Free cash flow remains highly volatile, swinging from a $17.6 million inflow in 2025Q4 to a $28.3 million outflow in 2026Q1.
Orthofix Medical Inc. (OFIX) 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 | -560.71K | 33.35M | 25.79M | -45.75M | -11.54M | 18.48M | 74.27M | 32.03M | 49.92M | 53.34M | 44.71M | 43.22M | 50.96M | 67.44M | 11.21M | 64.78M | 42.47M | 49.97M | 26.77M | 21.5M | 8.17M | 106.67M | 27.48M | 31.79M | 29.3M | 18.87M | 56.31M | 8.45M | 6M | 4.6M | 2.2M |
| Operating CF Margin % | - | 4.06% | 3.23% | -6.13% | -2.5% | 3.98% | 18.27% | 6.96% | 11.02% | 12.3% | 10.91% | 10.9% | 12.67% | 16.84% | 2.42% | 11.19% | 7.53% | 9.16% | 5.15% | 4.38% | 2.24% | 34.05% | 9.59% | 15.61% | 16.5% | 11.62% | 42.73% | 6.97% | 5.76% | 5.11% | 2.85% |
| Operating CF Growth % | -274.24% | 29.3% | 156.37% | -296.54% | -162.45% | -75.13% | 131.86% | -35.83% | -6.42% | 19.31% | 3.43% | -15.18% | -24.45% | 501.87% | -82.7% | 52.52% | -15% | 86.66% | 24.53% | 163.08% | -92.34% | 288.11% | -13.54% | 8.48% | 55.31% | -66.49% | 566.38% | 40.83% | 30.43% | 109.09% | -53.19% |
| Net Income | -61.72M | -92.19M | -126M | -151.4M | -19.75M | -38.38M | 2.52M | -28.46M | 13.81M | 6.22M | 3.06M | -2.81M | -8.54M | -28.48M | 51.3M | -1.07M | 44.21M | 24.47M | -228.55M | 10.97M | -7.04M | 73.4M | 34.15M | 24.73M | 25.91M | 20.96M | 44.82M | 12.91M | 14.3M | 3.1M | -500K |
| Depreciation & Amortization | 145.2M | 83.25M | 75.96M | 60.6M | 32.08M | 33.09M | 34.28M | 24.7M | 18.66M | 20.12M | 20.84M | 20.92M | 22.88M | 22.66M | 20.26M | 22.78M | 22.52M | 22.34M | 32.68M | 32.33M | 16.96M | 17.53M | 15.08M | 6.95M | 5.83M | 7.95M | 7.38M | 6.83M | 6.5M | 6.5M | 6.2M |
| Stock-Based Compensation | 48.74M | 28.69M | 32.45M | 35.71M | 18.44M | 15.43M | 16.21M | 21.54M | 18.93M | 12.56M | 15.97M | 7.21M | 5.72M | 6.27M | 6.3M | 6.65M | 8.14M | 10.75M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Deferred Taxes | 1.3M | 223K | 1.88M | 579K | 314K | 24.48M | 10.79M | 1.39M | -2.66M | 21.29M | 10.46M | -1.16M | -7.05M | -1.19M | 871K | -801K | 178K | -4.41M | -79.16M | -12.17M | -12.36M | -1.53M | -3.87M | 131K | 1.09M | -381K | 962K | -169K | -5M | -200K | 300K |
| Other Non-Cash Items | 118.25M | 34.87M | 60.74M | 62.72M | -13.39M | 1.95M | -9.21M | 42.24M | 8.18M | 10.33M | 6.47M | 3.55M | 5.17M | 31.94M | 54.07M | 21.06M | -164K | 17.03M | 327.76M | 40.21M | 11.53M | 4.53M | 7.13M | 9.74M | 9.78M | 5.35M | 1.3M | 1.83M | 300K | -100K | 100K |
| Working Capital Changes | -113.38M | -21.5M | -19.25M | -53.96M | -29.23M | -18.1M | 19.7M | -29.38M | -7M | -17.18M | -12.09M | 15.51M | 32.77M | 36.24M | -121.6M | 16.17M | -32.41M | -20.22M | -27.31M | -44.03M | -41.45M | 12.74M | -25M | -9.76M | -13.31M | -15.02M | 1.85M | -12.96M | -10.1M | -8.2M | -9.6M |
