Alphatec Holdings, Inc. · NASDAQ:ATEC
Alphatec — Q4 2025 Earnings Presentation
35 slides from Alphatec's earnings presentation, Feb 24, 2026
Slide 1: Q4 2025 Financial Results
Q4 2025 FINANCIAL RESULTS PAT MILES, CHAIRMAN & CEO | KONING TODD , EVP & CFO | FEBRUARY 24, 2026
Slide 2: Forward-Looking Statements
FORWARD-LOOKING STATEMENTS This presentation contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainty. Such statements are based on management's current expectations and are subject to a number of risks and un
Slide 3: ATEC Is Uniquely Positioned
ATEC IS 100% SPINE FOCUS UNIQUELY COMPELLING SURGEON ADOPTION THROUGH CLINICAL DISTINCT POSITIONED LEADING & ADVANCING LATERAL ® VALENCE EARNING SHARE, DRIVING ADOPTION WITH DEFORMITY LEADERSHIP & EOS ®INSIG PROCEDURAL GROWTH ENGINE, POISED FOR -LIKE A PTP RUN INFRASTRUCTURE BUILT FOR LONG R FOUNDAT
Slide 4: Q4 2025 Highlights: Profitable Growth
PROFITABLE GROWTH 20% Total revenue 21% Surgical revenue 20% Revenue growth in growth growth established territories Q4 2025 HIGHLIGHTS 23% $33M +$8M $213M Net new surgeon users Adjusted EBITDA Free Cash Flow Total Revenue 4 | Reference non-GAAP reconciliation in appendix
Slide 5: 2025 Full Year Highlights
2025 FULL YEAR HIGHLIGHTS PROFITABLE, REVENUE -GROWTH LEADERSHIP TOTAL REVENUE GROWTH LEADERSHIP KEY PROCEDURAL ADVANCEMENTS $764M 25% $153M of YoY growth Total revenue growth BONE MINERAL DENSITY ADJUSTED EBITDA FREE CASH FLOW $93M 12% of revenue +$3M Improving $131M YoY 5 | Reference non-GAAP reco
Slide 6: Q4 Revenue Performance
Q4 REVENUE PERFORMANCE GROWTH DRIVEN BY SURGICAL VOLUME Q4 2025 YOY$ YOY% $33M Surgical Revenue YoY $ Growth Surgical Revenue $190M $33M 21% EOS Revenue $23M $3M 14% • 21% surgical volume growth TOTAL REVENUE $213M $36M 20% • Revenue per case flat year over year • U.S. surgical revenue per case up 1
Slide 7: Sustainable Topline Growth
SUSTAINABLE TOPLINE GROWTH 3Q AND 4Q 2025 SURGEON USER GROWTH THE HIGHEST IN THE EARS LAST TWO Y 26% 23% 21% 20% 21% 19% 20% 19% Q1 24 Q2 24 Q3 24 Q4 24 Q1 25 Q2 25 Q3 25 Q4 25 SURGEON USERS SURGEON GROWTH % 7
Slide 8: Sustainable Topline Growth
SUSTAINABLE TOPLINE GROWTH STRONG MOMENTUM AND EVOLVING SEASONALITY In $ millions Surgical Revenue Surgical $ Growth YoY $200 $45 $180 $40 $160 $35 $140 $30 $120 $25 $100 $20 $80 $15 $60 $40 $10 $20 $5 $0 $0 1Q24 2Q24 3Q24 4Q24 1Q25 2Q25 3Q25 4Q25 1Q23 2Q23 3Q23 4Q23 1Q24 2Q24 3Q24 4Q24 1Q25 2Q25 3Q
Slide 9: Q4 2025 Non-GAAP P&L Highlights
Q4 2025 NON-GAAP P&L HIGHLIGHTS DISCIPLINED EXECUTION DRIVING PROFITABILITY AEBITDA $M AEBITDA % $35 35% Q4 2025 YOY $30 30% $25 25% TOTAL REVENUE $213M 20% $20 20% Gross Margin % 70.5% +80 bps $15 15% R&D % 6.5% (110 bps) $10 10% $5 5% SG&A % 55.5% (410 bps) $0 0% Total Operating Expense % 62.0% (5
Slide 10: FY 2025 Financial Overview
FY 2025 FINANCIAL OVERVIEW PROFITABLE, FULL YEAR GROWTH FY 2025 YOY Surgical Revenue EOS Revenue $687M $77M 26% 15% 22% 3% Surgical volume Avg revenue / case TOTAL REVENUE $764M 25% growth growth Gross Margin % 70.2% 0 bps R&D % 7.4% (140 bps) SG&A % 58.7% (790 bps) Total Operating Expense % 66.2% (
Slide 11: Balance Sheet
BALANCE SHEET CASH GENERATION REINFORCING FINANCIAL STRENGTH BALANCE SHEET Q4 2025 Q4 2025 FY 2025 Cash $161M Operating Cash Flow $21M $45M Available Borrowing1 $60M PP&E Investments ($13M) ($42M) CASH + AVAILABLE CASH $221M FREE CASH FLOW2 $8M $3M Full year 2025 free cash flow improved by $131M 11
Slide 12: 2026 Revenue Outlook
