Gross margins have experienced a sharp contraction from 49.4% in 2023Q4 to 18.2% in 2026Q1, reflecting significant pressure on the company's core service profitability.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 | Dec'04 | Dec'03 | Dec'02 | Dec'01 | Dec'00 | Dec'99 | Dec'98 | Dec'97 | Dec'96 |
|---|
| Sales/Revenue | 29.05M | 28.08M | 28.34M | 21.32M | 19.75M | 17.63M | 17.84M | 20.61M | 19.71M | 19.56M | 18.7M | 16.55M | 15.42M | 17.58M | 17.05M | 22.22M | 16.68M | 16.77M | 19.1M | 22.62M | 20.39M | 18.23M | 16.39M | 16.18M | 13.37M | 11.76M | 9.34M | 7.16M | 35.16M | 37.17M | 37M |
| Revenue Growth % | -0.62% | -0.91% | 32.9% | 8% | 12.02% | -1.17% | -13.43% | 4.52% | 0.81% | 4.58% | 13% | 7.34% | -12.32% | 3.14% | -23.28% | 33.26% | -0.55% | -12.2% | -15.57% | 10.97% | 11.82% | 11.24% | 1.3% | 21.04% | 13.68% | 25.94% | 30.46% | -79.65% | -5.41% | 0.46% | 8.5% |
| Cost of Goods Sold | 23.67M | 23.04M | 19.16M | 11.98M | 11.36M | 10.9M | 13.37M | 13.69M | 12.23M | 10.89M | 9.9M | 9.83M | 10.14M | 10.64M | 10.12M | 14.22M | 9.47M | 9.78M | 10.88M | 13.35M | 4.5M | 3.68M | 3.08M | 3.17M | 1.93M | 1.35M | 1.17M | 549K | 20.27M | 20.65M | 21.1M |
| COGS % of Revenue | - | 82.04% | 67.59% | 56.18% | 57.55% | 61.84% | 74.96% | 66.42% | 62.03% | 55.7% | 52.97% | 59.42% | 65.76% | 60.51% | 59.35% | 64.01% | 56.77% | 58.33% | 56.95% | 59.03% | 22.08% | 20.17% | 18.82% | 19.63% | 14.42% | 11.52% | 12.5% | 7.67% | 57.65% | 55.54% | 57.03% |
| Gross Profit | 5.39M | 5.04M | 9.19M | 9.34M | 8.38M | 6.73M | 4.47M | 6.92M | 7.49M | 8.66M | 8.79M | 6.71M | 5.28M | 6.94M | 6.93M | 8M | 7.21M | 6.99M | 8.22M | 9.27M | 15.88M | 14.55M | 13.3M | 13M | 11.44M | 10.4M | 8.17M | 6.61M | 14.89M | 16.53M | 15.9M |
| Gross Margin % | 18.54% | 17.96% | 32.41% | 43.82% | 42.45% | 38.16% | 25.04% | 33.58% | 37.97% | 44.3% | 47.03% | 40.58% | 34.24% | 39.49% | 40.65% | 35.99% | 43.23% | 41.67% | 43.05% | 40.97% | 77.92% | 79.83% | 81.18% | 80.37% | 85.58% | 88.48% | 87.5% | 92.33% | 42.35% | 44.46% | 42.97% |
| Gross Profit Growth % | - | -45.1% | -1.7% | 11.48% | 24.62% | 50.6% | -35.46% | -7.56% | -13.59% | -1.5% | 30.98% | 27.2% | -23.98% | 0.2% | -13.34% | 10.93% | 3.18% | -15.02% | -11.29% | -41.66% | 9.15% | 9.4% | 2.31% | 13.67% | 9.95% | 27.36% | 23.64% | -55.63% | -9.89% | 3.94% | 55.88% |
| Operating Expenses | 7.16M | 7.06M | 11.99M | 9.07M | 5.95M | 5.38M | 13.93M | 4.06M | 3.99M | 4.32M | 3.8M | 3.5M | 3.63M | 4.03M | 4.04M | 4.04M | 4.24M | 4.27M | 4.32M | 6.59M | 6.16M | 11.08M | 10.03M | 10.03M | 9.22M | 6.18M | 4.92M | 3.42M | 10.67M | 12.3M | 12.3M |
| OpEx % of Revenue | - | 25.13% | 42.31% | 42.55% | 30.14% | 30.49% | 78.09% | 19.7% | 20.26% | 22.11% | 20.33% | 21.13% | 23.55% | 22.89% | 23.73% | 18.19% | 25.43% | 25.47% | 22.63% | 29.14% | 30.2% | 60.79% | 61.18% | 61.98% | 69% | 52.53% | 52.73% | 47.78% | 30.35% | 33.09% | 33.24% |
