Revenue reached $212.9 million in 2025Q4, though gross margins have experienced volatility, compressing to 61.2% from historical levels near 70%.
| 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 |
|---|
| Sales/Revenue | 594.98M | 764.15M | 611.56M | 482.26M | 350.87M | 243.21M | 144.86M | 113.43M | 91.69M | 101.74M | 120.25M | 185.28M | 206.98M | 204.72M | 196.28M | 197.71M | 171.61M | 132.16M | 101.31M | 80.03M | 74M | 42.33M | 17.82M |
| Revenue Growth % | -7.36% | 24.95% | 26.81% | 37.45% | 44.26% | 67.89% | 27.71% | 23.7% | -9.87% | -15.39% | -35.1% | -10.48% | 1.1% | 4.3% | -0.72% | 15.21% | 29.85% | 30.44% | 26.59% | 8.14% | 74.85% | 137.5% | - |
| Cost of Goods Sold | 198.18M | 232.27M | 187.3M | 172.06M | 117.81M | 85.45M | 42.36M | 35.83M | 28.46M | 39.41M | 44.11M | 63.74M | 61.83M | 78.67M | 70.76M | 80.78M | 58.79M | 48.02M | 36.6M | 29.82M | 25.7M | 17.72M | 5.46M |
| COGS % of Revenue | - | 30.4% | 30.63% | 35.68% | 33.58% | 35.13% | 29.24% | 31.59% | 31.03% | 38.73% | 36.69% | 34.4% | 29.87% | 38.43% | 36.05% | 40.86% | 34.26% | 36.33% | 36.13% | 37.27% | 34.73% | 41.87% | 30.64% |
| Gross Profit | 533.27M | 531.89M | 424.26M | 310.2M | 233.06M | 157.76M | 102.5M | 77.59M | 63.24M | 62.33M | 76.13M | 121.54M | 145.15M | 126.06M | 125.52M | 116.93M | 112.82M | 84.14M | 64.71M | 50.21M | 48.3M | 24.6M | 12.36M |
| Gross Margin % | 89.63% | 69.6% | 69.37% | 64.32% | 66.42% | 64.87% | 70.76% | 68.41% | 68.97% | 61.27% | 63.31% | 65.6% | 70.13% | 61.57% | 63.95% | 59.14% | 65.74% | 63.67% | 63.87% | 62.73% | 65.27% | 58.13% | 69.36% |
| Gross Profit Growth % | - | 25.37% | 36.77% | 33.1% | 47.73% | 53.91% | 32.1% | 22.7% | 1.45% | -18.13% | -37.36% | -16.27% | 15.14% | 0.43% | 7.34% | 3.65% | 34.08% | 30.03% | 28.88% | 3.94% | 96.33% | 99.04% | - |
| Operating Expenses | 590.23M | 614.02M | 560.43M | 483.6M | 380.03M | 285.82M | 161.36M | 124.87M | 83.23M | 69.99M | 87.48M | 127.62M | 142.6M | 143.84M | 134.27M | 130.6M | 122.22M | 87.31M | 89.76M | 60.55M | 70.42M | 39.65M | 12.18M |
| OpEx % of Revenue | - | 80.35% | 91.64% | 100.28% | 108.31% | 117.52% | 111.39% | 110.09% | 90.77% | 68.79% | 72.75% | 68.88% | 68.89% | 70.26% | 68.41% | 66.05% | 71.22% | 66.07% | 88.6% | 75.66% | 95.15% | 93.67% | 68.36% |
| Selling, General & Admin | 493.34M | 498.53M | 450.2M | 374.08M | 300.01M | 229.27M | 129.16M | 101.71M | 72.51M | 64.38M | 77.3M | 105.72M | 120.56M | 124.91M | 115.12M | 111.56M | 101.29M | 73.83M | 65.8M | 54.19M | 66.83M | 35.58M | 11.01M |
| SG&A % of Revenue | - | 65.24% | 73.61% | 77.57% | 85.51% | 94.27% | 89.16% | 89.67% | 79.08% | 63.28% | 64.28% | 57.06% | 58.25% | 61.01% | 58.65% | 56.42% | 59.02% | 55.86% | 64.95% | 67.71% | 90.3% | 84.06% | 61.76% |
| Research & Development | 77.25M | 76.27M | 80.72M | 70.11M | 44.03M | 32.02M | 18.75M | 13.85M | 9.98M | 4.92M | 9.25M | 18.04M | 17.33M | 14.19M | 15.23M | 16.89M | 19.4M | 13.49M | 12.96M | 6.36M | 3.59M | 4.07M | 1.18M |
| R&D % of Revenue | - | 9.98% | 13.2% | 14.54% | 12.55% | 13.16% | 12.94% | 12.21% | 10.89% | 4.84% | 7.69% | 9.74% | 8.37% | 6.93% | 7.76% | 8.54% | 11.3% | 10.21% | 12.8% | 7.95% | 4.85% | 9.61% | 6.6% |
