Carlsmed, Inc. · NASDAQ:CARL
Carlsmed — Piper Sandler 37th Annual Healthcare Conference (December 2025)
29 slides from Carlsmed's conference presentation, December 2025
Slide 1: Pioneering AI-Enabled Personalized Spine Surgery
PIONEERING AI-ENABLED PERSONALIZED SPINE SURGERY DECEMBER 2025
Slide 2: Forward Looking Statements
Forward Looking Statements Any statements in this presentation about future expectations, plans and prospects, including statements about Carlsmed’s abi lity to advance its personalized spine surgery platform to transform patient outcomes and drive long -term growth, Carlsmed’s estimates regarding t
Slide 3: Non-GAAP Financial Measures
Non-GAAP Financial Measures This presentation contains certain financial information that is not presented in conformity with U.S. generally accepted acc ounting principles (“GAAP”), including Adjusted EBITDA. The non-GAAP financial measures are provided as supplemental information to Carlsmed’s fin
Slide 4: Pioneering AI-Enabled Personalized Surgery
Pioneering AI-Enabled Personalized Surgery To improve $19B+ U.S. lumbar our market our mission our technology outcomes and and cervical spine lower the cost of fusion market 1 healthcare for spine surgery and beyond 1. Based on an es timat ed 445,200 lumbar fusion surgeries and an estimated 373,000
Slide 5: Q3 2025 Financial Highlights
Q3 2025 Financial Highlights QTRLY REVENUE ($MILLIONS) 1 13.1 10.2 12.1 $13.1M 75.9% 9.4 Q3 '25 REVENUE 1 Q3 '25 GROSS MARGIN 1 6.6 6.1 5.1 2.1 3.5 3.8 4.3 ($8.2M) $142.4M Q3 '25 ADJUSTED EBITDA 2 CASH & ACCESS TO CASH 1,3 1. Presented q uarterly revenue is unaudited. Full year 2023 and 2024 revenue
Slide 6: FY'25 Revenue Guidance
$49M – $50M FY’25 Revenue Guidance 80% – 84% YoY Growth 1 1. Based on revenue repo rted in 2024 audited financial st at ements. © 2025 ALL RIGHTS RESERVED | 6
Slide 7: Experienced Executive Leadership Team
Experienced Executive Leadership Team Mike Cordonnier Leo Greenstein Jennifer Kamocsay Scott Durall Sharon Schulzki Chief Executive Officer Chief Financial Officer Chief Legal Officer Chief Commercial Officer Chief Clinical & Market Access Officer Shariq Hussain Niall Casey Jeff Bertolini Jodi Allen
Slide 8: The Technology Platform
The Technology Platform END-TO-END INTEGRATED DIGITAL TECHNOLOGY PLATFORM 1 2 3 PRE-OP INTRA-OP POST-OP AI-ENABLED 3D PLANNING CUSTOM-MADE ANATOMICALLY POST-OPERATIVE DATA & VISUALIZATION SOFTWARE DESIGNED DEVICES INSIGHTS & ANALYSIS © 2025 ALL RIGHTS RESERVED | 8
Slide 9: Large Addressable Procedure Volume
Large Addressable Procedure Volume Lumbar Cervical ~445,000 lumbar spine ~373,000 cervical fusion procedures in the fusion procedures in the 800,000+ U.S. in 2025. U.S. spine fusion U.S. in 2025. procedures ~$13B Total Addressable annually ~$6B Total Addressable Market. Market. 1. U.S. data from Sma
Slide 10: Degenerative Disc Disease Pathology
Degenerative Disc Disease Pathology DDD TAKES PLACE IN THE DISC SPACE Degenerative Disc Disease (DDD) is Healthy Disc Degeneration the progressive breakdown of spinal discs that are interposed between Well-hydrated, proper disc Loss of hydration and disc height, vertebrae to provide mobility and hei
Slide 11: Vertebral Endplate Degeneration
Vertebral Endplate Degeneration DISC DEGENERATION CAN DAMAGE VERTEBRAL ENDPLATES AND LEAD TO ADULT SPINAL DEFORMITY Healthy Endplate Degenerated Endplate Adult Spinal Deformity (ASD) is a severe form of DDD involving structural abnormalities or curvature across multiple spine levels. It leads to dis
Slide 12: Delivers Personalized Correction in the Disc Space
Delivers Personalized Correction in the Disc Space Traditional Spine Fusion • Spinal fusion is a surgery that connects two or more vertebrae in the spine to improve stability and reduce pain. • The diseased disc is removed and an interbody fusion device is placed in the disc space. © 2025 ALL RIGHTS
Slide 13: Pre-Op: Review Pathology Plan
1 PRE-OP Review Pathology Plan Approve Track Case Personalized Device Plan or Provide Digital Details Correction Designs Changes Production APPLICATION PROVIDES INTERACTIVE 3D VISUALIZATIONS © 2025 ALL RIGHTS RESERVED | 13
Slide 14: Personalized Devices Purposefully Designed
2 INTRA-OP LATERAL Personalized Devices Purposefully Designed • After the myaprevo® plan is approved by TRANSFORMINAL - OBLIQUE the surgeon, aprevo® devices are 3D printed, sterile packed, and, as of October 2025, delivered to the OR within 8 business TRANSFORMINAL - CURVED days. • The aprevo® devic
