Xtant Medical Holdings, Inc. (XTNT) 10-Year Financial Performance & Capital Metrics

XTNT • • Industrial / General

HealthcareMedical DevicesOrthopedic & Musculoskeletal DevicesSpinal Implants & Fusion Systems

AboutXtant Medical Holdings, Inc. develops, manufactures, and markets regenerative medicine products and medical devices for orthopedic and neurological surgeons in the United States and internationally. Its biomaterial products include OsteoSponge that provides a natural scaffold for cellular in-growth and exposes bone-forming proteins to the healing environment; OsteoSponge SC that fills bony defects in the subchondral region of joints; OsteoSelect DBM Putty for osteoinductive bone growth; OsteoSelect PLUS DBM Putty for use as a bone void filler and bone graft substitute in the pelvis, extremities, and posterolateral spine; OsteoFactor, which contains various proteins and peptides that support bone formation and remodeling; OsteoWrap; and OsteoVive Plus, a growth factor enriched cellular bone matrix. The company also provides 3Demin, a family of allografts that maximizes osteoconductivity and the osteoinductive potential of human bone. In addition, it processes and distributes sports allografts for anterior and posterior cruciate ligament repairs, anterior cruciate ligament reconstruction, and meniscal repair; milled spinal allografts for cortical bone milled to desired shapes and dimensions; and traditional allografts for orthopedics, neurology, podiatry, oral/maxillofacial, genitourinary, and plastic/reconstructive applications. Further, the company offers Certex spinal fixation, Spider cervical plating, Axle interspinous fusion, Silex Sacroiliac joint fusion, Xpress minimally invasive pedicle screw, and Fortex Pedicle screw systems. Additionally, it provides Calix for cervical and thoracolumbar applications, Axle-X interspinous fusion system, Irix-C cervical integrated fusion system, and Irix-A Lumbar integrated fusion system. The company was formerly known as Bacterin International Holdings, Inc. and changed its name to Xtant Medical Holdings, Inc. in July 2015. Xtant Medical Holdings, Inc. is headquartered in Belgrade, Montana.Show more

Revenue $117M +28.4%
EBITDA -$8M -12.4%
Net Income -$16M -2592.3%
EPS (Diluted) -0.12 -2407.7%
Gross Margin 58.17% -4.2%
EBITDA Margin -6.69% +12.5%
Operating Margin -10.3% +7.5%
Net Margin -14.03% -2040.4%
ROE -34.88% -2359.9%
ROIC -12.84% +15.6%
Debt/Equity 0.82 +78.3%
Interest Coverage -2.90 +16.1%

Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

✓Strong 5Y sales CAGR of 12.6%
✓Efficient asset utilization: 1.2x turnover

✗Weaknesses

✗Weak Piotroski F-Score: 2/9
✗Negative free cash flow
✗Trading more than 30% below 52-week high

Price & Volume

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Growth Metrics

Revenue CAGR

10Y12.75%

5Y12.64%

3Y28.5%

TTM16.88%

Profit (Net Income) CAGR

10Y-

5Y-

3Y-

TTM109.96%

EPS CAGR

10Y-

5Y-

3Y-

TTM107.7%

ROCE

10Y Avg-24.17%

5Y Avg-13.37%

3Y Avg-16.96%

Latest-17.9%

Peer Comparison

Spinal Implants & Fusion Systems

Name	Market Cap	Current Price	P/E Ratio	Revenue Growth 1Y	Net Margin	ROE	FCF Yield	Debt/Equity
GMEDGlobus Medical, Inc.	10.46B	93.89	125.19	60.62%	15.3%	9.63%	3.87%	0.13
TNONTenon Medical, Inc.	10.6M	0.95	-0.08	11.92%	-396.26%	-267.01%		0.07
BBLGBone Biologics Corporation	3M	1.67	-0.35			-65.59%
OFIXOrthofix Medical Inc.	570.24M	14.40	-4.36	7.08%	-14.56%	-26.92%		0.36
XTNTXtant Medical Holdings, Inc.	91M	0.65	-5.42	28.44%	1.32%	3.48%		0.82
ATECAlphatec Holdings, Inc.	2.59B	17.46	-15.45	26.81%	-21.29%	-13.47%		64.65
SIBNSI-BONE, Inc.	762.82M	17.58	-23.44	20.37%	-11.24%	-12.64%		0.22