| Change in Receivables | -1.53M | -1.58M | -9.53M | -10.41M | -6.74M | -7.05M | 13.28M | -11.04M | -3.71M | -6.56M | 392K | -1.55M | 6.14M | 25.75M | -31.6M | -25.82M | -14.77M | -23.86M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Change in Inventory | -38.55M | -10.75M | -5.55M | -58.05M | -18.13M | 619K | -873K | -5.71M | 9.7M | -15.64M | -5.28M | 3.14M | 8.11M | -6.63M | -6.69M | -13.81M | -222K | -8.94M | -13.73M | -22.75M | -12.87M | -1.5M | -882K | -435K | -3.79M | -380K | -2.35M | -1M | -3.6M | -500K | -3M |
| Change in Payables | -12.03M | 2.6M | -5.57M | 8.64M | 2.28M | 4.25M | 2.53M | 2.14M | -170K | 2.32M | -1.77M | 3.01M | -6.45M | -2.28M | 5.55M | 576K | -2.86M | -1.31M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Investing | -54.44M | -34.6M | -27.58M | -33.13M | -24.53M | -23.01M | -52.33M | -22.92M | -61M | -16.47M | -21.95M | -38.35M | -19.95M | -30.24M | 125M | -31.01M | -2.15M | -22.29M | -13.94M | -30.37M | -354.9M | -12.25M | -11.42M | -155.46M | -16.76M | -14.64M | -12.87M | -10.79M | 8.4M | -3.3M | -3.7M |
| Capital Expenditures | -64.45M | -34.63M | -34.88M | -62.05M | -23.16M | -19.59M | -17.09M | -20.52M | -15.26M | -16.95M | -18.33M | -27.9M | -18.52M | -30.24M | -28.77M | -25.76M | -26.36M | -22M | -20.19M | -27.23M | -12.61M | -12.25M | -12.24M | -5.24M | -7.13M | -6.77M | -5.58M | -5.45M | -3.4M | -3.4M | -3.2M |
| CapEx % of Revenue | 7.74% | 4.21% | 4.36% | 8.31% | 5.03% | 4.22% | 4.2% | 4.46% | 3.37% | 3.91% | 4.47% | 7.04% | 4.61% | 7.55% | 6.22% | 4.45% | 4.67% | 4.03% | 3.89% | 5.55% | 3.45% | 3.91% | 4.27% | 2.57% | 4.01% | 4.17% | 4.24% | 4.49% | 3.27% | 3.78% | 4.15% |
| Acquisitions | 0 | 0 | 0 | 29.42M | -1.5M | 0 | -18M | 0 | -44.29M | 0 | 0 | 0 | 18.52M | 0 | 153.77M | -5.25M | 24.21M | 0 | 5.48M | -3.14M | -342.29M | 0 | -2.56M | -150.57M | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 10.01M | 28K | -100K | -500K | 0 | -1.25M | -24.33M | -2.4M | -1.45M | 474K | 0 | 4.8M | -18.52M | 810K | 0 | 0 | 0 | -2M | 0 | 0 | 0 | 0 | 3.38M | 354K | -9.63M | 1.08M | -7.29M | -5.35M | 12.2M | 100K | -500K |
| Cash from Financing | 127.74M | -786K | 50.71M | 65.32M | -78K | -3.62M | 3.25M | -10.69M | 2.99M | 3.54M | -46.11M | 25.11M | -19.99M | -38.35M | -138.61M | -13.66M | -39.99M | -29.34M | -22.32M | 7.69M | 307.82M | -55.61M | -22.11M | 106.62M | -313K | -19.66M | -2.25M | 5.16M | -11.7M | -800K | -1.9M |
| Debt Issued (Net) | 127.58M | -762K | 54.39M | 67.95M | -2.59M | -537K | -323K | -365K | 0 | 0 | 0 | 0 | -20M | -16K | -189.99M | -10.06M | -34.55M | -28.07M | -24.07M | -9.51M | 294.14M | -62.09M | -33.53M | 102.1M | 1.12M | -4.97M | -3.04M | 5.17M | -10.1M | -300K | -2.3M |