| Other Operating Expenses | 3M | 39.22M | 29.51M | 39.4M | 35.99M | 24.53M | 13.46M | 9.31M | 738K | 0 | -715K | 6.98M | -33K | -1.66M | -794K | 2.15M | 1.53M | 0 | 0 | 0 | 0 | 0 | 0 |
| Operating Income | -56.96M | -82.13M | -136.17M | -173.4M | -146.97M | -128.06M | -58.86M | -47.28M | -22.44M | -9M | -15.38M | -172.44M | 1.84M | -73.43M | -9.84M | -24.52M | -11.79M | -9.56M | -27.81M | -19.69M | -22.11M | -15.04M | 177.81K |
| Operating Margin % | -9.57% | -10.75% | -22.27% | -35.95% | -41.89% | -52.65% | -40.63% | -41.68% | -24.47% | -8.85% | -12.79% | -93.07% | 0.89% | -35.87% | -5.01% | -12.4% | -6.87% | -7.23% | -27.45% | -24.6% | -29.88% | -35.54% | 1% |
| Operating Income Growth % | - | 39.69% | 21.47% | -17.98% | -14.77% | -117.55% | -24.51% | -110.68% | -149.25% | 41.45% | 91.08% | -9451.36% | 102.51% | -646.5% | 59.88% | -107.96% | -23.35% | 65.63% | -41.25% | 10.98% | -47% | -8560.46% | - |
| EBITDA | 4.42M | 435K | -52.85M | -113.71M | -103.05M | -97.88M | -47.23M | -38.77M | -15.65M | -1.52M | -3.01M | -168.59M | 6.55M | -68.69M | -5.91M | -22.36M | -10.25M | 2.4M | -19.07M | -9.06M | -13.1M | -11.5M | 811.66K |
| EBITDA Margin % | 0.74% | 0.06% | -8.64% | -23.58% | -29.37% | -40.25% | -32.6% | -34.18% | -17.07% | -1.5% | -2.51% | -90.99% | 3.17% | -33.55% | -3.01% | -11.31% | -5.98% | 1.82% | -18.83% | -11.33% | -17.7% | -27.18% | 4.55% |
| EBITDA Growth % | 106.07% | 100.82% | 53.52% | -10.35% | -5.28% | -107.24% | -21.83% | -147.7% | -928.32% | 49.49% | 98.21% | -2672.26% | 109.54% | -1062.68% | 73.58% | -118.1% | -527.43% | 112.58% | -110.42% | 30.8% | -13.87% | -1517.24% | - |
| D&A (Non-Cash Add-back) | 61.38M | 82.56M | 83.32M | 59.68M | 43.93M | 30.17M | 11.63M | 8.51M | 6.79M | 7.48M | 12.36M | 3.85M | 4.71M | 4.74M | 3.93M | 2.15M | 1.53M | 11.96M | 8.73M | 10.62M | 9.02M | 3.54M | 633.85K |
| EBIT | -83.64M | -122.26M | -137.19M | -170.27M | -146.5M | -137.05M | -66.47M | -47.28M | -23.03M | 3.04M | -25.57M | -168.4M | 3.33M | -75.09M | -10.51M | -23.66M | -10.54M | -9.92M | -26.95M | -18.74M | -22.11M | -15.04M | 917.09K |
| Net Interest Income | -30.37M | -21.14M | -24.88M | -16.64M | -5.5M | -7.11M | -12.37M | -9.87M | -7.14M | -7.62M | -5.37M | -3.99M | -3.01M | -3.95M | -5.99M | -2.88M | -5.87M | -3.4M | -1.5M | -75K | -1.43M | -1.93M | -311.51K |
| Interest Income | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 9.87M | 0 | 0 | 0 | 11K | 10K | 6K | 118K | 148K | 81K | 67K | 374K | 793K | 701K | 0 | 0 |
| Interest Expense | 25.42M | 21.14M | 24.88M | 16.64M | 5.5M | 7.11M | 12.37M | 0 | 7.14M | 7.62M | 5.37M | 4M | 3.02M | 3.96M | 6.11M | 3.03M | 4.7M | 3.49M | 1.88M | 868K | 2.13M | 1.93M | 311.51K |
| Other Income/Expense | -68.33M | -61.27M | -25.9M | -13.52M | -5.03M | -16.11M | -19.99M | -9.87M | -7.73M | 4.43M | -15.56M | 3.46M | -13.28M | -5.62M | -1.16M | -4.51M | -2.05M | -9.87M | -1.01M | 74K | -3.43M | -2.05M | 427.77K |
| Pretax Income | -125.29M | -143.4M | -162.07M | -186.91M | -152.01M | -144.16M | -78.85M | -57.14M | -30.17M | -4.57M | -30.93M | -178M | -11.79M | -79.05M | -16.62M | -26.69M | -16.49M | -13.05M | -28.82M | -19.61M | -25.55M | -17.09M | 605.58K |
