth playbook: FY2025 revenue grew 20.2% to $201M, with gross margin at a software-like 79.6% and the loss narrowing for the fourth straight year (-$56.6M → -$18.9M from FY2021 to FY2025). The MD&A confirms the commercial flywheel is real — 140,000+ procedures performed since 2009, U.S. sales force expanded to 89 TSMs / 83 CSSs / 320 third-party agents (up from 87/71/252), and three FDA-designated breakthrough device platforms now extend the franchise from SI-joint fusion into thoracolumbar fixation and pelvic trauma. ASC/OBL mix above 33% is a positive site-of-service tailwind that should aid utilization without proportionate sales-force cost.

The balance sheet supports the runway: $42.2M cash, $35.6M long-term debt, $178M equity, current ratio of ~8.5x ($216M / $25.3M), and operating cash flow essentially at breakeven (-$675K, up 94.6% YoY). That meaningfully de-risks the bear case of a dilutive raise — at the current burn, SI-BONE can self-fund the path to profitability without tapping equity holders, who already absorbed 4.0% YoY dilution and sit on $450M in accumulated deficit. Operating margin improved to -11.1% from a deeper hole, and R&D at 9% of revenue (vs. >19% several years ago) shows real operating leverage as the top line scales.