| Selling, General & Admin | 7.16M | 7.06M | 7.41M | 7.02M | 5.14M | 4.53M | 4.61M | 4.06M | 3.99M | 4.32M | 3.8M | 3.5M | 3.63M | 4.03M | 4.04M | 4.04M | 4.24M | 4.27M | 4.32M | 4.65M | 4M | 3.61M | 2.96M | 3.25M | 3.31M | 3.25M | 2.65M | 1.8M | 5.12M | 5.9M | 5.3M |
| SG&A % of Revenue | - | 25.13% | 26.14% | 32.93% | 26.06% | 25.7% | 25.83% | 19.7% | 20.26% | 22.11% | 20.33% | 21.13% | 23.55% | 22.89% | 23.73% | 18.19% | 25.43% | 25.47% | 22.63% | 20.54% | 19.6% | 19.82% | 18.08% | 20.12% | 24.79% | 27.6% | 28.44% | 25.2% | 14.55% | 15.87% | 14.32% |
| Research & Development | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| R&D % of Revenue | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Operating Expenses | 0 | 0 | 4.58M | 2.05M | 806K | 844K | 9.32M | 0 | 0 | 3K | 15K | 18K | 28K | 25K | 0 | 0 | 0 | 0 | 0 | 1.95M | 2.16M | 7.47M | 7.06M | 6.77M | 5.91M | 2.93M | 2.27M | 1.62M | 5.56M | 6.4M | 7M |
| Operating Income | -1.77M | -2.01M | -2.81M | 270K | 2.43M | 1.35M | -9.46M | -4.54M | 1.86M | 2.41M | 3.29M | 1.98M | -50K | 1.12M | 730K | 1.59M | 865K | 653K | 1.46M | 2.68M | 3.86M | 3.47M | 3.28M | 2.98M | 2.22M | 4.23M | 3.25M | 3.19M | 4.22M | 4.23M | 3.6M |
| Operating Margin % | -6.09% | -7.17% | -9.9% | 1.27% | 12.31% | 7.66% | -53.05% | -22.01% | 9.44% | 12.34% | 17.57% | 11.97% | -0.32% | 6.37% | 4.28% | 7.15% | 5.19% | 3.89% | 7.65% | 11.83% | 18.96% | 19.04% | 20% | 18.4% | 16.59% | 35.96% | 34.77% | 44.55% | 12% | 11.37% | 9.73% |
| Operating Income Growth % | - | 28.2% | -1138.89% | -88.89% | 79.94% | 114.28% | -108.67% | -343.69% | -22.88% | -26.57% | 65.96% | 4060% | -104.46% | 53.42% | -54.06% | 83.7% | 32.47% | -55.34% | -45.37% | -30.75% | 11.32% | 5.89% | 10.15% | 34.24% | -47.56% | 30.25% | 1.82% | -24.45% | -0.17% | 17.42% | 151.43% |
| EBITDA | 3.79M | 3.7M | 3.37M | 5.43M | 7.55M | 6.63M | -2.49M | 2.88M | 8.68M | 9.09M | 9.61M | 8.17M | 6.33M | 7.53M | 6.83M | 7.86M | 6.87M | 7.14M | 8.18M | 8.79M | 9.83M | 8.97M | 8.17M | 7.29M | 5.75M | 7.23M | 5.6M | 4.81M | 10.31M | 10.98M | 10.6M |
| EBITDA Margin % | 13.04% | 13.18% | 11.89% | 25.49% | 38.24% | 37.62% | -13.98% | 13.96% | 44.02% | 46.48% | 51.41% | 49.37% | 41.08% | 42.82% | 40.04% | 35.38% | 41.18% | 42.61% | 42.81% | 38.84% | 48.21% | 49.22% | 49.85% | 45.05% | 42.99% | 61.5% | 60.01% | 67.2% | 29.34% | 29.54% | 28.65% |
| EBITDA Growth % | 39.05% | 9.82% | -38.01% | -28.02% | 13.86% | 366.02% | -186.68% | -66.86% | -4.52% | -5.44% | 17.66% | 29.01% | -15.9% | 10.31% | -13.17% | 14.49% | -3.9% | -12.62% | -6.94% | -10.58% | 9.52% | 9.83% | 12.09% | 26.85% | -20.54% | 29.06% | 16.51% | -53.38% | -6.05% | 3.58% | 488.89% |
| D&A (Non-Cash Add-back) | 5.56M | 5.71M | 6.17M | 5.17M | 5.12M | 5.28M | 6.97M | 7.41M | 6.82M | 6.68M | 6.33M | 6.19M | 6.38M | 6.41M | 6.1M | 6.27M | 6M | 6.49M | 6.71M | 6.11M | 5.96M | 5.5M | 4.89M | 4.31M | 3.53M | 3M | 2.36M | 1.62M | 6.09M | 6.75M | 7M |