Profit & Loss

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Sales/Revenue+	59.35M	90M	82.61M	72.2M	64.68M	53.34M	55.26M	57.97M	91.3M	117.27M
Revenue Growth %	0.68%	0.52%	-0.08%	-0.13%	-0.1%	-0.18%	0.04%	0.05%	0.58%	0.28%
Cost of Goods Sold+	20.26M	27.71M	32.51M	28.72M	22.17M	18.95M	22.77M	25.83M	35.84M	49.05M
COGS % of Revenue	0.34%	0.31%	0.39%	0.4%	0.34%	0.36%	0.41%	0.45%	0.39%	0.42%
Gross Profit+	39.08M	62.29M	50.1M	43.49M	42.52M	34.39M	32.49M	32.14M	55.47M	68.22M
Gross Margin %	0.66%	0.69%	0.61%	0.6%	0.66%	0.64%	0.59%	0.55%	0.61%	0.58%
Gross Profit Growth %	0.75%	0.59%	-0.2%	-0.13%	-0.02%	-0.19%	-0.06%	-0.01%	0.73%	0.23%
Operating Expenses+	48.34M	68.44M	63.77M	50.88M	44.77M	35.14M	36.34M	38.89M	65.63M	80.29M
OpEx % of Revenue	0.81%	0.76%	0.77%	0.7%	0.69%	0.66%	0.66%	0.67%	0.72%	0.68%
Selling, General & Admin	41.97M	60.09M	55.84M	45.06M	43.78M	34.49M	35.47M	37.98M	64.29M	77.91M
SG&A % of Revenue	0.71%	0.67%	0.68%	0.62%	0.68%	0.65%	0.64%	0.66%	0.7%	0.66%
Research & Development	2.55M	3.41M	2.44M	1.7M	932K	657K	870K	915K	1.34M	2.38M
R&D % of Revenue	0.04%	0.04%	0.03%	0.02%	0.01%	0.01%	0.02%	0.02%	0.01%	0.02%
Other Operating Expenses	388.18K	-351.91K	-74.71K	3K	58K	0	0	0	0	0
Operating Income+	-12.08M	-7.55M	-37.83M	-60.08M	-2.35M	-751K	-3.85M	-6.75M	-10.16M	-12.07M
Operating Margin %	-0.2%	-0.08%	-0.46%	-0.83%	-0.04%	-0.01%	-0.07%	-0.12%	-0.11%	-0.1%
Operating Income Growth %	-0.93%	0.38%	-4.01%	-0.59%	0.96%	0.68%	-4.13%	-0.75%	-0.5%	-0.19%
EBITDA+	-7.19M	-303.39K	-29.44M	-54.34M	847K	1.33M	-2.51M	-5.46M	-6.98M	-7.85M
EBITDA Margin %	-0.12%	-0%	-0.36%	-0.75%	0.01%	0.02%	-0.05%	-0.09%	-0.08%	-0.07%
EBITDA Growth %	-0.35%	0.96%	-96.04%	-0.85%	1.02%	0.57%	-2.89%	-1.17%	-0.28%	-0.12%
D&A (Non-Cash Add-back)	4.89M	7.24M	8.39M	5.74M	3.2M	2.08M	1.34M	1.3M	3.17M	4.22M
EBIT	-11.98M	-7.18M	-37.71M	-59.95M	-2.35M	-751K	-3.85M	-6.72M	1.9M	-12.1M
Net Interest Income+	-7.73M	-12.26M	-14.71M	-10.14M	-5.77M	-5.98M	-995K	-1.66M	-2.79M	-4.16M
Interest Income	0	0	0	0	0	0	0	31K	149K	0
Interest Expense	7.73M	12.26M	14.7M	10.14M	5.77M	5.98M	995K	1.69M	2.94M	4.16M
Other Income/Expense	-7.63M	-11.9M	-14.58M	-10.02M	-5.87M	-5.98M	-995K	-1.66M	9.12M	-4.19M
Pretax Income+	-19.71M	-19.44M	-52.41M	-70.1M	-8.12M	-6.73M	-4.85M	-8.42M	-1.04M	-16.26M
Pretax Margin %	-0.33%	-0.22%	-0.63%	-0.97%	-0.13%	-0.13%	-0.09%	-0.15%	-0.01%	-0.14%
Income Tax+	-17.54M	50.36K	0	124K	98K	296K	0	69K	-1.7M	187K
Effective Tax Rate %	0.11%	1%	1%	1%	1.01%	1.04%	1%	1.01%	-0.64%	1.01%
Net Income+	-2.17M	-19.49M	-52.41M	-70.1M	-8.22M	-7.02M	-4.85M	-8.48M	660K	-16.45M
Net Margin %	-0.04%	-0.22%	-0.63%	-0.97%	-0.13%	-0.13%	-0.09%	-0.15%	0.01%	-0.14%
Net Income Growth %	0.79%	-7.96%	-1.69%	-0.34%	0.88%	0.15%	0.31%	-0.75%	1.08%	-25.92%
Net Income (Continuing)	-2.17M	-19.49M	-52.41M	-70.1M	-8.22M	-7.02M	-4.85M	-8.48M	660K	-16.45M
Discontinued Operations	0	0	0	0	0	0	0	0	0	0
Minority Interest	0	0	0	0	0	0	0	0	0	0
EPS (Diluted)+	-2.62	-18.32	-34.51	-5.93	-0.62	-0.25	-0.06	-0.09	0.01	-0.12
EPS Growth %	0.86%	-5.99%	-0.88%	0.83%	0.9%	0.6%	0.77%	-0.59%	1.06%	-
EPS (Basic)	-2.62	-18.46	-34.76	-5.97	-0.62	-0.25	-0.06	-0.09	0.01	-0.12
Diluted Shares Outstanding	829.71K	1.06M	1.52M	11.83M	13.16M	28.5M	85.46M	94.09M	126.79M	133.67M
Basic Shares Outstanding	829.71K	1.06M	1.51M	11.74M	13.16M	28.5M	85.46M	94.09M	119.09M	133.67M
Dividend Payout Ratio	-	-	-	-	-	-	-	-	-	-