| Pretax Margin % | -21.06% | -18.77% | -26.5% | -38.76% | -43.32% | -59.27% | -54.43% | -50.38% | -32.9% | -4.5% | -25.73% | -96.07% | -5.7% | -38.61% | -8.47% | -13.5% | -9.61% | -9.87% | -28.45% | -24.51% | -34.52% | -40.38% | 3.4% |
| Income Tax | 69K | -45K | 50K | -277K | -716K | -1.13M | 145K | -239K | -1.36M | -34K | -4.49M | 681K | 1.09M | 3.18M | -1.16M | -4.51M | -2.05M | 243K | 468K | 590K | 270K | -3.04M | 96.13K |
| Effective Tax Rate % | -0.06% | 0.03% | -0.03% | 0.15% | 0.47% | 0.78% | -0.18% | 0.42% | 4.51% | 0.74% | 14.51% | -0.38% | -9.22% | -4.02% | 6.97% | 16.89% | 12.46% | -1.86% | -1.62% | -3.01% | -1.06% | 17.77% | 15.87% |
| Net Income | -125.36M | -143.36M | -162.12M | -186.64M | -151.29M | -143.03M | -78.99M | -57M | -28.98M | -2.29M | -30.32M | -178.68M | -12.88M | -82.23M | -15.46M | -22.18M | -14.36M | -13.29M | -29.29M | -20.2M | -25.82M | -14.05M | 509.45K |
| Net Margin % | -21.07% | -18.76% | -26.51% | -38.7% | -43.12% | -58.81% | -54.53% | -50.25% | -31.6% | -2.25% | -25.21% | -96.44% | -6.22% | -40.16% | -7.88% | -11.22% | -8.36% | -10.06% | -28.91% | -25.24% | -34.88% | -33.2% | 2.86% |
| Net Income Growth % | 24.27% | 11.57% | 13.14% | -23.36% | -5.78% | -81.07% | -38.58% | -96.73% | -1163.08% | 92.43% | 83.03% | -1287.02% | 84.33% | -431.9% | 30.31% | -54.52% | -8.02% | 54.63% | -44.98% | 21.75% | -83.69% | -2858.67% | - |
| Net Income (Continuing) | -125.36M | -143.36M | -162.12M | -186.64M | -151.29M | -143.03M | -78.99M | -56.9M | -28.81M | -4.54M | -26.3M | -171.25M | -98K | -82.23M | -15.46M | -22.18M | -14.43M | -13.29M | -29.29M | -20.2M | -25.82M | -14.05M | 509.45K |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -100K | 0 | 2.25M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2.72M | 1.91M | 0 |
| EPS (Diluted) | -0.81 | -0.96 | -1.13 | -1.54 | -1.47 | -1.50 | -1.18 | -1.09 | -0.82 | -0.17 | -3.53 | -21.53 | -1.58 | -10.25 | -2.06 | -3.00 | -2.19 | -3.24 | -7.59 | -6.50 | -11.37 | -9.27 | 0.60 |
| EPS Growth % | 27.83% | 15.04% | 26.62% | -4.76% | 2% | -27.12% | -8.26% | -32.93% | -382.35% | 95.18% | 83.6% | -1262.66% | 84.59% | -397.57% | 31.33% | -36.99% | 32.41% | 57.31% | -16.77% | 42.83% | -22.65% | -1645% | - |
| EPS (Basic) | - | -0.96 | -1.13 | -1.54 | -1.47 | -1.50 | -1.18 | -1.09 | -0.82 | -0.18 | -3.53 | -21.53 | -1.59 | -10.25 | -2.06 | -3.00 | -2.19 | -3.24 | -7.59 | -6.50 | -11.37 | -9.27 | 0.72 |
| Diluted Shares Outstanding | 154.05M | 150.06M | 142.95M | 121.24M | 103.37M | 96.2M | 67.02M | 52.23M | 35.31M | 13.28M | 8.58M | 8.3M | 8.14M | 8.02M | 7.52M | 7.4M | 6.55M | 4.11M | 3.86M | 3.11M | 2.27M | 1.18M | 801.69K |
| Basic Shares Outstanding | 154.05M | 150.06M | 142.95M | 121.24M | 103.37M | 96.2M | 67.02M | 52.23M | 35.31M | 12.79M | 8.58M | 8.3M | 8.11M | 8.02M | 7.52M | 7.4M | 6.55M | 4.11M | 3.86M | 3.11M | 2.27M | 1.16M | 764.9K |
| Dividend Payout Ratio | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
Persistent operating losses
According to quarterly financial disclosures, ATEC maintained robust top-line momentum with year-over-year revenue growth consistently exceeding 20%, reaching $212.9 million in 2025Q4, which suggests that the company's proceduralization strategy continues to successfully capture market share from legacy spinal implant incumbents despite broader industry headwinds.
