Xtant Medical Holdings (AMEX:XTNT) shares fell about 4.7% in pre-market trading Tuesday after the company reported fourth-quarter results that topped expectations but issued 2026 revenue guidance well below Wall Street forecasts.
For the quarter, the medical technology firm posted adjusted earnings per share of $0.00, outperforming the analyst estimate of -$0.01. Revenue came in at $32.4 million, exceeding the consensus projection of $30.8 million.
Quarterly revenue increased 3% year-over-year from $31.5 million. However, the company said the earlier-than-expected completion of the Companion Spine transaction reduced fourth-quarter revenue by roughly $2.0 million. For the full year 2025, revenue reached $133.9 million, marking a 14% increase compared with the prior year.
Despite the stronger quarterly performance, Xtant’s outlook for 2026 disappointed investors. The company projected revenue between $95 million and $99 million, significantly below the analyst consensus estimate of $110.1 million. The midpoint of $97 million represents roughly a 12% shortfall versus expectations.
Management said the forecast reflects expected organic growth in its core biologics segment, offset by several structural changes to the business. These include the December 2025 divestiture of the non-core Coflex and CoFix product lines and international hardware operations to Companion Spine, as well as the expiration of license revenue from Q-Code and amniotic membrane agreements recognized in 2025.
“Our fourth quarter 2025 caps a truly transformational year for Xtant, during which we meaningfully sharpened our focus on our core biologics business while driving the new product innovation for which we are known,” said Sean Browne, President and CEO.
Profitability improved during the quarter, with gross margin rising to 54.9% from 50.8% a year earlier. Xtant reported net income of $0.1 million compared with a net loss of $3.2 million in the fourth quarter of 2024, while adjusted EBITDA increased to $1.9 million from $0.4 million in the prior-year period.