Balance Sheet

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Total Current Assets+	45.04M	48.99M	39.5M	34.68M	32.25M	31.36M	44.33M	49.32M	64.87M	67.12M
Cash & Short-Term Investments	6.37M	2.58M	2.86M	6.8M	5.24M	2.34M	18.24M	20.3M	5.71M	6.2M
Cash Only	6.37M	2.58M	2.86M	6.8M	5.24M	2.34M	18.24M	20.3M	5.71M	6.2M
Short-Term Investments	0	0	0	0	0	0	0	0	0	0
Accounts Receivable	15.39M	18.99M	12.71M	9.99M	10.12M	6.88M	7.15M	10.85M	20.73M	20.66M
Days Sales Outstanding	94.63	77.02	56.18	50.5	57.13	47.08	47.25	68.34	82.88	64.31
Inventory	22.68M	26.27M	22.23M	17.3M	16.1M	21.41M	17.95M	17.29M	36.88M	38.63M
Days Inventory Outstanding	408.63	345.99	249.56	219.9	265.13	412.45	287.62	244.23	375.68	287.48
Other Current Assets	0	0	0	0	0	0	144K	882K	1.54M	1.62M
Total Non-Current Assets+	97.64M	95.12M	66.2M	11.74M	10.91M	10.1M	10.36M	10.91M	27.74M	26.72M
Property, Plant & Equipment	11.82M	15.84M	9.91M	7.17M	6.79M	6.04M	6.47M	7.17M	10.21M	10.96M
Fixed Asset Turnover	5.02x	5.68x	8.33x	10.06x	9.52x	8.84x	8.54x	8.09x	8.94x	10.70x
Goodwill	41.53M	41.53M	41.53M	3.21M	3.21M	3.21M	3.21M	3.21M	7.3M	7.3M
Intangible Assets	40.24M	35.94M	13.83M	573K	515K	457K	400K	344K	10.09M	8.36M
Long-Term Investments	0	0	0	0	0	0	0	0	0	0
Other Non-Current Assets	4.05M	1.8M	925.25K	793K	394K	402K	287K	197K	141K	103K
Total Assets+	143.06M	144.1M	105.7M	46.42M	43.16M	41.47M	54.69M	60.23M	92.61M	93.84M
Asset Turnover	0.41x	0.62x	0.78x	1.56x	1.50x	1.29x	1.01x	0.96x	0.99x	1.25x
Asset Growth %	4.12%	0.01%	-0.27%	-0.56%	-0.07%	-0.04%	0.32%	0.1%	0.54%	0.01%
Total Current Liabilities+	21.47M	31.12M	25.82M	12.05M	9.39M	25.65M	11.08M	15.22M	22.99M	28.58M
Accounts Payable	9.39M	10.47M	9.32M	6.46M	2.19M	2.29M	2.62M	3.49M	7.05M	7.92M
Days Payables Outstanding	169.08	137.94	104.59	82.17	36.03	44.1	41.91	49.31	71.85	58.92
Short-Term Debt	35.14K	10.69M	365.48K	426K	570K	16.8M	3.62M	5.71M	4.62M	12.12M
Deferred Revenue (Current)	1000K	1000K	1000K	1000K	1000K	0	0	0	0	0
Other Current Liabilities	5.19M	3.42M	-234.68K	1.4M	-4.46M	4.71M	3.18M	4.46M	0	5.57M
Current Ratio	2.10x	1.57x	1.53x	2.88x	3.43x	1.22x	4.00x	3.24x	2.82x	2.35x
Quick Ratio	1.04x	0.73x	0.67x	1.44x	1.72x	0.39x	2.38x	2.10x	1.22x	1.00x
Cash Conversion Cycle	334.17	285.07	201.14	188.23	286.23	415.43	292.96	263.26	386.71	292.87
Total Non-Current Liabilities+	112.71M	120.05M	138.59M	78.14M	77.97M	1.3M	12.73M	10.84M	18.27M	22.29M
Long-Term Debt	110.67M	119.22M	137.96M	77.94M	76.24M	0	11.79M	9.69M	17.17M	22.04M
Capital Lease Obligations	7.8K	832.15K	624K	204K	1.73M	1.3M	945K	1.15M	875K	213K
Deferred Tax Liabilities	0	0	0	0	0	0	0	0	21K	42K
Other Non-Current Liabilities	0	0	-221	0	0	0	0	0	210K	0
Total Liabilities	134.18M	151.17M	164.4M	90.19M	87.36M	26.95M	23.81M	26.06M	41.26M	50.87M
Total Debt+	112.74M	130.75M	138.95M	78.57M	78.54M	18.54M	16.84M	17.07M	23.56M	35.14M
Net Debt	106.38M	128.17M	136.1M	71.77M	73.3M	16.2M	-1.4M	-3.23M	17.84M	28.94M
Debt / Equity	12.70x	-	-	-	-	1.28x	0.55x	0.50x	0.46x	0.82x
Debt / EBITDA	-	-	-	-	92.73x	13.96x	-	-	-	-
Net Debt / EBITDA	-	-	-	-	86.54x	12.20x	-	-	-	-
Interest Coverage	-1.56x	-0.62x	-2.57x	-5.92x	-0.41x	-0.13x	-3.87x	-3.99x	-3.46x	-2.90x
Total Equity+	8.88M	-7.07M	-58.7M	-43.77M	-44.2M	14.51M	30.88M	34.17M	51.35M	42.96M
Equity Growth %	2.14%	-1.8%	-7.3%	0.25%	-0.01%	1.33%	1.13%	0.11%	0.5%	-0.16%
Book Value per Share	10.70	-6.65	-38.65	-3.70	-3.36	0.51	0.36	0.36	0.40	0.32
Total Shareholders' Equity	8.88M	-7.07M	-58.7M	-43.77M	-44.2M	14.51M	30.88M	34.17M	51.35M	42.96M
Common Stock	11	17	2	0	0	0	0	0	0	0
Retained Earnings	-73.04M	-92.53M	-144.95M	-215.04M	-223.27M	-230.34M	-235.19M	-243.67M	-243.01M	-259.46M
Treasury Stock	0	0	0	0	0	0	0	0	0	0
Accumulated OCI	-5.43M	-7.86M	-11.29M	-12.91M	0	0	0	0	29K	-316K
Minority Interest	0	0	0	0	0	0	0	0	0	0

