Q3 2026 free cash flow margin reached 20.8% ($85.7M) on 6.46x OCF/NI conversion, but this coincides with capital expenditure falling to 2.5% of revenue from 7.1-7.8% in mid-2024, leaving $37.1M of D&A outrunning reinvestment by roughly $27M per quarter.
Integra LifeSciences Holdings Corporation (IART) cash flow statement — 30-year operating, investing & financing cash flows
| 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 |
|---|
| Cash from Operations | 140.4M | 50.38M | 129.38M | 139.96M | 264.47M | 312.43M | 203.83M | 231.43M | 199.68M | 114.54M | 116.41M | 94.48M | 79.46M | 53.27M | 58.72M | 104.33M | 105.57M | 143.24M | 72.59M | 47.03M | 71.7M | 56.85M | 38.98M | 34.83M | 31.98M | 15.7M | -4.96M | 2.5M | -9.8M | -7.9M | -8M |
| Operating CF Margin % | - | 3.08% | 8.03% | 9.08% | 16.98% | 20.26% | 14.86% | 15.25% | 13.56% | 9.64% | 11.73% | 10.7% | 8.56% | 6.37% | 7.07% | 13.37% | 14.42% | 20.99% | 11.09% | 8.54% | 17.1% | 20.45% | 16.96% | 18.76% | 28.4% | 16.8% | -7.63% | 5.88% | -56% | -53.74% | -61.07% |
| Operating CF Growth % | 400.66% | -61.06% | -7.55% | -47.08% | -15.35% | 53.28% | -11.93% | 15.9% | 74.33% | -1.6% | 23.2% | 18.9% | 49.18% | -9.28% | -43.72% | -1.18% | -26.3% | 97.32% | 54.36% | -34.41% | 26.13% | 45.86% | 11.91% | 8.88% | 103.71% | 416.55% | -298.4% | 125.51% | -24.05% | 1.25% | -42.86% |
| Net Income | 13.01M | -516.47M | -6.94M | 67.74M | 180.55M | 169.07M | 133.89M | 50.2M | 60.8M | 64.74M | 74.56M | 6.85M | 34M | -16.98M | 41.2M | 27.99M | 65.67M | 50.95M | 34.93M | 33.47M | 29.41M | 37.19M | 17.2M | 26.86M | 35.28M | 26.16M | -10.96M | -6M | -12.3M | -17M | -7.5M |
| Depreciation & Amortization | 152.13M | 151.83M | 140.89M | 123.51M | 118.3M | 119.84M | 116.03M | 109.46M | 110.73M | 88.94M | 72.67M | 58.86M | 61.13M | 47.01M | 52.61M | 50.17M | 39.17M | 39.69M | 33.15M | 27.04M | 21.48M | 13.22M | 11.59M | 9.04M | 7.16M | 6.26M | 5.18M | 2.2M | 1.3M | 1.8M | 2M |
| Stock-Based Compensation | 5.84M | 18.58M | 24.38M | 20.14M | 27.73M | 36.21M | 19.59M | 21.25M | 20.78M | 21.55M | 17.31M | 15.45M | 15.11M | 10.39M | 9.05M | 26.8M | 17.21M | 15.58M | -1.22M | -1.22M | -1.33M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Deferred Taxes | -10.95M | -66.26M | -20.73M | -11.88M | -4.58M | -2.75M | -64.14M | -19.05M | -8.18M | -67.3M | -6.47M | -351K | -964K | -10.83M | 1.54M | 1.16M | 4.13M | 548K | -28.28M | -12.72M | 3.23M | 9.89M | 6.1M | 12.36M | -13.4M | -12.09M | 0 | -1.8M | 0 | 0 | 0 |
| Other Non-Cash Items | -41.61M | 496.44M | 22.79M | 22.02M | -18.1M | -28.1M | 39.77M | 84.07M | 13.81M | 7.93M | -30.43M | 30.57M | 9.52M | 57.53M | -21.69M | 13.29M | -1.57M | 6.68M | 57.53M | 20.67M | 21.08M | 1.43M | 24.27M | 1.2M | 2.52M | 443K | 11.84M | 100K | 100K | 6.7M | -800K |
| Working Capital Changes | 21.84M | -33.74M | -31.01M | -81.57M | -39.42M | 18.16M | -41.31M | -14.51M | 1.75M | -1.32M | -11.23M | -16.9M | -39.33M | -33.86M | -23.99M | -15.09M | -19.04M | 29.78M | -23.52M | -20.21M | -2.16M | -4.89M | -20.18M | -14.64M | 431K | -5.08M | -11.03M | 11.6M | 1.1M | 600K | -1.7M |