| Equity Issued (Net) | 5.54M | 5.93M | 6.26M | 5.13M | 4.34M | 8.82M | 7.6M | 11.55M | 7.1M | 7.78M | -43.7M | -7.87M | 11.07M | -36.04M | 25.59M | 20.11M | 7.85M | 70K | 1.73M | 15.05M | 11.51M | 6.47M | 12.25M | 7.31M | -1.43M | -14.68M | 789K | -12K | -1.6M | 400K | 200K |
| 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 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -63.42M | -11.57M | 0 | -39.49M | 0 | 0 | 0 | -220K | 0 | 0 | 0 | 0 | 0 | -4.39M | -21.89M | -16.46M | -2.06M | -681K | -2.1M | 0 | 0 |
| Other Financing | -5.39M | -5.95M | -9.94M | -7.75M | -1.82M | -11.91M | -4.03M | -21.87M | -4.11M | -4.25M | -2.41M | 32.98M | -11.27M | -2.29M | 26.82M | -23.72M | -13.33M | -1.34M | 22K | 2.15M | 2.17M | 0 | -821K | -2.78M | 0 | 0 | 0 | 0 | 0 | -900K | 200K |
| Net Change in Cash | 71.47M | -623K | 47.98M | -12.94M | -37.15M | -8.97M | 26.42M | -1.79M | -8.97M | 41.59M | -24.09M | 26.85M | 7.89M | -569K | -2.15M | 19.65M | 233K | -1.27M | -10.47M | -817K | -37.91M | 37.84M | -5.41M | -15.25M | 14.54M | -16.19M | 40.73M | 2.75M | 2.9M | 500K | -3.4M |
| Free Cash Flow | -55.3M | -1.28M | -9.09M | -107.8M | -34.7M | -1.12M | 57.18M | 11.51M | 34.66M | 36.39M | 26.37M | 15.32M | 32.43M | 37.2M | -17.57M | 39.02M | 16.11M | 27.97M | 6.58M | -5.73M | -4.44M | 94.42M | 15.24M | 26.55M | 22.17M | 12.1M | 50.73M | 3M | 2.6M | 1.2M | -1M |
| FCF Margin % | -6.64% | -0.16% | -1.14% | -14.44% | -7.53% | -0.24% | 14.06% | 2.5% | 7.65% | 8.39% | 6.44% | 3.87% | 8.06% | 9.29% | -3.8% | 6.74% | 2.85% | 5.13% | 1.27% | -1.17% | -1.22% | 30.14% | 5.32% | 13.03% | 12.49% | 7.45% | 38.49% | 2.48% | 2.5% | 1.33% | -1.3% |
| FCF Growth % | -12095.9% | 85.92% | 91.57% | -210.69% | -3006.36% | -101.95% | 396.81% | -66.8% | -4.76% | 37.99% | 72.09% | -52.75% | -12.82% | 311.77% | -145.02% | 142.18% | -42.4% | 325.24% | 214.74% | -29.06% | -104.7% | 519.51% | -42.59% | 19.74% | 83.27% | -76.15% | 1588.65% | 15.54% | 116.67% | 220% | -155.56% |
| FCF per Share | -1.35 | -0.03 | -0.24 | -2.94 | -1.73 | -0.06 | 2.95 | 0.61 | 1.83 | 1.97 | 1.43 | 0.82 | 1.76 | 1.99 | -0.91 | 2.14 | 0.90 | 1.63 | 0.38 | -0.34 | -0.27 | 5.80 | 0.95 | 1.81 | 1.51 | 0.82 | 3.63 | 0.22 | 0.20 | 0.09 | -0.08 |
| FCF Conversion (FCF/Net Income) | 0.90x | -0.36x | -0.20x | 0.30x | 0.58x | -0.48x | 29.51x | -1.13x | 3.61x | 8.57x | 14.63x | -15.39x | -5.97x | -2.37x | 0.22x | -60.37x | 0.96x | 2.04x | -0.12x | 1.96x | -1.16x | 1.45x | 0.80x | 1.29x | 1.13x | 0.90x | 1.26x | 0.65x | 0.42x | 1.48x | -4.40x |
| Interest Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 811K | 672K | 852K | 1.31M | 2.05M | 4.57M | 17.09M | 16.03M | 26.72M | 19.31M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3.27M | 4.42M | 3.16M | 2.22M | 8.77M | 18.27M | 26.23M | 29.74M | 17.66M | 12.6M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Quick answers to the most common questions about buying OFIX stock.