Cash Flow

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Cash from Operations+	-9.1M	-14.41M	-543.18K	1.21M	-413K	-731K	439K	-5.34M	-9.52M	-11.9M
Operating CF Margin %	-0.15%	-0.16%	-0.01%	0.02%	-0.01%	-0.01%	0.01%	-0.09%	-0.1%	-0.1%
Operating CF Growth %	-0.24%	-0.58%	0.96%	3.23%	-1.34%	-0.77%	1.6%	-13.17%	-0.78%	-0.25%
Net Income	-2.17M	-19.49M	-52.41M	-70.1M	-8.22M	-7.02M	-4.85M	-8.48M	660K	-16.45M
Depreciation & Amortization	4.89M	7.24M	8.41M	6.59M	3.14M	2.08M	1.33M	1.29M	3.17M	4.22M
Stock-Based Compensation	836.74K	522.99K	211.81K	694K	515K	1.08M	2.21M	2.46M	2.74M	4.12M
Deferred Taxes	-19.09M	-467.74K	25.26M	53.25M	958K	0	0	0	-1.9M	21K
Other Non-Cash Items	5.37M	6.78M	14.68M	9.85M	5.75M	6.4M	954K	2.2M	-10.55M	1.54M
Working Capital Changes	1.07M	-9M	3.3M	931K	-2.55M	-3.27M	793K	-2.81M	-3.63M	-5.35M
Change in Receivables	-5.51M	-2.68M	4.75M	2.54M	-647K	2.89M	-319K	-3.94M	-8.74M	-755K
Change in Inventory	-545.71K	-4.07M	2.12M	40K	692K	-5.79M	2.62M	-1.15M	-1.89M	-2.49M
Change in Payables	644.15K	319.09K	-1.64M	-3.01M	-4.28M	101K	-332K	875K	2.98M	1.03M
Cash from Investing+	-73.57M	-5.82M	-1.61M	-367K	-544K	-1.3M	-1.89M	-1.56M	-24.78M	-3.73M
Capital Expenditures	-2.26M	-5.83M	-1.64M	-624K	-879K	-1.54M	-2.12M	-1.76M	-1.46M	-4.11M
CapEx % of Revenue	0.04%	0.06%	0.02%	0.01%	0.01%	0.03%	0.04%	0.03%	0.02%	0.04%
Acquisitions	-	-	-	-	-	-	-	-	-	-
Investments	-	-	-	-	-	-	-	-	-	-
Other Investing	1.67M	16.4K	32.5K	257K	0	241K	225K	205K	175K	383K
Cash from Financing+	84.57M	16.43M	2.43M	3.1M	-603K	-861K	17.5M	9.02M	19.69M	16.07M
Debt Issued (Net)	-	-	-	-	-	-	-	-	-	-
Equity Issued (Net)	-	-	-	-	-	-	-	-	-	-
Dividends Paid	0	0	0	0	0	0	0	0	0	0
Share Repurchases	-	-	-	-	-	-	-	-	-	-
Other Financing	-531.4K	10.25M	455	-3.36M	-148K	-1.01M	-337K	0	-500K	-816K
Net Change in Cash	-	-	-	-	-	-	-	-	-	-
Free Cash Flow+	-11.36M	-20.24M	-2.18M	588K	-1.29M	-2.28M	-1.68M	-7.11M	-10.97M	-16.01M
FCF Margin %	-0.19%	-0.22%	-0.03%	0.01%	-0.02%	-0.04%	-0.03%	-0.12%	-0.12%	-0.14%
FCF Growth %	-0.49%	-0.78%	0.89%	1.27%	-3.2%	-0.76%	0.26%	-3.24%	-0.54%	-0.46%
FCF per Share	-13.70	-19.02	-1.44	0.05	-0.10	-0.08	-0.02	-0.08	-0.09	-0.12
FCF Conversion (FCF/Net Income)	4.18x	0.74x	0.01x	-0.02x	0.05x	0.10x	-0.09x	0.63x	-14.42x	0.72x
Interest Paid	0	0	0	0	0	0	846K	1.45M	2.55M	3.64M
Taxes Paid	0	0	0	0	0	0	0	0	0	0

Key Ratios

Metric	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Return on Equity (ROE)	-394.77%	-2162.07%	-	-	-	-48.39%	-21.36%	-26.09%	1.54%	-34.88%
Return on Invested Capital (ROIC)	-14.61%	-4.79%	-28.59%	-85.5%	-6.18%	-1.88%	-9.6%	-16.77%	-15.22%	-12.84%
Gross Margin	65.86%	69.21%	60.65%	60.23%	65.73%	64.48%	58.79%	55.44%	60.75%	58.17%
Net Margin	-3.66%	-21.66%	-63.44%	-97.09%	-12.71%	-13.17%	-8.77%	-14.64%	0.72%	-14.03%
Debt / Equity	12.70x	-	-	-	-	1.28x	0.55x	0.50x	0.46x	0.82x
Interest Coverage	-1.56x	-0.62x	-2.57x	-5.92x	-0.41x	-0.13x	-3.87x	-3.99x	-3.46x	-2.90x
FCF Conversion	4.18x	0.74x	0.01x	-0.02x	0.05x	0.10x	-0.09x	0.63x	-14.42x	0.72x
Revenue Growth	67.97%	51.66%	-8.21%	-12.6%	-10.42%	-17.54%	3.61%	4.9%	57.5%	28.44%

Revenue by Segment

	2012	2013	2014	2015	2016	2019	2020	2021	2022	2024
Orthobiologics	-	-	-	-	-	-	-	-	-	66.42M
Orthobiologics Growth	-	-	-	-	-	-	-	-	-	-
Spinal Implant	-	-	-	-	-	-	-	-	-	49.35M
Spinal Implant Growth	-	-	-	-	-	-	-	-	-	-
License Revenue	-	-	-	-	-	-	-	-	-	1.5M
License Revenue Growth	-	-	-	-	-	-	-	-	-	-
Other Revenue	-	-	-	-	-	147K	149K	117K	11K	-
Other Revenue Growth	-	-	-	-	-	-	1.36%	-21.48%	-90.60%	-

Revenue by Geography

	2012	2013	2014	2015	2016	2019	2020	2021	2022	2024
UNITED STATES	-	-	-	56.75M	85.62M	-	-	-	-	105.52M
UNITED STATES Growth	-	-	-	-	50.87%	-	-	-	-	-
World	-	-	-	-	-	2.31M	1.19M	-	-	11.75M
World Growth	-	-	-	-	-	-	-48.37%	-	-	-
United States	31.95M	-	-	-	-	62.38M	52.15M	-	-	-
United States Growth	-	-	-	-	-	-	-16.40%	-	-	-
Rest Of World	1.03M	584.59K	688.24K	2.6M	4.38M	-	-	-	-	-
Rest Of World Growth	-	-43.36%	17.73%	277.10%	68.94%	-	-	-	-	-
US	-	32.49M	34.64M	-	-	-	-	-	-	-
US Growth	-	-	6.63%	-	-	-	-	-	-	-

Frequently Asked Questions

Growth & Financials

Xtant Medical Holdings, Inc. (XTNT) reported $133.1M in revenue for fiscal year 2024. This represents a 341% increase from $30.1M in 2011.

