SI-BONE, Inc. (SI-BONE) (Nasdaq: SIBN) closed 2025 with record financial performance, delivering $200.9 million in worldwide revenue more than 20% year-over-year growth. The strong top line growth translated into positive adjusted EBITDA* for full year 2025 and free cash flow in the fourth quarter of 2025. SI-BONE’s ability to deliver revenue at a cumulative average growth rate of 20% since IPO underscores the strength, scalability, and discipline of their business model.
A record 1,640 U.S. physicians performed SI-BONE procedures in Q4 alone, an 18% increase over the prior year period and the company’s 20th consecutive quarter of double-digit physician adoption growth. Further underscoring the growth trajectory, more than 2,400 U.S. physicians performed nearly 22,000 procedures using SI-BONE technologies in 2025. The company has now supported over 140,000 total procedures worldwide since its founding in 2009.
Key Growth Initiatives Continue to Advance in 2026
A Growing Portfolio
SI-BONE continues to expand its portfolio of innovative and differentiated platform technologies. In February, the company received FDA 510(k) clearance for the iFuse INTRA Ti™ implant, its newest a 3D-printed titanium solution designed for intra-articular placement in the SI joint to deliver biomechanical stability and promote fusion for durable, long-term outcomes. Additionally, management is targeting the commercialization of its third breakthrough device technology later in 2026 — an important milestone that will meaningfully expand SI-BONE’s total addressable market as it targets what they believe to be the largest unmet need within their established spine call point.
Expanding Commercial Footprint: Smith+NephewDistributionPartnership
Powering access, SI-BONE entered into a strategic distribution agreement with Smith+Nephew (LSE: SN, NYSE: SNN), one of the largest global medtech companies. Under the arrangement, Smith+Nephew will distribute SI-BONE’s iFuse TORQ® and iFuse TORQ TNT® implants across Level 1 and Level 2 trauma centers nationwide, with rollout beginning in March and expected to ramp throughout 2026.
The device at the center of that engagement, iFuse TORQ TNT, carries FDA Breakthrough Device Designation for pelvic fracture fixation and is eligible for a Medicare New Technology Add-on Payment (NTAP) of up to $4,136 of incremental reimbursement per hospital inpatient procedure. It was engineered for osseointegration with the potential to provide more effective fixation of pelvic fractures than the current standard of care, cannulated screws.
Strong Reimbursement Environment
SI-BONE enters 2026 with a highly favorable reimbursement backdrop. Effective January 1, 2026, Medicare reimbursement for SI joint fusion performed in non-facility settings (e.g., Office-Based Labs or OBLs) increased by 17%, bringing the unadjusted Medicare non-
facility payment rate to nearly $14,000 per procedure. This is particularly meaningful as SI-BONE now offers its iFuse INTRA X SI joint fusion system, which is well suited for the OBL setting.
Further, two recent CMS policy decisions improve the reimbursement environment for SI-BONE’s portfolio. The iFuse Bedrock Granite® system has been granted Transitional Pass-Through (TPT) payment status, allowing hospital outpatient departments and
ambulatory surgical centers to receive additional reimbursement that offsets device cost. In parallel, CMS approved inclusion of the open SI joint fusion procedure (CPT 27280) within the same outpatient reimbursement framework and TPT eligibility. Together, these changes reduce the financial burden on providers and support more predictable economics for outpatient SI joint fusion procedures.
A Favorable Outlook
Looking ahead, SI-BONE is entering a period of heightened momentum. New product introductions, an expanding IP portfolio focused on patients with compromised bone, and strategic partnerships underscore the company’s long-term strategy. At the same time, a more favorable reimbursement landscape is improving procedural economics.
After years of building a strong clinical and economic foundation for SI joint fusion, the company now stands at an inflection point — shifting from category validation to broader execution and scale, with multiple strategic tailwinds aligning in its favor.
As CEO Laura Francis stated, “Our 2025 results reflect the strength of our strategy and execution, and I am confident in the momentum we are carrying into 2026. We are positioned to deliver strong revenue growth and increased profitability and cash flow as we expand our platform, remain disciplined in how we operate and invest, and welcome an
exciting pipeline of new product launches ahead in the U.S. and abroad.”
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*Adjusted EBITDA and Free Cash Flow are non-GAAP financial measures. For more on this please refer to SI-BONE’s recently filed 8K and earnings press release. Non-GAAP measures should be considered supplemental to, and not a substitute for financial information prepared in accordance with GAAP.
PM-12548-US-A (April 2026)