Orthofix Medical Inc. (OFIX) generated $33.3M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Orthofix Medical Inc. (OFIX) reported negative free cash flow of $1.3M in 2025, indicating capital requirements exceeded cash from operations.
Orthofix Medical Inc. (OFIX) spent $34.6M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
Key Metrics
Top Statement Risk
Integration and Sales Attrition
Metrics are mathematically derived from official filings.
Earnings Quality Masked by Accruals
According to recent financial disclosures, the persistent gap between net losses and operating cash flow, highlighted by a 2025Q4 OCF/NI ratio of -12.82, suggests that non-cash charges and working capital volatility are significantly distorting the company's true underlying cash-generating capacity during this integration phase.
The extreme variance in the OCF/NI ratio indicates that GAAP net income is a poor proxy for the company's actual cash performance. Investors should monitor whether these discrepancies are driven by recurring non-cash adjustments or if they reflect fundamental difficulties in converting revenue into realized cash inflows.
Free Cash Flow Remains Volatile
As reported in quarterly filings, Orthofix's free cash flow trajectory remains highly inconsistent, swinging from a $17.6 million inflow in 2025Q4 to a $28.3 million outflow in 2026Q1, which underscores the difficulty in achieving sustainable cash generation following the recent merger with SeaSpine.
The inability to maintain positive FCF margins suggests that the business model is currently consuming capital rather than generating it. This volatility warrants further investigation into whether the cash burn is a temporary byproduct of integration or a structural issue related to the company's cost base.
Working Capital Dragging Cash Flow
Based on the provided cash flow statements, working capital changes have frequently acted as a significant drain on liquidity, including a $55.1 million outflow in 2025Q4, indicating that the company is struggling to manage its inventory and receivables effectively during the current transition period.
The recurring negative impact of working capital changes suggests potential inefficiencies in the 'kit and tray' inventory model or delays in collecting from third-party payers. Such trends may indicate that the company's operational scaling is outpacing its ability to manage the associated cash conversion cycle.
Capital Intensity Pressuring Cash Reserves
Data from recent financial statements reveals that capital expenditures, which reached $20.6 million in 2025Q4, continue to represent a meaningful portion of revenue, suggesting that the company must maintain high levels of investment to support its hardware portfolio despite the current lack of profitability.
The persistent capital intensity appears to be a necessary burden for maintaining competitiveness in the spine hardware market. Analysts should monitor whether these investments are yielding the expected surgeon conversion rates or if they are merely sustaining existing, lower-margin product lines.
SBC Obscuring True Cash Burn
Analysis of the cash flow statement reveals that stock-based compensation, which peaked at $20.8 million in 2025Q4, consistently offsets reported net losses, potentially masking the true extent of the company's operational cash burn and the dilution risk inherent in the current compensation structure.
By relying on equity-based incentives to manage cash expenses, the company may be understating the true cost of its human capital. This practice warrants close scrutiny as it may hide the actual cash-based operating expenses required to retain talent during a period of significant leadership instability.