Xtant Medical Holdings, Inc. (XTNT) grew revenue by 28.4% over the past year. This is strong growth.

Yes, Xtant Medical Holdings, Inc. (XTNT) is profitable, generating $1.8M in net income for fiscal year 2024 (-14.0% net margin).

Dividend & Returns

Xtant Medical Holdings, Inc. (XTNT) has a return on equity (ROE) of -34.9%. Negative ROE indicates the company is unprofitable.

Xtant Medical Holdings, Inc. (XTNT) generated $5.2M in free cash flow for fiscal year 2024. Positive FCF indicates the company can fund dividends, buybacks, or reinvestment.

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Xtant Medical Holdings, Inc. (XTNT) 10-Year Financial Performance & Capital Metrics

XTNT • • Industrial / General

HealthcareMedical DevicesOrthopedic & Musculoskeletal DevicesSpinal Implants & Fusion Systems

Revenue $117M +28.4%
EBITDA -$8M -12.4%
Net Income -$16M -2592.3%
EPS (Diluted) -0.12 -2407.7%
Gross Margin 58.17% -4.2%
EBITDA Margin -6.69% +12.5%
Operating Margin -10.3% +7.5%
Net Margin -14.03% -2040.4%
ROE -34.88% -2359.9%
ROIC -12.84% +15.6%
Debt/Equity 0.82 +78.3%
Interest Coverage -2.90 +16.1%

Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

✓Strong 5Y sales CAGR of 12.6%
✓Efficient asset utilization: 1.2x turnover

✗Weaknesses

✗Weak Piotroski F-Score: 2/9
✗Negative free cash flow
✗Trading more than 30% below 52-week high

Price & Volume

Loading chart...

Growth Metrics

Revenue CAGR

10Y12.75%

5Y12.64%

3Y28.5%

TTM16.88%

Profit (Net Income) CAGR

10Y-

5Y-

3Y-

TTM109.96%

EPS CAGR

10Y-

5Y-

3Y-

TTM107.7%

ROCE

10Y Avg-24.17%

5Y Avg-13.37%

3Y Avg-16.96%

Latest-17.9%

Peer Comparison

Spinal Implants & Fusion Systems

Name	Market Cap	Current Price	P/E Ratio	Revenue Growth 1Y	Net Margin	ROE	FCF Yield	Debt/Equity
GMEDGlobus Medical, Inc.	10.46B	93.89	125.19	60.62%	15.3%	9.63%	3.87%	0.13
TNONTenon Medical, Inc.	10.6M	0.95	-0.08	11.92%	-396.26%	-267.01%		0.07
BBLGBone Biologics Corporation	3M	1.67	-0.35			-65.59%
OFIXOrthofix Medical Inc.	570.24M	14.40	-4.36	7.08%	-14.56%	-26.92%		0.36
XTNTXtant Medical Holdings, Inc.	91M	0.65	-5.42	28.44%	1.32%	3.48%		0.82
ATECAlphatec Holdings, Inc.	2.59B	17.46	-15.45	26.81%	-21.29%	-13.47%		64.65
SIBNSI-BONE, Inc.	762.82M	17.58	-23.44	20.37%	-11.24%	-12.64%		0.22