| EBIT | -1.77M | -2.01M | 2.74M | 1.81M | 3.32M | 1.69M | -8.4M | 2.86M | 3.49M | 4.34M | 4.99M | 3.22M | 1.27M | 2.92M | 3.08M | 4.06M | 3.08M | 2.78M | 4.3M | 2.68M | 9.73M | 3.47M | 3.28M | 2.98M | 2.22M | 4.23M | 3.25M | 3.3M | 4.3M | 4.23M | 3.6M |
| Net Interest Income | -1.44M | -1.57M | -1.25M | -686K | -719K | -742K | -1.05M | -1.3M | -1.43M | -1.92M | -1.69M | -1.22M | -1.67M | -1.77M | -2.1M | -2.23M | -2M | -2M | -2.03M | -1.62M | -1.85M | -1.87M | -2.16M | -2.43M | -2.27M | -1.98M | -1.31M | 0 | -3.13M | 0 | -4.2M |
| Interest Income | 0 | 0 | 248K | 426K | 87K | 0 | 10K | 16K | 198K | 3K | 15K | 18K | 28K | 25K | 58K | 108K | 107K | 60K | 404K | 328K | 308K | 202K | 102K | 121K | 171K | 480K | 804K | 0 | 54K | 0 | 0 |
| Interest Expense | 1.44M | 1.57M | 1.5M | 1.11M | 806K | 742K | 1.06M | 1.32M | 1.63M | 1.93M | 1.71M | 1.24M | 1.7M | 1.8M | 2.15M | 2.37M | 2.1M | 2.06M | 2.44M | 1.95M | 2.16M | 2.08M | 2.26M | 2.55M | 2.44M | 2.46M | 2.12M | 0 | 3.19M | 0 | 4.2M |
| Other Income/Expense | -1.08M | -1.21M | 4.04M | 426K | 87K | -404K | 10K | 16K | 220K | -576K | -93K | -2.12M | -383K | -1.15M | -1.97M | -2.26M | 107K | -2.35M | -2.03M | -806K | -1.01M | -924K | -881K | -807K | -660K | -2.73M | -1.93M | -1.3M | 17.38M | -2.69M | 200K |
| Pretax Income | -2.85M | -3.22M | 1.24M | 696K | 2.52M | 947K | -9.45M | 1.56M | 2.08M | 1.84M | 3.19M | -142K | -433K | -29K | 920K | 1.7M | 972K | 713K | 1.01M | 1.87M | 2.86M | 2.55M | 2.4M | 2.17M | 1.56M | 1.5M | 1.31M | 1.99M | 21.56M | 1.53M | 3.8M |
| Pretax Margin % | -9.83% | -11.47% | 4.36% | 3.26% | 12.75% | 5.37% | -53% | 7.56% | 10.56% | 9.39% | 17.07% | -0.86% | -2.81% | -0.16% | 5.4% | 7.64% | 5.83% | 4.25% | 5.29% | 8.27% | 14.02% | 13.97% | 14.63% | 13.41% | 11.65% | 12.77% | 14.05% | 27.82% | 61.33% | 4.12% | 10.27% |
| Income Tax | -78K | -493K | -295K | 431K | 963K | 269K | -1.74M | 128K | 451K | -1.1M | 943K | 434K | 129K | 84K | 107K | 208K | 166K | 247K | 534K | 919K | 1.2M | 780K | 412K | 787K | 455K | 433K | 0 | -716K | 1.51M | 10K | 4M |
| Effective Tax Rate % | 2.73% | 15.31% | -23.85% | 61.93% | 38.24% | 28.41% | 18.38% | 8.22% | 21.67% | -60.04% | 29.53% | -305.63% | -29.79% | -289.66% | 11.63% | 12.26% | 17.08% | 34.64% | 52.82% | 49.14% | 42.06% | 30.62% | 17.19% | 36.28% | 29.22% | 28.85% | 0% | -35.96% | 7.02% | 0.65% | 105.26% |
| Net Income | -1.54M | -1.55M | 2.19M | 610K | 1.33M | 194K | -7.06M | 659K | 1.02M | 1.92M | 930K | -1.52M | -952K | -312K | 38K | 506K | 57K | -188K | 477K | 951K | 1.66M | 1.77M | 1.99M | 1.38M | 1.1M | 1.07M | 1.31M | 2.71M | 20.05M | 1.52M | -400K |
| Net Margin % | -5.3% | -5.53% | 7.71% | 2.86% | 6.73% | 1.1% | -39.57% | 3.2% | 5.19% | 9.83% | 4.97% | -9.2% | -6.17% | -1.77% | 0.22% | 2.28% | 0.34% | -1.12% | 2.5% | 4.2% | 8.12% | 9.69% | 12.11% | 8.54% | 8.24% | 9.08% | 14.05% | 37.83% | 57.02% | 4.09% | -1.08% |
