Cash conversion efficiency has deteriorated, as evidenced by the OCF/NI ratio plummeting to -0.17 in 2026Q1 compared to 1.64 in 2025Q4, despite maintaining a low CapEx/Revenue ratio of 1.0%.
| 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 |
|---|
| Cash from Operations | 70.58M | 74M | 66.2M | 26.77M | -17.89M | -1.98M | -30.26M | -39.41M | 35.8M | 62.94M | 25.83M | 18.81M | 16.8M | -285.48K | -3.38M | -6.66M | -8.16M | -8.56M | -8.14M | -23.67K | -23.65K |
| Operating CF Margin % | - | 17.68% | 18.97% | 8.33% | -6.68% | -0.82% | -12.19% | -13.17% | 9.97% | 19.6% | 10.54% | 10.04% | 14.21% | -0.48% | -12.51% | -85.88% | -1034.07% | - | - | - | - |
| Operating CF Growth % | -16.11% | 11.79% | 147.24% | 249.64% | -802.77% | 93.45% | 23.21% | -210.1% | -43.13% | 143.69% | 37.33% | 11.93% | 5985.59% | 91.57% | 49.21% | 18.3% | 4.65% | -5.15% | -34276.9% | -0.08% | - |
| Net Income | 30.7M | 48.58M | 42M | 67.44M | -19.95M | -12.3M | -49.28M | -25.58M | -29.98M | 64.73M | 11.97M | 29.45M | 6.22M | -4.11M | -7.66M | -10.19M | -11.42M | -11.92M | -17.37M | -38.86K | -16.74K |
| Depreciation & Amortization | 16.5M | 14.88M | 6.04M | 3.43M | 4.05M | 5.18M | 6.86M | 7.58M | 6.92M | 5.76M | 5.46M | 2.73M | 2.13M | 1.69M | 1.85M | 1.78M | 1.11M | 1.09M | 500.26K | 0 | 0 |
| Stock-Based Compensation | 14.7M | 16.4M | 16.93M | 16.96M | 0 | 14.16M | 15.36M | 12.06M | 14.77M | 21.2M | 17.82M | 16.9M | 11.45M | 6.01M | 2.54M | 1.66M | 1.17M | 0 | 0 | 0 | 0 |
| Deferred Taxes | 4.18M | 8.71M | 12.47M | -37.8M | 0 | 0 | 0 | 1.58M | 25.54M | -26.67M | -594K | -7.08M | -11.45M | 404.9K | 1.8M | 10.51M | 599K | -1.4M | 0 | 0 | 0 |
| Other Non-Cash Items | -5.99M | 8.42M | -5.81M | -4.83M | 6.03M | 10.33M | 12.5M | -15M | -53K | -1.55M | 1.67M | 42K | 11.45M | 1.33M | 3.28M | -10.19M | 287.45K | 1.41M | 9.11M | 0 | 0 |
| Working Capital Changes | 3.48M | -22.98M | -5.43M | -18.42M | -8.01M | -19.35M | -15.69M | -20.05M | 18.6M | -523K | -10.5M | -23.23M | -3M | -5.61M | -5.19M | -233.23K | 92.96K | 857.16K | -377.05K | 15.19K | -6.91K |
| Change in Receivables | 9.02M | -26.39M | -2.55M | -12.24M | -5.94M | -10.62M | -3.1M | -10.94M | 16.45M | -479K | -11.4M | -27.08M | -10.58M | -8.44M | -5.76M | -1.21M | -162.38K | 0 | 0 | 0 | 0 |
| Change in Inventory | -2.16M | -1.53M | -2.36M | -7.84M | -1.79M | -1.41M | -1.26M | 6.88M | -6.52M | 2.75M | -2.84M | -2.33M | -1.25M | -857.99K | -2.31M | -253.94K | -80.63K | 0 | 0 | 0 | 0 |
| Change in Payables | 2.6M | 2.12M | -1.41M | 783K | 839K | -159K | 177K | -6.17M | 6.58M | -1.32M | -3.67M | 3.14M | 1.29M | 1.21M | -81.11K | 1.26M | 218.94K | 0 | 0 | 0 | 0 |
| Cash from Investing | -12.12M | -6.89M | -9.58M | -2.15M | -2.66M | -3.4M | -4.55M | 504K | -9.22M | -5.4M | -11.74M | -678K | -12.15M | -3.03M | -582.93K | -702.51K | -151.62K | -356.68K | 593.47K | 0 | 0 |
| Capital Expenditures | -192K | -3.12M | -1.72M | -2.15M | -2.68M | -3.22M | -4.23M | -2.22M | -10.03M | -5.4M | -7.11M | -6.68M | -3.15M | -3.03M | -582.93K | -486.09K | -151.62K | -360.49K | -1.17M | 0 | 0 |
| CapEx % of Revenue | 0.05% | 0.75% | 0.49% | 0.67% | 1% | 1.33% | 1.7% | 0.74% | 2.79% | 1.68% | 2.9% | 3.57% | 2.67% | 5.11% | 2.15% | 6.26% | 19.22% | - | - | - | - |
| Acquisitions | 0 | -3.76M | -7.86M | 0 | 24K | 0 | 0 | 0 | 30K | 0 | -7.63M | -6M | 0 | 0 | 0 | -466.42K | 0 | 0 | 1.73M | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -11.93M | 0 | 0 | 0 | 0 | -177K | -327K | 2.72M | 808K | -271K | -842K | 5.15M | -9.59M | -689K | -582.93K | 250K | -151.62K | 6.58K | 36.69K | 0 | 0 |
| Cash from Financing | -5.12M | -5.41M | -34.2M | -8.57M | -580K | -3.35M | 61.56M | 62.86M | -8.93M | -60.39M | -8.18M | -36.23M | -2.15M | 40.63M | 6.61M | 10.14M | 7M | 2.2M | 3.84M | 17.5K | 30K |
| Debt Issued (Net) | -1.13M | -1M | -31.72M | -52K | -41K | -38K | -25.81M | 70.88M | -3K | -29K | -102K | -117K | -117K | 0 | -427.13K | 6.11M | 500K | 0 | 0 | 0 | 10K |
| Equity Issued (Net) | -2.56M | -3.12M | -2.64M | -8.52M | -539K | -4.75M | 97.67M | -1.47M | -12.49M | -72.34M | -11.54M | -40.28M | -5.61M | 36.6M | 0 | 3.73M | 3.12M | 0 | 2.2M | 2.16K | 20K |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -2.56M | -3.12M | -2.64M | -9.52M | -1.19M | -4.75M | -2.33M | -1.47M | -12.49M | -72.34M | -11.54M | -40.28M | -5.61M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | -1.43M | -1.29M | 159K | 0 | 0 | 1.44M | -10.29M | -6.54M | 3.56M | 11.99M | 3.49M | 4.17M | 3.58M | 4.03M | 7.04M | 295.75K | 3.37M | 2.2M | 6 | 3.83M | 0 |