| Change in Receivables | 1.51M | -485K | 7.4M | 4.59M | -33.91M | 7.26M | 52.1M | -9.43M | -17.02M | -89.7M | -17.52M | -16.23M | -16.14M | -2.89M | 3.78M | -1.88M | -3.78M | 9.81M | -2.84M | -2.84M | -26.13M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Change in Inventory | 20.79M | -46.76M | -28.15M | -59.77M | -29.12M | 5.37M | -48.35M | -43.31M | 8.3M | 99K | -9.58M | -3.76M | -27.01M | -42.02M | -711K | 1.7M | -7.37M | 9.4M | 10.82M | -18.59M | 3.46M | -9.98M | -9.74M | -1.83M | 1.15M | -6.99M | -3.06M | 2.8M | 500K | 300K | -1.3M |
| Change in Payables | 18.87M | 26.72M | -2.67M | -20.23M | 17.34M | 32.87M | -57.51M | 14.67M | 3.59M | 95.32M | -414K | 1.63M | 2.43M | 9.95M | -21.07M | -11.84M | 6.74M | 4.55M | 118K | 118K | 14.01M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Investing | -103.28M | -108.06M | -390.81M | -94.18M | -58.58M | -161.44M | -68.07M | -162.67M | -49.7M | -1.22B | -42.62M | -372.01M | -363.32M | -50.3M | -79.28M | -190.38M | -42.32M | -88.35M | -100.28M | -122.97M | -142.69M | -30.84M | 12.74M | -94.33M | -30.98M | -94.74M | -14.5M | 400K | 9.2M | -2.2M | -21.3M |
| Capital Expenditures | -27.46M | -81.44M | -104.42M | -66.86M | -47.09M | -48.02M | -63.89M | -69.54M | -77.74M | -43.5M | -47.33M | -33.41M | -42.4M | -47.85M | -69.03M | -38.42M | -37.14M | -27.57M | -13.4M | -22.57M | -11.52M | -8.05M | -8.51M | -3.84M | -2.25M | -2.86M | -3.27M | -17.3M | -1.2M | -800K | -1.2M |
| CapEx % of Revenue | 1.66% | 4.98% | 6.48% | 4.34% | 3.02% | 3.11% | 4.66% | 4.58% | 5.28% | 3.66% | 4.77% | 3.79% | 4.57% | 5.72% | 8.31% | 4.93% | 5.07% | 4.04% | 2.05% | 4.1% | 2.75% | 2.9% | 3.7% | 2.07% | 2% | 3.06% | 5.03% | 40.71% | 6.86% | 5.44% | 9.16% |
| Acquisitions | 0 | 0 | -277.81M | 0 | -27.55M | -113.44M | 3.66M | -30.51M | 26.7M | -1.2B | 225K | -328.89M | -320.92M | -2.98M | -7.28M | -151.95M | -5.18M | -60.78M | -86.87M | -100.81M | -228.66M | -50.6M | -29.3M | -50.41M | -25.02M | -6.35M | -16.19M | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -41.36M | -14.2M | -14.08M | 0 | 16.05M | -55K | 3.66M | -64.21M | 1.33M | 483K | 4.48M | -9.71M | -4.06M | 535K | -10.24M | 0 | 0 | -2.33M | 411K | 411K | 689K | 0 | 0 | -1.5M | 0 | 0 | 1.36M | 6.4M | 1.2M | 200K | 300K |
| Cash from Financing | -15.23M | 28.34M | 237.86M | -229.93M | -251.95M | -98.23M | 121.63M | -8.77M | -180.87M | 1.17B | -15.12M | 258.51M | 242.78M | 19.02M | 12.13M | 60.14M | -1.57M | -171.34M | 153.54M | 108.48M | 45.64M | -48.34M | -8.12M | 94.67M | -2.04M | 109.46M | 14.27M | 11.2M | 3.8M | 400K | 36.5M |
| Debt Issued (Net) | -6.33M | 46.75M | 299.37M | 54.5M | -107.8M | -100M | 305.5M | -9.2M | -488.8M | 1.19B | -16.22M | 76.15M | 229.4M | -135M | 7.8M | 161.56M | 16.77M | -178M | 140.44M | 229.96M | 98.47M | -245K | 0 | 115.92M | -3.6M | -13.65M | 893K | -1.12M | 0 | 0 | 0 |