2026 REVENUE OUTLOOK ADOPTION OF OUR UNIQUE PROCEDURAL APPROACH FUELS DURABLE GROWTH REVENUE $890M Total Revenue Surgical Revenue FY’26E $805M YOY 17% mid -teens % Surgical volume growth EOS Revenue $85M 10% lsd% Avg revenue / case growth TOTAL REVENUE $890M 17% Topline growing $126M YoY, including
Slide 13: Compelling Surgeon Adoption
COMPELLING SURGEON ADOPTION DURABLE FUTURE GROWTH DRIVEN BY SURGEON UTILIZATION ALGORITHM SURGEON USERS SURGEON UTILIZATION 1,800 1,600 AVG CASES/ SURGEON 1,400 1,200 1,000 800 600 400 200 0 2018 2019 2020 2021 2022 2023 2024 2025 2018 2019 2020 2021 2022 2023 2024 2025 Steady new surgeon adoption |
Slide 14: P&L Outlook for 2026
P&L OUTLOOK FOR 2026 PROFITABLE, FULL YEAR GROWTH Global Revenue FY 2026 YOY $1,000 Surgical Revenue $805M 17% $500 EOS Revenue $85M 10% $0 TOTAL REVENUE $890M 17% 2025 2026 Gross Margin % 70.5% 30 bps YoY Growth: 17% R&D % 6.5% (90 bps) SG&A % 56.0% (270 bps) Adj EBITDA $150 Total Operating Expense
Slide 15: 2026 AEBITDA & Cash Flow
2026 AEBITDA & CASH FLOW DRIVING POWERFUL LEVERAGE BY DESIGN AEBITDA $M AEBITDA % FY 2026 $150 45% ADJUSTED EBITDA $134M $130 Cash Interest Expense ($23) 35% $110 $90 $134M Adjusted EBITDA 25% Non-cash E&O Other Working Capital +$15 ($18) $70 margin of 15% CASH FLOW AVAILABLE $110M $50 15% $30 Inven
Slide 16: Our Strategy Is Steadfast, Our Execution Is Relentless
OUR STRATEGY IS STEADFAST OUR EXECUTION IS RELENTLESS EXECUTING WITH PRECISION AND MOMENTUM —FULFILLING COMMITMENTS 1 2 3 CREATE CLINICAL COMPEL SURGEON EXPAND, ELEVATE & DISTINCTION ADOPTION ENABLE SALES FORCE Architect unparalleled Earn loyalty through Build a high-performing, procedural solutions
Slide 17: Unrivaled Leadership in Lateral
UNRIVALED LEADERSHIP IN LATERAL THE INDUSTRY’S MOST COMPREHENSIVE LATERAL PLATFORM ADVANCING INTO HIGHER COMPLEXITY ® CLINICAL DISTINCTION WITH SAFEOP A procedural investment approach and Our competitive moat in lateral— expanding indications of PTP and LTP Automated proprietary neuromonitoring enab
Slide 18: Valence Extends Our Lateral Advantage
VALENCE EXTENDS OUR LATERAL ADVANTAGE ARCHITECTED EXCLUSIVELY FOR SPINE —PTP CATALYST PROCEDURALLY INTEGRATED Committed to ATEC's proceduralized approach to spine surgery, Valence® serves as the intraoperative centerpiece of our expanding InformatiX portfolio, connecting advanced technologies to cre
Slide 19: Vast Untapped Opportunity in U.S.
VAST UNTAPPED OPPORTUNITY IN U.S. SIGNIFICANTLY UNDERPENETRATED ACROSS KEY SEGMENTS WITH ENORMOUS UPSIDE ~$10B U.S. SPINE MARKET $2B U.S. TLIF & PLIF conventional techniques that can be treated with PTP FASTEST- GROWING SEGMENTS LATERAL & DEFORMITY $1B U.S. LATERAL MARKET ~20% SHARE 19 | Management
Slide 20: Lateral Confidence Earns Surgeon Trust
LATERAL CONFIDENCE CREATION LATERAL DISTINCTION AND UNIQUE APPROACH TO EARNS SURGEON TRUST… PROCEDURAL SOLUTIONS POSITIONERS SURGEON USERS 1,800 1,600 1,400 LATERAL 1,200 BIOLOGICS INFORMATIX 1,000 800 600 400 200 0 CUSTOM RODS 2018 2019 2020 2021 2022 2023 2024 2025 ACCESS NAVIGATION SURGEON UTILIZ
Slide 21: Accelerating Deformity Influence Through EOS Integration
ACCELERATING DEFORMITY INFLUENCE THROUGH EOS INTEGRATION END-TO-END ECOSYSTEM POSITIONS ATEC TO BECOME THE PROCEDURAL DER IN LEA DEFORMITY 21
Slide 22: Advancing Pediatric Deformity
ADVANCING PEDIATRIC DEFORMITY ELEMENTS OF FULL DEFORMITY SOLUTION ARE CONVERGING TO ENABLE THER PTP ANO-LIKE RUN MOST - COVETED IMAGING AUTOMATED ALIGNMENT 3D SURGICAL PLANNING WITH AXIAL ROTATIO PEDIATRIC POSITIONING CURVE CORRECTION MEASURED BEST-IN-CLASS FIXATION NEUROMONITORING USING INTRAOP ALI
Slide 23: Advancing Patient-Specific Spine Care via Actionable Informatics