Profit & Loss

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Sales/Revenue+	59.35M	90M	82.61M	72.2M	64.68M	53.34M	55.26M	57.97M	91.3M	117.27M
Revenue Growth %	0.68%	0.52%	-0.08%	-0.13%	-0.1%	-0.18%	0.04%	0.05%	0.58%	0.28%
Cost of Goods Sold+	20.26M	27.71M	32.51M	28.72M	22.17M	18.95M	22.77M	25.83M	35.84M	49.05M
COGS % of Revenue	0.34%	0.31%	0.39%	0.4%	0.34%	0.36%	0.41%	0.45%	0.39%	0.42%
Gross Profit+	39.08M	62.29M	50.1M	43.49M	42.52M	34.39M	32.49M	32.14M	55.47M	68.22M
Gross Margin %	0.66%	0.69%	0.61%	0.6%	0.66%	0.64%	0.59%	0.55%	0.61%	0.58%
Gross Profit Growth %	0.75%	0.59%	-0.2%	-0.13%	-0.02%	-0.19%	-0.06%	-0.01%	0.73%	0.23%
Operating Expenses+	48.34M	68.44M	63.77M	50.88M	44.77M	35.14M	36.34M	38.89M	65.63M	80.29M
OpEx % of Revenue	0.81%	0.76%	0.77%	0.7%	0.69%	0.66%	0.66%	0.67%	0.72%	0.68%
Selling, General & Admin	41.97M	60.09M	55.84M	45.06M	43.78M	34.49M	35.47M	37.98M	64.29M	77.91M
SG&A % of Revenue	0.71%	0.67%	0.68%	0.62%	0.68%	0.65%	0.64%	0.66%	0.7%	0.66%
Research & Development	2.55M	3.41M	2.44M	1.7M	932K	657K	870K	915K	1.34M	2.38M
R&D % of Revenue	0.04%	0.04%	0.03%	0.02%	0.01%	0.01%	0.02%	0.02%	0.01%	0.02%
Other Operating Expenses	388.18K	-351.91K	-74.71K	3K	58K	0	0	0	0	0
Operating Income+	-12.08M	-7.55M	-37.83M	-60.08M	-2.35M	-751K	-3.85M	-6.75M	-10.16M	-12.07M
Operating Margin %	-0.2%	-0.08%	-0.46%	-0.83%	-0.04%	-0.01%	-0.07%	-0.12%	-0.11%	-0.1%
Operating Income Growth %	-0.93%	0.38%	-4.01%	-0.59%	0.96%	0.68%	-4.13%	-0.75%	-0.5%	-0.19%
EBITDA+	-7.19M	-303.39K	-29.44M	-54.34M	847K	1.33M	-2.51M	-5.46M	-6.98M	-7.85M
EBITDA Margin %	-0.12%	-0%	-0.36%	-0.75%	0.01%	0.02%	-0.05%	-0.09%	-0.08%	-0.07%
EBITDA Growth %	-0.35%	0.96%	-96.04%	-0.85%	1.02%	0.57%	-2.89%	-1.17%	-0.28%	-0.12%
D&A (Non-Cash Add-back)	4.89M	7.24M	8.39M	5.74M	3.2M	2.08M	1.34M	1.3M	3.17M	4.22M
EBIT	-11.98M	-7.18M	-37.71M	-59.95M	-2.35M	-751K	-3.85M	-6.72M	1.9M	-12.1M
Net Interest Income+	-7.73M	-12.26M	-14.71M	-10.14M	-5.77M	-5.98M	-995K	-1.66M	-2.79M	-4.16M
Interest Income	0	0	0	0	0	0	0	31K	149K	0
Interest Expense	7.73M	12.26M	14.7M	10.14M	5.77M	5.98M	995K	1.69M	2.94M	4.16M
Other Income/Expense	-7.63M	-11.9M	-14.58M	-10.02M	-5.87M	-5.98M	-995K	-1.66M	9.12M	-4.19M
Pretax Income+	-19.71M	-19.44M	-52.41M	-70.1M	-8.12M	-6.73M	-4.85M	-8.42M	-1.04M	-16.26M
Pretax Margin %	-0.33%	-0.22%	-0.63%	-0.97%	-0.13%	-0.13%	-0.09%	-0.15%	-0.01%	-0.14%
Income Tax+	-17.54M	50.36K	0	124K	98K	296K	0	69K	-1.7M	187K
Effective Tax Rate %	0.11%	1%	1%	1%	1.01%	1.04%	1%	1.01%	-0.64%	1.01%
Net Income+	-2.17M	-19.49M	-52.41M	-70.1M	-8.22M	-7.02M	-4.85M	-8.48M	660K	-16.45M
Net Margin %	-0.04%	-0.22%	-0.63%	-0.97%	-0.13%	-0.13%	-0.09%	-0.15%	0.01%	-0.14%
Net Income Growth %	0.79%	-7.96%	-1.69%	-0.34%	0.88%	0.15%	0.31%	-0.75%	1.08%	-25.92%
Net Income (Continuing)	-2.17M	-19.49M	-52.41M	-70.1M	-8.22M	-7.02M	-4.85M	-8.48M	660K	-16.45M
Discontinued Operations	0	0	0	0	0	0	0	0	0	0
Minority Interest	0	0	0	0	0	0	0	0	0	0
EPS (Diluted)+	-2.62	-18.32	-34.51	-5.93	-0.62	-0.25	-0.06	-0.09	0.01	-0.12
EPS Growth %	0.86%	-5.99%	-0.88%	0.83%	0.9%	0.6%	0.77%	-0.59%	1.06%	-
EPS (Basic)	-2.62	-18.46	-34.76	-5.97	-0.62	-0.25	-0.06	-0.09	0.01	-0.12
Diluted Shares Outstanding	829.71K	1.06M	1.52M	11.83M	13.16M	28.5M	85.46M	94.09M	126.79M	133.67M
Basic Shares Outstanding	829.71K	1.06M	1.51M	11.74M	13.16M	28.5M	85.46M	94.09M	119.09M	133.67M
Dividend Payout Ratio	-	-	-	-	-	-	-	-	-	-