Slide 15: Data Insights Patient Analysis
3 POST-OP Data Insights Patient Analysis • Each patient’s imaging is analyzed to generate a detailed aprevo® intelligence case report. • The aprevo® intelligence report compares pre-op, planned, and post-op alignment, giving surgeons detailed analytics to evaluate surgical outcomes against surgical
Slide 16: Statistically Significant Reduction in Revision Rates with aprevo
Statistically Significant Reduction in Revision Rates with stock 1-year revision rate resulting from mechanical 2-year revision rate resulting from mechanical REVISION RATE complications in ASD complications in ASD WITH STOCK patients1 patients3 DEVICES 1-year revision rate for 2-year revision rate
Slide 17: Launch December 2025
Launch December 2025 © 2025 ALL RIGHTS RESERVED | 17
Slide 18: Clinical Challenges with Traditional ACDF Procedures
Clinical Challenges with Traditional ACDF Procedures aprevo® Cervical has the potential to transform clinical outcomes by addressing the Patients have poor Experience unpredictable Require revision after root causes of failure and bone quality alignment outcomes long-construct fusions greatest areas
Slide 19: aprevo Cervical Personalized Devices
aprevo® Cervical Personalized Devices 3D Correction is Built Into Each aprevo® Personalized Interbody Device ACDF and ACDF Interfixated • Lordosis from 0˚ to 30˚ • Coronal angulation up to 5˚ • ML width up to 30mm A Precision Fit Designed to Optimize Surgical Outcomes Utilizing patient data and adva
Slide 20: End-to-End Integrated Platform
An End-to-End Integrated Platform Designed for Better Surgical Results, Reduced Revisions and Improved Long-Term Outcomes PRE-OP INTRA-OP POST-OP 3D planning and visualization software provides 3D correction is built into each aprevo® Interbody Personalized digital insights are translated into actio
Slide 21: aprevo Cervical vs. Stock Devices
aprevo® Cervical vs. Stock Devices Stock Device Endplate-matching implant geometry is designed to optimize load distribution1 and preserve bone to mitigate subsidence risk, maintain segmental alignment, and enhance fusion. 1. Carlsmed Data o n File © 2025 ALL RIGHTS RESERVED | 21
Slide 22: aprevo Cervical Clinical Data
aprevo® Cervical Clinical Data Initial data demonstrates Predictable 3D Intervertebral Alignment of personalized aprevo® of personalized aprevo® interbody levels achieved interbody levels achieved targeted sagittal alignment targeted coronal alignment within 3°.1 within 3°.1 1. Wang, et al. Pro c In
Slide 23: Q3 2025 Company Highlights
Q3 2025 Company Highlights OPERATIONAL COMMERCIAL PATIENT-CENTRIC CLINICAL EXCELLENCE EXECUTION INNOVATION OUTCOME DATA Reduced lead New surgeon Made great 2-year data time for our enthusiasm progress with our presented at aprevo® outpaced plan, cervical clinical Scoliosis Research interbody with 72
Slide 24: CEO Quote on Commercial Performance
“ Our strong commercial performance was driven by the continued adoption of our highly differentiated AI-enabled aprevo® technology platform and growing recognition of its ability to deliver more favorable patient outcomes than legacy devices. Mike Cordonnier, Chairman and CEO © 2025 ALL RIGHTS RESE
Slide 25: Appendix
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Slide 26: Established and Distinct Hospital Reimbursement with new MS-DRGs
Established and Distinct Hospital Reimbursement with new MS-DRGs The majority of aprevo® lumbar cases map to the below MS-DRGs National Average MS-DRG MS-DRG Description MS-DRG Payment* Incremental reimbursement to hospitals for the aprevo® procedure mapping to Multiple level combined anterior and p
Slide 27: NTAP reimbursement is incremental to MS-DRG payment
NTAP reimbursement is incremental to MS-DRG payment All aprevo® cervical cases map to the below MS-DRGs National Average MS-DRG MS-DRG Description MS-DRG Payment* Up to $21,125 incremental CMS reimbursement to Combined Anterior and Posterior 429 Cervical Spinal Fusion with MCC $65,561 hospitals for
Slide 28: Reconciliation Of GAAP Net Loss To Adjusted EBITDA
Reconciliation Of GAAP Net Loss To Adjusted EBITDA (UNAUDITED) 1. Exhibit 99.1 © 2025 ALL RIGHTS RESERVED | 28
Slide 29: MKT-132 Rev 1, 12/2025
MKT-132 Rev 1, 12/2025
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