Free cash flow remains inconsistent, oscillating between a $5.0M peak in 2025Q4 and a -$2.3M outflow in 2026Q1, reflecting erratic cash conversion efficiency.
Xtant Medical Holdings, Inc. (XTNT) cash flow statement — 18-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 |
|---|
| Cash from Operations | 570K | 12.55M | -11.9M | -9.52M | -5.34M | 439K | -731K | -413K | 1.21M | -543.18K | -14.41M | -9.1M | -7.32M | -5.62M | -10.79M | -7.36M | -8.37M | -3.67M | 38.64K |
| Operating CF Margin % | - | 9.37% | -10.14% | -10.42% | -9.21% | 0.79% | -1.37% | -0.64% | 1.68% | -0.66% | -16.01% | -15.33% | -20.73% | -17% | -32.72% | -24.42% | -54.3% | -49.66% | 8.42% |
| Operating CF Growth % | 139.33% | 205.46% | -25.02% | -78.15% | -1316.63% | 160.05% | -77% | -134.08% | 323.13% | 96.23% | -58.32% | -24.25% | -30.3% | 47.92% | -46.59% | 12.06% | -128.02% | -9601.08% | - |
| Net Income | -11.14M | 4.97M | -16.45M | 660K | -8.48M | -4.85M | -7.02M | -8.22M | -70.1M | -52.41M | -19.49M | -2.17M | -10.51M | -12.69M | -7.71M | -3.01M | -19.47M | -4.13M | -15.85K |
| Depreciation & Amortization | 4.02M | 5.22M | 4.22M | 3.17M | 1.29M | 1.33M | 2.08M | 3.14M | 6.59M | 8.41M | 7.24M | 4.89M | 952.32K | 753.52K | 782.89K | 755.39K | 682.54K | 707.93K | 0 |
| Stock-Based Compensation | 2.99M | 2.89M | 4.12M | 2.74M | 2.46M | 2.21M | 1.08M | 515K | 694K | 211.81K | 522.99K | 836.74K | 935.32K | 838.85K | 1.55M | 2.56M | 2.85M | 837.35K | 0 |
| Deferred Taxes | 0 | 0 | 21K | -1.9M | 0 | 0 | 0 | 958K | 53.25M | 25.26M | -467.74K | -19.09M | -150.47K | 1.45M | -373.07K | -1.64M | 0 | -5.25K | 0 |
| Other Non-Cash Items | 8.55M | 2.5M | 1.54M | -10.55M | 2.2M | 954K | 6.4M | 5.75M | 9.85M | 14.68M | 6.78M | 5.37M | 2.45M | 1.79M | 1.05M | -903.49K | 11.08M | 181K | 0 |
| Working Capital Changes | -3.85M | -3.05M | -5.35M | -3.63M | -2.81M | 793K | -3.27M | -2.55M | 931K | 3.3M | -9M | 1.07M | -999.98K | 2.24M | -6.09M | -5.12M | -3.51M | -1.27M | 54.49K |
| Change in Receivables | 4.21M | -591K | -755K | -8.74M | -3.94M | -319K | 2.89M | -647K | 2.54M | 4.75M | -2.68M | -5.51M | 283.62K | 797.68K | -414.86K | -4.82M | -2.28M | -739.21K | -33.36K |
| Change in Inventory | -4.24M | -2M | -2.49M | -1.89M | -1.15M | 2.62M | -5.79M | 692K | 40K | 2.12M | -4.07M | -545.71K | -17.39K | 747.69K | -5.27M | -2.37M | -2.62M | -851.02K | -7.16K |
| Change in Payables | 72K | -3.12M | 1.03M | 2.98M | 875K | -332K | 101K | -4.28M | -3.01M | -1.64M | 319.09K | 644.15K | 715.71K | -1M | 1.25M | 334.18K | 1.43M | 150.35K | 0 |
| Cash from Investing | 14.39M | 7.9M | -3.73M | -24.78M | -1.56M | -1.89M | -1.3M | -544K | -367K | -1.61M | -5.82M | -73.57M | -298.35K | 35.32K | -1.84M | -1.02M | -816.37K | 49.87K | 0 |
| Capital Expenditures | -1.27M | -2.38M | -4.11M | -1.46M | -1.76M | -2.12M | -1.54M | -879K | -624K | -1.64M | -5.83M | -2.26M | -299.98K | -693.3K | -1.84M | -1.1M | -816.37K | -93.67K | 0 |
| CapEx % of Revenue | 1.16% | 1.78% | 3.51% | 1.59% | 3.04% | 3.83% | 2.9% | 1.36% | 0.86% | 1.99% | 6.48% | 3.81% | 0.85% | 2.1% | 5.57% | 3.65% | 5.29% | 1.27% | - |
| Acquisitions | 0 | 0 | 0 | -23.5M | 0 | 0 | 0 | 335K | 257K | 32.5K | 16.4K | -72.98M | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 15.65M | 10.28M | 383K | 175K | 205K | 225K | 241K | 0 | 257K | 32.5K | 16.4K | 1.67M | 1.63K | 728.62K | -11.16K | 82.4K | -33.32K | 143.53K | 0 |
| Cash from Financing | -12.03M | -9.57M | 16.07M | 19.69M | 9.02M | 17.5M | -861K | -603K | 3.1M | 2.43M | 16.43M | 84.57M | 9.04M | 3.71M | 16.8M | 8.8M | 9.46M | 3.44M | 0 |
| Debt Issued (Net) | -11.84M | -9.33M | 12.43M | 6.18M | -291K | -592K | -471K | -455K | -359K | 2.25M | 3.09M | 82.47M | 3.17M | -771.7K | 12.88M | 4.43M | 3.97M | 486.99K | 0 |
| Equity Issued (Net) | -65K | -65K | 4.46M | 14.01M | 9.31M | 18.43M | 620K | 0 | 6.81M | 178K | 3.09M | 2.63M | 0 | 4.45M | 3.88M | 2.97M | 4.43M | 1.95M | 0 |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -65K | -65K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -726.71K | 0 | 0 |
| Other Financing | -130K | -175K | -816K | -500K | 0 | -337K | -1.01M | -148K | -3.36M | 455 | 10.25M | -531.4K | 5.87M | 27.57K | 46K | 1.4M | 1.06M | 1M | 0 |
| Net Change in Cash | 3.18M | 11.11M | 298K | -14.58M | 2.12M | 16.05M | -2.9M | -1.56M | 3.94M | 277.69K | -3.79M | 1.9M | 1.42M | -1.88M | 4.17M | 423.63K | 273.33K | -184.74K | 38.64K |