The consistent double-digit growth trajectory indicates that the PTP surgical approach is gaining traction among surgeons, effectively driving volume-based revenue. However, investors should monitor whether this growth rate can be sustained as the company scales, given the increasing competitive response from larger, more established medical device entities.
As reported in recent income statements, ATEC's gross margin profile has exhibited notable fluctuations, dipping to 61.2% in 2025Q4 from historical levels near 70%, which may indicate emerging pricing pressures or shifts in the product mix toward lower-margin capital equipment placements within the hospital channel.
While the company historically maintained premium margins through specialized lateral implants, the recent compression warrants investigation into whether hospital group purchasing organizations are exerting greater pricing power. This margin volatility suggests that the company's reliance on high-cost instrument sets may be creating a drag on profitability that is not easily offset by current pricing strategies.
Based on the provided financial data, ATEC continues to struggle with operating leverage, as SG&A expenses remain elevated at $113.5 million in 2025Q4, preventing the company from achieving consistent operating profitability despite the significant scale-up in total revenue observed over the last ten quarters.
The persistent gap between gross profit and operating expenses highlights a heavy reliance on aggressive sales force expansion and commission-heavy compensation models. Until the company can demonstrate a decoupling of revenue growth from SG&A spending, the path to sustainable operating income appears uncertain and highly dependent on future cost discipline.
Analysis of the income statement reveals that stock-based compensation remains a significant non-cash expense, totaling $19.4 million in 2025Q4, which effectively obscures the underlying cash-burn reality and complicates the assessment of the company's true path toward GAAP profitability for prospective equity investors.
The heavy utilization of equity to attract and retain sales talent is a common but dilutive practice in high-growth medtech, which may artificially inflate the reported net loss figures. Investors should carefully adjust for these non-cash items to better understand the operational efficiency of the business model independent of its aggressive talent acquisition strategy.
Quick answers to the most common questions about buying ATEC stock.
For fiscal year 2025, Alphatec Holdings, Inc. (ATEC) reported total revenue of $764.2M. This represents a 4187.9% increase compared to $17.8M in 2004.
Alphatec Holdings, Inc. (ATEC) reported a net loss of $143.4M for the fiscal year ending 2025.
Alphatec Holdings, Inc. (ATEC) reported an operating income of $-82.1M, resulting in an operating profit margin of -10.7%. This margin reflects the operational efficiency of the business before interest and taxes.
Alphatec Holdings, Inc. (ATEC) generated $531.9M in gross profit for the year, representing a gross profit margin of 69.6%. This demonstrates the company's core pricing power and production efficiency.