Balance Sheet

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Total Current Assets+	45.04M	48.99M	39.5M	34.68M	32.25M	31.36M	44.33M	49.32M	64.87M	67.12M
Cash & Short-Term Investments	6.37M	2.58M	2.86M	6.8M	5.24M	2.34M	18.24M	20.3M	5.71M	6.2M
Cash Only	6.37M	2.58M	2.86M	6.8M	5.24M	2.34M	18.24M	20.3M	5.71M	6.2M
Short-Term Investments	0	0	0	0	0	0	0	0	0	0
Accounts Receivable	15.39M	18.99M	12.71M	9.99M	10.12M	6.88M	7.15M	10.85M	20.73M	20.66M
Days Sales Outstanding	94.63	77.02	56.18	50.5	57.13	47.08	47.25	68.34	82.88	64.31
Inventory	22.68M	26.27M	22.23M	17.3M	16.1M	21.41M	17.95M	17.29M	36.88M	38.63M
Days Inventory Outstanding	408.63	345.99	249.56	219.9	265.13	412.45	287.62	244.23	375.68	287.48
Other Current Assets	0	0	0	0	0	0	144K	882K	1.54M	1.62M
Total Non-Current Assets+	97.64M	95.12M	66.2M	11.74M	10.91M	10.1M	10.36M	10.91M	27.74M	26.72M
Property, Plant & Equipment	11.82M	15.84M	9.91M	7.17M	6.79M	6.04M	6.47M	7.17M	10.21M	10.96M
Fixed Asset Turnover	5.02x	5.68x	8.33x	10.06x	9.52x	8.84x	8.54x	8.09x	8.94x	10.70x
Goodwill	41.53M	41.53M	41.53M	3.21M	3.21M	3.21M	3.21M	3.21M	7.3M	7.3M
Intangible Assets	40.24M	35.94M	13.83M	573K	515K	457K	400K	344K	10.09M	8.36M
Long-Term Investments	0	0	0	0	0	0	0	0	0	0
Other Non-Current Assets	4.05M	1.8M	925.25K	793K	394K	402K	287K	197K	141K	103K
Total Assets+	143.06M	144.1M	105.7M	46.42M	43.16M	41.47M	54.69M	60.23M	92.61M	93.84M
Asset Turnover	0.41x	0.62x	0.78x	1.56x	1.50x	1.29x	1.01x	0.96x	0.99x	1.25x
Asset Growth %	4.12%	0.01%	-0.27%	-0.56%	-0.07%	-0.04%	0.32%	0.1%	0.54%	0.01%
Total Current Liabilities+	21.47M	31.12M	25.82M	12.05M	9.39M	25.65M	11.08M	15.22M	22.99M	28.58M
Accounts Payable	9.39M	10.47M	9.32M	6.46M	2.19M	2.29M	2.62M	3.49M	7.05M	7.92M
Days Payables Outstanding	169.08	137.94	104.59	82.17	36.03	44.1	41.91	49.31	71.85	58.92
Short-Term Debt	35.14K	10.69M	365.48K	426K	570K	16.8M	3.62M	5.71M	4.62M	12.12M
Deferred Revenue (Current)	1000K	1000K	1000K	1000K	1000K	0	0	0	0	0
Other Current Liabilities	5.19M	3.42M	-234.68K	1.4M	-4.46M	4.71M	3.18M	4.46M	0	5.57M
Current Ratio	2.10x	1.57x	1.53x	2.88x	3.43x	1.22x	4.00x	3.24x	2.82x	2.35x
Quick Ratio	1.04x	0.73x	0.67x	1.44x	1.72x	0.39x	2.38x	2.10x	1.22x	1.00x
Cash Conversion Cycle	334.17	285.07	201.14	188.23	286.23	415.43	292.96	263.26	386.71	292.87
Total Non-Current Liabilities+	112.71M	120.05M	138.59M	78.14M	77.97M	1.3M	12.73M	10.84M	18.27M	22.29M
Long-Term Debt	110.67M	119.22M	137.96M	77.94M	76.24M	0	11.79M	9.69M	17.17M	22.04M
Capital Lease Obligations	7.8K	832.15K	624K	204K	1.73M	1.3M	945K	1.15M	875K	213K
Deferred Tax Liabilities	0	0	0	0	0	0	0	0	21K	42K
Other Non-Current Liabilities	0	0	-221	0	0	0	0	0	210K	0
Total Liabilities	134.18M	151.17M	164.4M	90.19M	87.36M	26.95M	23.81M	26.06M	41.26M	50.87M
Total Debt+	112.74M	130.75M	138.95M	78.57M	78.54M	18.54M	16.84M	17.07M	23.56M	35.14M
Net Debt	106.38M	128.17M	136.1M	71.77M	73.3M	16.2M	-1.4M	-3.23M	17.84M	28.94M
Debt / Equity	12.70x	-	-	-	-	1.28x	0.55x	0.50x	0.46x	0.82x
Debt / EBITDA	-	-	-	-	92.73x	13.96x	-	-	-	-
Net Debt / EBITDA	-	-	-	-	86.54x	12.20x	-	-	-	-
Interest Coverage	-1.56x	-0.62x	-2.57x	-5.92x	-0.41x	-0.13x	-3.87x	-3.99x	-3.46x	-2.90x
Total Equity+	8.88M	-7.07M	-58.7M	-43.77M	-44.2M	14.51M	30.88M	34.17M	51.35M	42.96M
Equity Growth %	2.14%	-1.8%	-7.3%	0.25%	-0.01%	1.33%	1.13%	0.11%	0.5%	-0.16%
Book Value per Share	10.70	-6.65	-38.65	-3.70	-3.36	0.51	0.36	0.36	0.40	0.32
Total Shareholders' Equity	8.88M	-7.07M	-58.7M	-43.77M	-44.2M	14.51M	30.88M	34.17M	51.35M	42.96M
Common Stock	11	17	2	0	0	0	0	0	0	0
Retained Earnings	-73.04M	-92.53M	-144.95M	-215.04M	-223.27M	-230.34M	-235.19M	-243.67M	-243.01M	-259.46M
Treasury Stock	0	0	0	0	0	0	0	0	0	0
Accumulated OCI	-5.43M	-7.86M	-11.29M	-12.91M	0	0	0	0	29K	-316K
Minority Interest	0	0	0	0	0	0	0	0	0	0