ADVANCING PATIENT-SPECIFIC SPINE CARE VIA ACTIONABLE INFORMATICS BONE MINERAL X DENSITY CUSTOM ROD 23
Slide 24: Proprietary Data-Driven Procedural Ecosystem
ADVANCING SPINE THROUGH PROPRIETARY DATA-DRIVEN PROCEDURAL ECOSYSTEM INTRA-OP Navigated/Robot Real-time Assisted HW Neurophysiology Intra-Op Patient Specific Placement Monitoring Alignment Implants Reconciliation PLAN RECONCILIATION 3D Surgical Planning & AUTOMATED NERVE MONITORING Consistent P Simu
Slide 25: Exclusive BMP2 Distribution Partnership with Theradaptive
EXCLUSIVE BMP2 DISTRIBUTION PARTNERSHIP WITH THERADAPTIVE $2.5B TOTAL ADDRESSAB LE SPINE MARKET ~$700M EST. ANNUAL SALES OF COMPETITIVE BMP2 SOLUTION 1 Exclusive Distribution Agreement forOsteoAdapt® THE MOST ADVANCED BMP2 BONE GRAFT IN EXISTENCE. • Easy to use, familiar handling—enables precise del
Slide 26: Foundational Infrastructure Built—Well-Positioned for Profitable Growth
FOUNDATIONAL INFRASTRUCTURE BUILT— WELL-POSITIONED FOR PROFITABLE GROWTH DISCIPLINED EXECUTION IS UNLOCKING SCALE, DRIVING THE NEXT OF GROWTH PHASE $200 • Lever infrastructure investments • Integrate data and informatic platform into surgical experience • Expand and evolve procedural approaches $150
Slide 27: 2026 Financial Outlook
2026 FINANCIAL OUTLOOK GROWTH LEADERSHIP POWERFUL LEVERAGE FREE CASH FLOW $890M Total revenue; $134M Adjusted EBITDA; $20M Investing in growth and 17% growth 15% margin generating cash COMMITTED TO CONTINUING INDUSTRY -LEADING PROFITABLE GROWTH OVATION & INN 27 | Reference non-GAAP reconciliation in
Slide 28: ATEC Is Uniquely Positioned
ATEC IS 100% SPINE FOCUS UNIQUELY COMPELLING SURGEON ADOPTION THROUGH CLINICAL DISTINCT POSITIONED LEADING & ADVANCING LATERAL EARNING SHARE, DRIVING ADOPTION WITH VALENCE® DEFORMITY LEADERSHIP & EOS ®INSIG PROCEDURAL GROWTH ENGINE, POISED FOR -LIKE A PTP RUN INFRASTRUCTURE BUILT FOR LONG R FOUNDATI
Slide 29: The Preferred Destination in Spine.
THE PREFERRED DESTINATION IN SPINE. 29
Slide 30: Appendix
APPENDIX 30
Slide 31: Supplemental Financial Information: Historical GAAP P&L
SUPPLEMENTAL FINANCIAL INFORMATION HISTORICAL GAAP P&L TREND - CONSOLIDATED ($000's) Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Revenue from products and services $ 109,110 $ 116,920 $ 118,262 $ 137,970 $ 482,262 $ 138,477 $ 145,573 $ 150,719 $ 176,793 $ 611,562 $ 169
Slide 32: Supplemental Financial Information: Non-GAAP Reconciliation
SUPPLEMENTAL FINANCIAL INFORMATION NON-GAAP RECONCILIATION - CONSOLIDATED ($000's) NON-GAAP GROSS PROFIT & GROSS MARGIN Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Gross Profit, GAAP $ 70,425 $ 64,541 $ 80,047 $ 95,190 $ 310,203 $ 97,351 $ 102,594 $ 102,729 $ 121,588 $
Slide 33: Supplemental Financial Information: Adjusted EBITDA Reconciliation
SUPPLEMENTAL FINANCIAL INFORMATION NON-GAAP RECONCILIATION - CONSOLIDATED ($000's) ADJUSTED EBITDA Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Net loss, GAAP $ (43,529) $ (51,377) $ (42,654) $ (49,078) $ (186,638) $ (48,495) $ (40,680) $ (39,616) $ (33,332) $ (162,123)
Slide 34: Supplemental Financial Information: Non-GAAP P&L Trend
SUPPLEMENTAL FINANCIAL INFORMATION NON-GAAP P&L TREND - CONSOLIDATED ($000's) Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Revenue from products and services $ 109,110 $ 116,920 $ 118,262 $ 137,970 $ 482,262 $ 138,477 $ 145,573 $ 150,719 $ 176,793 $ 611,562 $ 169,180 $
Slide 35: Supplemental Financial Information
SUPPLEMENTAL FINANCIAL INFORMATION 35 | Access this file at https://investors.alphatecspine.com/financials/financial-results/default.aspx