| Net Income Growth % | -206.8% | -171.04% | 258.36% | -54.07% | 584.54% | 102.75% | -1171.02% | -35.58% | -46.8% | 106.77% | 161.1% | -59.87% | -205.13% | -921.05% | -92.49% | 787.72% | 130.32% | -139.41% | -49.84% | -42.57% | -6.28% | -10.98% | 43.63% | 25.41% | 3.18% | -18.6% | -51.53% | -86.5% | 1217.41% | 480.5% | -105.48% |
| Net Income (Continuing) | -2.78M | -2.73M | 1.53M | 265K | 1.55M | 678K | -7.72M | 1.43M | 1.63M | 2.94M | 2.25M | -576K | -562K | -113K | 813K | 1.49M | 806K | 466K | 1.33M | 951K | 1.66M | 1.77M | 1.99M | 1.38M | 1.1M | 1.07M | 1.31M | 2.7M | 20.1M | 1.52M | -400K |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 3.18M | 3.66M | 4.84M | 3.65M | 4M | 4.35M | 4.38M | 5.78M | 5.95M | 6.03M | 5.68M | 5.05M | 4.73M | 4.43M | 4.9M | 4.97M | 3.47M | 3.35M | 3.21M | 3.15M | 3.04M | 2.53M | 2.31M | 1.73M | 1.45M | 1.17M | 1.16M | 890K | 731K | 588K | 600K |
| EPS (Diluted) | -0.23 | -0.23 | 0.33 | 0.10 | 0.21 | 0.03 | -1.14 | 0.24 | 0.17 | 0.33 | 0.17 | -0.28 | -0.19 | -0.07 | 0.01 | 0.11 | 0.01 | -0.04 | 0.10 | 0.19 | 0.33 | 0.35 | 0.39 | 0.27 | 0.22 | 0.21 | 0.24 | 0.48 | 3.15 | 0.24 | -0.08 |
| EPS Growth % | -200.84% | -169.7% | 245.91% | -54.57% | 556.25% | 102.81% | -575% | 41.18% | -48.48% | 94.12% | 160.71% | -47.37% | -171.43% | -800% | -90.91% | 1000% | 125% | -140% | -47.37% | -42.42% | -5.71% | -10.26% | 44.44% | 22.73% | 4.76% | -12.5% | -50% | -84.76% | 1212.5% | 400% | -104.57% |
| EPS (Basic) | - | -0.23 | 0.34 | 0.10 | 0.21 | 0.03 | -1.14 | 0.24 | 0.18 | 0.33 | 0.17 | -0.28 | -0.19 | -0.07 | 0.01 | 0.11 | 0.01 | -0.04 | 0.10 | 0.19 | 0.33 | 0.36 | 0.46 | 0.36 | 0.30 | 0.30 | 0.34 | 0.68 | 4.23 | 0.32 | -0.08 |
| Diluted Shares Outstanding | 6.72M | 6.62M | 6.7M | 6.39M | 6.3M | 6.06M | 6.18M | 5.93M | 6.02M | 5.83M | 5.47M | 5.44M | 5.01M | 4.46M | 4.61M | 4.62M | 4.61M | 4.7M | 4.99M | 5.01M | 5.02M | 5.05M | 5.09M | 4.8M | 4.85M | 3.56M | 3.86M | 3.97M | 4.77M | 6.31M | 5M |
| Basic Shares Outstanding | 6.72M | 6.62M | 6.5M | 6.36M | 6.3M | 6.04M | 6.18M | 5.92M | 5.84M | 5.75M | 5.47M | 5.44M | 5.01M | 4.46M | 4.61M | 4.61M | 4.6M | 4.7M | 4.99M | 5.01M | 5.02M | 4.91M | 4.32M | 3.84M | 3.67M | 3.56M | 3.86M | 3.97M | 4.75M | 4.76M | 5M |
| Dividend Payout Ratio | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | 75.18% | 57.61% | 51.05% | 35.21% | 44.14% | 39.75% | 33.8% | - | - | - | - | - |
Operational leverage and utilization
According to the provided quarterly income statements, AMS has experienced erratic top-line performance, with revenue fluctuating between $5.2M and $9.1M over the last ten quarters, ultimately failing to establish a consistent growth trajectory despite the recent 15.9% year-over-year increase observed in the 2026Q1 reporting period.
