Free cash flow remains erratic, alternating between a peak of $82.5 million in 2025Q2 and a deficit of $12.1 million in 2026Q1, largely driven by high capital expenditures that reached 51.5% of revenue in 2023Q4.
| Cash from Operations | 220.23M | 192.84M | 48.8M | -13.03M | -45.82M | -28.86M | -30.27M | -32.29M | -25.98M | -23.1M | -24.11M |
| Operating CF Margin % | - | 31.85% | 11.05% | -5.39% | -49.02% | -95.38% | -118.04% | -136.78% | -199.62% | -300.56% | -388.29% |
| Operating CF Growth % | 2205.66% | 295.14% | 474.6% | 71.57% | -58.73% | 4.63% | 6.26% | -24.25% | -12.49% | 4.19% | - |
| Net Income | 171.92M | 190.29M | 35.46M | -25.03M | -36.23M | -44.22M | -28.75M | -33.55M | -23.76M | -20.82M | -24.07M |
| Depreciation & Amortization | 32.91M | 27.18M | 19.76M | 8.18M | 3.48M | 1.82M | 1.58M | 1.22M | 769K | 630K | 426K |
| Stock-Based Compensation | 37.85M | 36.86M | 33.22M | 19.79M | 10.32M | 6.88M | 2.41M | 854K | 144K | 70K | 45K |
| Deferred Taxes | -82.48M | -83.54M | 0 | -1.66M | 0 | 0 | -431K | 336K | 1.01M | -316K | 292K |
| Other Non-Cash Items | -3.16M | 4.79M | 5.36M | 30.04M | 3.37M | 3.65M | 511K | 475K | 177K | 93K | 65K |
| Working Capital Changes | 63.17M | 17.25M | -45M | -44.35M | -26.76M | 3M | -5.59M | -1.63M | -4.33M | -2.75M | -872K |
| Change in Receivables | 51.56M | 13.95M | -34.31M | -33.82M | -21.68M | 840K | -218K | -3.17M | -2.51M | 454K | -758K |
| Change in Inventory | -13.62M | -7.72M | -8.35M | -28.09M | -8.02M | -4.89M | -1.74M | -4.12M | -2.7M | -2.5M | -1.59M |
| Change in Payables | 326K | -19K | -1.4M | 6.96M | -3.27M | 5.09M | -5.8M | 3.44M | 164K | -735K | 1.06M |
| Cash from Investing | -68.87M | -59.25M | -129.3M | -193.95M | 54.51M | 29.27M | -41.6M | -60.5M | 12.31M | 24.86M | -39.67M |
| Capital Expenditures | -68.87M | -59.25M | 0 | -151.85M | -11.91M | -3.52M | -455K | -165K | -418K | -263K | -1.48M |
| CapEx % of Revenue | 10.83% | 9.79% | 29.38% | 62.84% | 12.74% | 11.63% | 1.77% | 0.7% | 3.21% | 3.42% | 23.8% |
| Acquisitions | 0 | 0 | 441K | -14.89M | 107K | 0 | 41.14M | 60.34M | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 0 | 0 | -129.74M | -27.21M | -107K | 0 | -41.14M | -60.34M | 12.72M | 25.12M | -38.19M |
| Cash from Financing | 17.59M | 16.86M | 22.87M | 400.42M | 167.93M | 1.39M | 75.55M | 92.72M | 22.06M | 3K | 63.54M |
| Debt Issued (Net) | 0 | 0 | 0 | 445.38M | 22.46M | 0 | 0 | 0 | 24.36M | 0 | 0 |
| Equity Issued (Net) | 10.87M | -138K | 22.87M | 0 | 139.85M | 0 | 74.97M | 97.37M | 0 | 0 | 63.61M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 1.69M | -138K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | 6.72M | 17M | 0 | -44.96M | 5.61M | 1.39M | 584K | -4.64M | -2.3M | 3K | -64K |
| Net Change in Cash | 169.53M | 151.72M | -58.16M | 193.63M | 175.6M | 999K | 4.49M | -149K | 8.3M | 2.1M | -243K |
| Free Cash Flow | 151.36M | 133.59M | -80.94M | -192.09M | -57.72M | -32.38M | -30.72M | -32.45M | -26.4M | -23.36M | -25.59M |
| FCF Margin % | 23.8% | 22.06% | -18.33% | -79.5% | -61.76% | -107.01% | -119.82% | -137.48% | -202.83% | -303.98% | -412.1% |
| FCF Growth % | 339.39% | 265.04% | 57.86% | -232.77% | -78.25% | -5.41% | 5.33% | -22.91% | -13.02% | 8.7% | - |
| FCF per Share | 4.18 | 3.30 | -2.30 | -5.91 | -1.95 | -1.17 | -1.24 | -2.28 | -1.37 | -1.61 | -1.77 |
| FCF Conversion (FCF/Net Income) | 0.88x | 1.01x | 1.38x | 0.52x | 1.26x | 0.65x | 1.05x | 0.96x | 1.09x | 1.11x | 1.00x |
| Interest Paid | 0 | 0 | 0 | 8.09M | 0 | 3.33M | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Aviation logistics capital intensity
Based on reported financial data, the relationship between net income and operating cash flow is highly inconsistent, with OCF/NI ratios swinging from -0.11 in 2025Q1 to 3.35 in 2026Q1, suggesting that GAAP earnings are frequently decoupled from the actual cash generation of the core business.
The wide variance in conversion ratios indicates that non-cash adjustments and working capital swings are significantly distorting the perceived quality of earnings. Investors should monitor whether this volatility stems from the timing of service revenue recognition or the lumpy nature of logistics-related expenses.
As reported in recent quarterly filings, TransMedics' free cash flow trajectory is characterized by extreme instability, alternating between a peak of $82.5 million in 2025Q2 and a deficit of $47.6 million in 2024Q1, reflecting the company's ongoing struggle to achieve consistent cash flow self-sufficiency.
The inability to maintain positive FCF margins suggests that the business model is still in a heavy investment phase where growth is prioritized over cash preservation. This pattern warrants further investigation into whether the current scale is sufficient to absorb the fixed costs of the aviation fleet.
According to historical cash flow statements, the company maintains a high capital intensity, with CapEx/Revenue ratios frequently exceeding 20% and reaching as high as 51.5% in 2023Q4, highlighting the significant financial burden of building and maintaining a proprietary aviation fleet for organ transport.
This elevated capital expenditure profile suggests that the company is effectively acting as a capital-intensive utility rather than a traditional medical device manufacturer. The persistent need for asset investment may continue to suppress free cash flow until the fleet reaches optimal utilization levels.
Based on the provided quarterly data, working capital changes have been a major source of cash flow volatility, with a notable $44.4 million outflow in 2025Q1 followed by a $40.2 million inflow in 2025Q2, indicating significant fluctuations in the efficiency of the company's cash conversion cycle.
These dramatic shifts in working capital appear to reflect the complexities of managing a logistics-heavy service model alongside traditional device sales. Investors should monitor whether these swings are indicative of seasonal procurement patterns or potential challenges in collecting payments from hospital systems.
Quick answers to the most common questions about buying TMDX stock.
TransMedics Group, Inc. (TMDX) generated $192.8M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
TransMedics Group, Inc. (TMDX) generated $133.6M 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.
TransMedics Group, Inc. (TMDX) spent $59.3M 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, TransMedics Group, Inc. (TMDX) spent $0.1M on share repurchases. This shows the company's commitment to returning capital to its equity investors.