| Equity Issued (Net) | -337K | 736K | -52.47M | -275M | -119.53M | 6.82M | -105.08M | 0 | 349.59M | -7.12M | 0 | 0 | 15.21M | 152.46M | 0 | -83.46M | -31.28M | 0 | 11.5M | -66.09M | -54.16M | -46.96M | -8.12M | -21.25M | 1.56M | 123.11M | 13.41M | 12.36M | 3.81M | 400K | 36.5M |
| Dividends Paid | 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 | -67K | -100K | 0 | 0 | 0 |
| Share Repurchases | -337K | -221K | -52.47M | -275M | -125M | 0 | -100M | 0 | 0 | -7.12M | -4.85M | 0 | 0 | 0 | 0 | -83.46M | -31.28M | 0 | 0 | -106.53M | -70.03M | -56.34M | -14.24M | -35.4M | -1.76M | 0 | -170K | 0 | -286K | 0 | 0 |
| Other Financing | -8.56M | -19.15M | -9.04M | -9.43M | -24.62M | -5.05M | -78.8M | 434K | -41.66M | -13.93M | 1.1M | 172M | -1.83M | 1.56M | 4.33M | -17.96M | 12.93M | 6.66M | 1.59M | -55.38M | 1.33M | -1.13M | 0 | 0 | 0 | 0 | 35K | 42K | 38K | 0 | 0 |
| Net Change in Cash | 19.32M | -11.33M | -30.03M | -180.26M | -56.79M | 43.28M | 271.25M | 60.07M | -36.1M | 72.88M | 53.92M | -23.86M | -48.62M | 23.68M | -3.87M | -27.95M | 56.87M | -111.66M | 126.21M | 34.64M | -24.19M | -22.97M | 43.8M | 35.4M | -935K | 30.43M | -5.21M | 14M | 3.2M | 400K | 36.5M |
| Free Cash Flow | 98.74M | -45.25M | 24.96M | 73.09M | 217.38M | 264.35M | 139.94M | 96.9M | 121.94M | 71.04M | 69.08M | 61.07M | 37.07M | 5.42M | -10.32M | 65.9M | 68.43M | 115.67M | 59.19M | 24.45M | 60.18M | 48.8M | 30.47M | 30.98M | 29.73M | 12.84M | -8.23M | -14.8M | -11M | -8.7M | -9.2M |
| FCF Margin % | 5.96% | -2.77% | 1.55% | 4.74% | 13.96% | 17.14% | 10.2% | 6.39% | 8.28% | 5.98% | 6.96% | 6.92% | 3.99% | 0.65% | -1.24% | 8.45% | 9.35% | 16.95% | 9.04% | 4.44% | 14.35% | 17.56% | 13.26% | 16.69% | 26.4% | 13.74% | -12.66% | -34.82% | -62.86% | -59.18% | -70.23% |
| FCF Growth % | 782.49% | -281.28% | -65.84% | -66.38% | -17.77% | 88.9% | 44.42% | -20.54% | 71.65% | 2.84% | 13.11% | 64.76% | 584.27% | 152.51% | -115.65% | -3.7% | -40.84% | 95.42% | 142.04% | -59.37% | 23.34% | 60.16% | -1.67% | 4.21% | 131.53% | 256.06% | 44.41% | -34.55% | -26.44% | 5.43% | -8.24% |
| FCF per Share | 1.26 | -0.59 | 0.32 | 0.91 | 2.60 | 3.09 | 1.64 | 1.12 | 1.44 | 0.90 | 0.87 | 0.83 | 0.56 | 0.09 | -0.18 | 1.12 | 1.13 | 1.97 | 1.04 | 0.41 | 0.92 | 0.71 | 0.49 | 0.47 | 0.48 | 0.23 | -0.23 | -0.43 | -0.34 | -0.29 | -0.33 |
| FCF Conversion (FCF/Net Income) | 7.59x | -0.10x | -18.63x | 2.07x | 1.46x | 1.85x | 1.52x | 4.61x | 3.28x | 1.77x | 1.56x | -26.85x | 2.34x | -3.14x | 1.42x | 3.73x | 1.61x | 2.81x | 2.08x | 1.40x | 2.44x | 1.53x | 2.27x | 1.30x | 0.91x | 0.60x | 0.43x | -0.42x | 0.80x | 0.46x | 1.07x |
| Interest Paid | 0 | 0 | 64.4M | 44.3M | 42.2M | 43.2M | 47.3K | 48.9K | 58.3K | 32.3K | 57.2K | 12.7K | 10.9K | 9.5K | 12K | 13.2K | 0 | 11.34M | 17.26M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 22.7M | 23.6M | 35.9M | 49.5M | 29.8K | 16.2K | 10.4K | 14.6K | 4.3K | 21.3K | 6.8K | 3.7K | 12.7K | 14.5K | 0 | 20.53M | 41.25M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Quick answers to the most common questions about buying IART stock.