The revenue profile appears highly sensitive to the timing of project-based PBRT installations rather than steady-state procedure growth. Investors should monitor whether the recent uptick in revenue can be sustained or if it merely reflects lumpy, non-recurring project recognition that masks underlying weakness in the legacy Gamma Knife business.
As reported in the company's financial filings, gross margins have experienced a significant contraction, falling from a peak of 49.4% in 2023Q4 to just 18.2% in 2026Q1, reflecting the increasing difficulty of maintaining profitability amidst rising maintenance and equipment service costs.
This sharp decline suggests that the company's fee-per-use model is struggling to absorb inflationary pressures in technical service and parts. The inability to maintain historical margin levels indicates a potential lack of pricing power, which warrants further investigation into the long-term viability of current contract structures.
Based on the income statement data, AMS demonstrates a persistent inability to achieve positive operating leverage, as evidenced by the negative operating margin of -8.8% in 2026Q1, which highlights that corporate overhead continues to outpace the company's ability to scale its clinical partnership revenue.
The high fixed-cost nature of the medical equipment fleet means that even minor fluctuations in procedure volume lead to outsized impacts on operating income. Without a significant increase in fleet utilization, the company appears trapped in a cycle where revenue growth is insufficient to cover the necessary corporate and technical support infrastructure.
Data from recent quarterly reports suggests that the company's reliance on a capital-intensive, low-margin service model may be unsustainable, as net income has remained negative in four of the last five quarters, raising concerns about the long-term durability of the current clinical partnership strategy.
Short-term observers may focus on the persistent net losses and the potential for future impairment of aging equipment assets. The company's reliance on joint ventures and the associated non-controlling interests complicates the assessment of true economic profitability, suggesting that investors should be cautious regarding the quality of reported earnings.
Quick answers to the most common questions about buying AMS stock.
For fiscal year 2025, American Shared Hospital Services (AMS) reported total revenue of $28.1M. This represents a 24.1% decline compared to $37.0M in 1996.
American Shared Hospital Services (AMS) reported a net loss of $1.6M for the fiscal year ending 2025.
American Shared Hospital Services (AMS) reported an operating income of $-2.0M, resulting in an operating profit margin of -7.2%. This margin reflects the operational efficiency of the business before interest and taxes.
American Shared Hospital Services (AMS) generated $5.0M in gross profit for the year, representing a gross profit margin of 18.0%. This demonstrates the company's core pricing power and production efficiency.