| Free Cash Flow | -696K | 10.16M | -16.01M | -10.97M | -7.11M | -1.68M | -2.28M | -1.29M | 588K | -2.18M | -20.24M | -11.36M | -7.62M | -6.31M | -12.63M | -8.46M | -9.19M | -3.77M | 38.64K |
| FCF Margin % | -0.64% | 7.59% | -13.65% | -12.02% | -12.26% | -3.03% | -4.27% | -2% | 0.81% | -2.64% | -22.49% | -19.15% | -21.58% | -19.09% | -38.29% | -28.07% | -59.6% | -50.93% | 8.42% |
| FCF Growth % | 75.42% | 163.49% | -45.92% | -54.41% | -323.93% | 26.36% | -76.16% | -319.73% | 126.92% | 89.21% | -78.12% | -49.04% | -20.74% | 50% | -49.25% | 7.91% | -144.03% | -9843.46% | - |
| FCF per Share | -0.00 | 0.07 | -0.12 | -0.09 | -0.08 | -0.02 | -0.08 | -0.10 | 0.05 | -1.44 | -19.02 | -13.70 | -13.97 | -14.50 | -32.47 | -23.71 | -31.16 | -15.53 | 0.16 |
| FCF Conversion (FCF/Net Income) | 0.06x | 2.52x | 0.72x | -14.42x | 0.63x | -0.09x | 0.10x | 0.05x | -0.02x | 0.01x | 0.74x | 4.18x | 0.70x | 0.44x | 1.40x | 2.45x | 0.43x | 0.89x | -2.44x |
| Interest Paid | 0 | 0 | 3.64M | 2.55M | 1.45M | 846K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Quick answers to the most common questions about buying XTNT stock.
Xtant Medical Holdings, Inc. (XTNT) generated $12.5M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Xtant Medical Holdings, Inc. (XTNT) generated $10.2M 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.
Xtant Medical Holdings, Inc. (XTNT) spent $2.4M 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, Xtant Medical Holdings, Inc. (XTNT) spent $0.1M on share repurchases. This shows the company's commitment to returning capital to its equity investors.
Key Metrics
Top Statement Risk
High operating leverage sensitivity
Metrics are mathematically derived from official filings.
Earnings Quality Remains Highly Volatile
Based on reported financial data, the relationship between net income and operating cash flow is erratic, with the OCF/NI ratio fluctuating from 0.36 in 2025Q2 to 94.39 in 2025Q4, suggesting that accounting accruals and working capital swings frequently decouple reported earnings from actual cash generation.
The significant variance in the OCF/NI ratio indicates that net income is a poor proxy for the company's underlying cash-generating capacity. Investors should monitor whether this divergence stems from aggressive revenue recognition or the timing of inventory-related cash outflows inherent in the biologics supply chain.
Free Cash Flow Inflection Unproven
As reported in quarterly filings, XTNT's free cash flow trajectory remains inconsistent, oscillating between a peak of $5.0M in 2025Q4 and a low of -$6.5M in 2024Q1, which highlights the company's ongoing struggle to maintain positive cash flow margins amidst fluctuating operational performance.
The inability to sustain positive free cash flow suggests that the business model is currently sensitive to minor shifts in revenue volume. Without a consistent trend of positive FCF, the company may remain reliant on external financing or balance sheet liquidity to fund its ongoing operational requirements.
Working Capital Swings Drive Volatility
According to recent SEC filings, working capital changes have been a primary driver of cash flow instability, with quarterly fluctuations ranging from a $4.5M outflow in 2025Q2 to a $2.6M inflow in 2025Q4, reflecting the inherent challenges of managing inventory and receivables in a medical device environment.
These sharp swings in working capital suggest that the company's cash conversion cycle is highly sensitive to distributor stocking patterns and hospital procurement cycles. The reliance on consignment inventory likely exacerbates these fluctuations, as capital remains tied up in kits that have not yet been utilized in surgical procedures.
Capital Intensity Remains Relatively Low
Based on reported figures, XTNT maintains a disciplined approach to capital expenditure, with CapEx/Revenue ratios consistently hovering between 0.9% and 3.6% over the last ten quarters, indicating that the business is not currently burdened by heavy investment requirements for manufacturing or infrastructure expansion.
The low capital intensity suggests that the company's primary cash drain is operational rather than structural. While this preserves liquidity, it also implies that the company may be under-investing in the automation or technology required to improve long-term gross margins and reduce reliance on manual tissue processing.