Integra LifeSciences Holdings Corporation (IART) generated $50.4M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Integra LifeSciences Holdings Corporation (IART) reported negative free cash flow of $45.3M in 2025, indicating capital requirements exceeded cash from operations.
Integra LifeSciences Holdings Corporation (IART) spent $81.4M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, Integra LifeSciences Holdings Corporation (IART) spent $0.2M on share repurchases. This shows the company's commitment to returning capital to its equity investors.
Key Metrics
Top Statement Risk
Capex collapse masks maintenance shortfall
Metrics are mathematically derived from official filings.
Cash Conversion Diverges Sharply From Earnings
Integra's Q3 2026 OCF/NI ratio of 6.46x reflects $96.0M in operating cash flow against just $14.9M net income, driven by $37.1M in quarterly D&A and prior non-cash impairments — a persistent pattern suggesting reported earnings understate underlying cash generation but also that GAAP losses reflect real write-downs, not operational failure.
The sustained gap between net income and operating cash flow across all ten quarters — cumulative OCF of roughly $292M versus cumulative net losses exceeding $500M — is dominated by non-cash charges including the $484M impairment recognized in Q2 2025 and steady D&A exceeding $37M per quarter. While this suggests the core business remains cash-generative despite accounting losses, the volatility in OCF (ranging from -$11.3M in Q1 2025 to $96M in Q3 2026) indicates earnings quality is unstable and heavily influenced by working capital swings rather than consistent operational profitability.
Free Cash Flow Recovers but Lacks Durability
IART's FCF margin improved to 20.8% in Q3 2026 ($85.7M on ~$411M revenue) from -1.3% in Q1 2026, yet this improvement coincides with a sharp decline in capital expenditure rather than sustained operating momentum, making the recovery appear structurally fragile.
The recent FCF surge appears to be a function of both working capital release ($37.2M source in Q3) and a collapse in capex spending rather than a step-change in operating profitability. With operating margin at just 4.2% and revenue growth decelerating to 2.3%, the company cannot sustain 20%+ FCF margins without either restoring top-line momentum or accepting that reduced investment is masking underlying operating weakness.
Capital Intensity Halves Amid Quality Concerns
IART's capex-to-revenue ratio fell from 7.1-7.8% in mid-2024 to just 2.5% in Q3 2026, representing a roughly 60% decline in absolute quarterly capital spending from ~$30M to ~$10M — an aggressive reduction that warrants scrutiny given the company's ongoing manufacturing remediation obligations.
Quarterly capex declined from $29.7M in Q2 2024 to $10.2M in Q3 2026, a trajectory that appears difficult to reconcile with the operational narrative of remediating quality issues at facilities like Boston and Cincinnati. The D&A-to-capex ratio has widened to 3.6x in Q3 2026 from approximately 1.2x in Q2 2024, suggesting the company is not replacing depreciating assets at the rate they are wearing out — a dynamic that could compound the very manufacturing vulnerabilities that have driven recent production disruptions.
Five-Hundred-Million Dollar Earnings Hole
Cumulative net losses of approximately $505M over the trailing ten quarters stand against cumulative operating cash flow of roughly $292M, producing a $798M divergence driven primarily by the Q2 2025 impairment and subsequent non-cash reversals — a gap large enough that trailing valuation multiples remain unreliable.
The Q2 2025 impairment ($484.1M net loss) followed by the Q4 2025 operating gain reported in prior analysis creates a distorted baseline where any rolling four-quarter comparison will be contaminated by non-recurring charges. Investors should focus exclusively on post-Q4 2025 periods, where cumulative OCF of approximately $128.6M against cumulative NI of approximately $14.8M better reflects the current operating reality, though even this window is influenced by large working capital swings that may not repeat.
Cash Flow Statement Obscures Investment Deficit
The apparent cash flow strength in recent quarters is partially an artifact of underinvestment: D&A of $37.1M in Q3 2026 versus capex of just $10.2M implies the company consumed $27M more in asset depreciation than it reinvested, a pattern that may not be sustainable for a manufacturer dependent on specialized tissue-processing facilities.
Additionally, the absence of dividends and near-zero buybacks across all ten quarters means free cash flow is not being returned to shareholders or deployed into acquisitions (post the $282M Codman-related outflow in Q2 2024), suggesting management is prioritizing balance sheet repair or debt reduction — neither of which is explicitly visible in this cash flow data. The erratic working capital movements, swinging from a $30.6M use in Q1 2026 to a $37.2M source in Q3 2026, warrant investigation into whether inventory builds or receivables timing distort quarterly OCF in ways that mask the true operating trajectory.