Cash Flow

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Cash from Operations+	-9.1M	-14.41M	-543.18K	1.21M	-413K	-731K	439K	-5.34M	-9.52M	-11.9M
Operating CF Margin %	-0.15%	-0.16%	-0.01%	0.02%	-0.01%	-0.01%	0.01%	-0.09%	-0.1%	-0.1%
Operating CF Growth %	-0.24%	-0.58%	0.96%	3.23%	-1.34%	-0.77%	1.6%	-13.17%	-0.78%	-0.25%
Net Income	-2.17M	-19.49M	-52.41M	-70.1M	-8.22M	-7.02M	-4.85M	-8.48M	660K	-16.45M
Depreciation & Amortization	4.89M	7.24M	8.41M	6.59M	3.14M	2.08M	1.33M	1.29M	3.17M	4.22M
Stock-Based Compensation	836.74K	522.99K	211.81K	694K	515K	1.08M	2.21M	2.46M	2.74M	4.12M
Deferred Taxes	-19.09M	-467.74K	25.26M	53.25M	958K	0	0	0	-1.9M	21K
Other Non-Cash Items	5.37M	6.78M	14.68M	9.85M	5.75M	6.4M	954K	2.2M	-10.55M	1.54M
Working Capital Changes	1.07M	-9M	3.3M	931K	-2.55M	-3.27M	793K	-2.81M	-3.63M	-5.35M
Change in Receivables	-5.51M	-2.68M	4.75M	2.54M	-647K	2.89M	-319K	-3.94M	-8.74M	-755K
Change in Inventory	-545.71K	-4.07M	2.12M	40K	692K	-5.79M	2.62M	-1.15M	-1.89M	-2.49M
Change in Payables	644.15K	319.09K	-1.64M	-3.01M	-4.28M	101K	-332K	875K	2.98M	1.03M
Cash from Investing+	-73.57M	-5.82M	-1.61M	-367K	-544K	-1.3M	-1.89M	-1.56M	-24.78M	-3.73M
Capital Expenditures	-2.26M	-5.83M	-1.64M	-624K	-879K	-1.54M	-2.12M	-1.76M	-1.46M	-4.11M
CapEx % of Revenue	0.04%	0.06%	0.02%	0.01%	0.01%	0.03%	0.04%	0.03%	0.02%	0.04%
Acquisitions	-	-	-	-	-	-	-	-	-	-
Investments	-	-	-	-	-	-	-	-	-	-
Other Investing	1.67M	16.4K	32.5K	257K	0	241K	225K	205K	175K	383K
Cash from Financing+	84.57M	16.43M	2.43M	3.1M	-603K	-861K	17.5M	9.02M	19.69M	16.07M
Debt Issued (Net)	-	-	-	-	-	-	-	-	-	-
Equity Issued (Net)	-	-	-	-	-	-	-	-	-	-
Dividends Paid	0	0	0	0	0	0	0	0	0	0
Share Repurchases	-	-	-	-	-	-	-	-	-	-
Other Financing	-531.4K	10.25M	455	-3.36M	-148K	-1.01M	-337K	0	-500K	-816K
Net Change in Cash	-	-	-	-	-	-	-	-	-	-
Free Cash Flow+	-11.36M	-20.24M	-2.18M	588K	-1.29M	-2.28M	-1.68M	-7.11M	-10.97M	-16.01M
FCF Margin %	-0.19%	-0.22%	-0.03%	0.01%	-0.02%	-0.04%	-0.03%	-0.12%	-0.12%	-0.14%
FCF Growth %	-0.49%	-0.78%	0.89%	1.27%	-3.2%	-0.76%	0.26%	-3.24%	-0.54%	-0.46%
FCF per Share	-13.70	-19.02	-1.44	0.05	-0.10	-0.08	-0.02	-0.08	-0.09	-0.12
FCF Conversion (FCF/Net Income)	4.18x	0.74x	0.01x	-0.02x	0.05x	0.10x	-0.09x	0.63x	-14.42x	0.72x
Interest Paid	0	0	0	0	0	0	846K	1.45M	2.55M	3.64M
Taxes Paid	0	0	0	0	0	0	0	0	0	0

Key Ratios

Metric	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Return on Equity (ROE)	-394.77%	-2162.07%	-	-	-	-48.39%	-21.36%	-26.09%	1.54%	-34.88%
Return on Invested Capital (ROIC)	-14.61%	-4.79%	-28.59%	-85.5%	-6.18%	-1.88%	-9.6%	-16.77%	-15.22%	-12.84%
Gross Margin	65.86%	69.21%	60.65%	60.23%	65.73%	64.48%	58.79%	55.44%	60.75%	58.17%
Net Margin	-3.66%	-21.66%	-63.44%	-97.09%	-12.71%	-13.17%	-8.77%	-14.64%	0.72%	-14.03%
Debt / Equity	12.70x	-	-	-	-	1.28x	0.55x	0.50x	0.46x	0.82x
Interest Coverage	-1.56x	-0.62x	-2.57x	-5.92x	-0.41x	-0.13x	-3.87x	-3.99x	-3.46x	-2.90x
FCF Conversion	4.18x	0.74x	0.01x	-0.02x	0.05x	0.10x	-0.09x	0.63x	-14.42x	0.72x
Revenue Growth	67.97%	51.66%	-8.21%	-12.6%	-10.42%	-17.54%	3.61%	4.9%	57.5%	28.44%

Revenue by Segment

	2012	2013	2014	2015	2016	2019	2020	2021	2022	2024
Orthobiologics	-	-	-	-	-	-	-	-	-	66.42M
Orthobiologics Growth	-	-	-	-	-	-	-	-	-	-
Spinal Implant	-	-	-	-	-	-	-	-	-	49.35M
Spinal Implant Growth	-	-	-	-	-	-	-	-	-	-
License Revenue	-	-	-	-	-	-	-	-	-	1.5M
License Revenue Growth	-	-	-	-	-	-	-	-	-	-
Other Revenue	-	-	-	-	-	147K	149K	117K	11K	-
Other Revenue Growth	-	-	-	-	-	-	1.36%	-21.48%	-90.60%	-

Revenue by Geography

	2012	2013	2014	2015	2016	2019	2020	2021	2022	2024
UNITED STATES	-	-	-	56.75M	85.62M	-	-	-	-	105.52M
UNITED STATES Growth	-	-	-	-	50.87%	-	-	-	-	-
World	-	-	-	-	-	2.31M	1.19M	-	-	11.75M
World Growth	-	-	-	-	-	-	-48.37%	-	-	-
United States	31.95M	-	-	-	-	62.38M	52.15M	-	-	-
United States Growth	-	-	-	-	-	-	-16.40%	-	-	-
Rest Of World	1.03M	584.59K	688.24K	2.6M	4.38M	-	-	-	-	-
Rest Of World Growth	-	-43.36%	17.73%	277.10%	68.94%	-	-	-	-	-
US	-	32.49M	34.64M	-	-	-	-	-	-	-
US Growth	-	-	6.63%	-	-	-	-	-	-	-

Frequently Asked Questions

Growth & Financials

Xtant Medical Holdings, Inc. (XTNT) reported $133.1M in revenue for fiscal year 2024. This represents a 341% increase from $30.1M in 2011.

Xtant Medical Holdings, Inc. (XTNT) grew revenue by 28.4% over the past year. This is strong growth.

Yes, Xtant Medical Holdings, Inc. (XTNT) is profitable, generating $1.8M in net income for fiscal year 2024 (-14.0% net margin).

Dividend & Returns

Xtant Medical Holdings, Inc. (XTNT) has a return on equity (ROE) of -34.9%. Negative ROE indicates the company is unprofitable.

Xtant Medical Holdings, Inc. (XTNT) generated $5.2M in free cash flow for fiscal year 2024. Positive FCF indicates the company can fund dividends, buybacks, or reinvestment.