| Net Change in Cash | 53.34M | 61.7M | 22.42M | 16.05M | -21.13M | -8.73M | 26.74M | 23.95M | 17.64M | -2.85M | 5.91M | -18.1M | 2.5M | 37.32M | 2.64M | 2.77M | -1.31M | -6.71M | -3.71M | -6.17K | 6.35K |
| Free Cash Flow | 66.07M | 72.97M | 64.52M | 24.79M | -19.41M | -5.2M | -34.49M | -41.63M | 25.77M | 57.54M | 18.72M | 12.13M | 13.65M | -3.31M | -3.97M | -7.15M | -8.31M | -8.92M | -9.31M | -23.67K | -23.65K |
| FCF Margin % | 16.97% | 17.43% | 18.49% | 7.71% | -7.25% | -2.15% | -13.89% | -13.91% | 7.18% | 17.92% | 7.64% | 6.48% | 11.55% | -5.59% | -14.67% | -92.14% | -1053.29% | - | - | - | - |
| FCF Growth % | 11.54% | 13.11% | 160.27% | 227.73% | -273.21% | 84.92% | 17.15% | -261.56% | -55.22% | 207.43% | 54.32% | -11.14% | 512.28% | 16.56% | 44.51% | 13.94% | 6.81% | 4.22% | -39231.82% | -0.08% | - |
| FCF per Share | 0.45 | 0.49 | 0.43 | 0.17 | -0.17 | -0.05 | -0.32 | -0.39 | 0.24 | 0.50 | 0.17 | 0.11 | 0.12 | -0.03 | -0.05 | -0.10 | -0.14 | -0.24 | -1.61 | -0.00 | -0.00 |
| FCF Conversion (FCF/Net Income) | 2.15x | 1.52x | 1.56x | 0.40x | 0.59x | 0.16x | 0.61x | 1.54x | -1.19x | 0.97x | 2.16x | 0.64x | 2.70x | 0.07x | 0.44x | 0.65x | 0.71x | 0.72x | 0.47x | 0.61x | 1.41x |
| Interest Paid | 728K | 0 | 2.7M | 0 | 0 | 4.33M | 7.46M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 4.06M | 0 | 3.25M | 0 | 0 | 169K | 208K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Medicare reimbursement policy shifts
As reported in recent financial statements, the OCF/NI ratio plummeted to -0.17 in 2026Q1, a sharp reversal from the 1.64 observed in 2025Q4, indicating that the company's ability to translate accounting profits into actual cash generation remains highly volatile and sensitive to operational disruptions.
The significant divergence between net income and operating cash flow suggests that accrual-based accounting may be masking underlying cash flow volatility. Investors should monitor whether this disconnect is a temporary timing issue or a structural weakness in the company's revenue recognition and collection processes.
Based on the provided cash flow data, FCF margins contracted to 3.2% in 2026Q1 from a peak of 22.3% in 2025Q3, highlighting a deteriorating trajectory that suggests the company's core business model is struggling to maintain consistent cash generation amidst recent top-line pressures.
The erratic nature of FCF margins implies that the company's operational efficiency is highly susceptible to quarterly fluctuations in demand. This inconsistency warrants further investigation into whether the current cost structure is sufficiently flexible to withstand periods of revenue contraction.
According to the latest quarterly filings, working capital changes contributed a substantial $15.4M inflow in 2026Q1, which stands in stark contrast to the $11.0M outflow seen in 2025Q1, suggesting that aggressive management of receivables and payables is currently driving the company's reported cash position.
The reliance on working capital adjustments to bolster cash flow may indicate that the company is pulling forward collections or delaying payments to manage liquidity. Such tactics often provide only a temporary reprieve and may not be sustainable if operational performance does not stabilize.
As evidenced by the financial data, the company maintained a CapEx/Revenue ratio of 1.0% in 2026Q1, which remains consistent with historical trends and suggests that the business model is not overly capital-intensive despite the recent decline in overall revenue and profitability.
The low capital intensity indicates that the company does not require massive ongoing investment in physical infrastructure to support its current operations. This provides a degree of flexibility, as the company can theoretically preserve cash by scaling back discretionary spending without immediately impairing its core production capabilities.
Quick answers to the most common questions about buying MDXG stock.
MiMedx Group, Inc. (MDXG) generated $74.0M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
MiMedx Group, Inc. (MDXG) generated $73.0M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
MiMedx Group, Inc. (MDXG) spent $3.1M 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, MiMedx Group, Inc. (MDXG) spent $3.1M on share repurchases. This shows the company's commitment to returning capital to its equity investors.