Xtant Medical Announces Record Full Year 2023 Revenue of $91.3 Million

Establishes Full Year 2024 Revenue Guidance of $112 Million – $116 Million

BELGRADE, Mont., April 01, 2024 (GLOBE NEWSWIRE) — Xtant Medical Holdings, Inc. (NYSE American: XTNT), a global medical technology company focused on surgical solutions for the treatment of spinal disorders, today reported financial and operating results for the fourth quarter and year ended December 31, 2023.

“2023 was a transformative year for Xtant Medical. We achieved record annual revenues of $91.3 million, up 58% year-over-year, on which we generated organic growth of 15% compared to the prior year,” said Sean Browne, President and CEO of Xtant Medical. “Additionally, we successfully integrated three separate businesses that are integral to our growth platform. From a profitability perspective, we increased our annual gross margin by 540 basis points, which helped us achieve three straight quarters of positive adjusted EBITDA. Looking ahead, our 2024 revenue guidance reflects our confidence in building upon this momentum as we continue executing our strategic initiatives to drive long-term sustainable growth.”

Fourth Quarter and Full Year 2023 Financial Results

Fourth quarter 2023 revenue grew 84.1% to $28.1 million, compared to $15.3 million for the same quarter in 2022. Full year 2023 revenue grew 58% to $91.3 million, compared to $58.0 million for 2022. These revenue increases are attributed primarily to greater independent agent and private label sales, sales from the acquired Coflex and CoFix product lines, and sales from the acquisition of Surgalign.

Gross margin for the fourth quarter of 2023 was 61.0%, compared to 54.4% for the same period in 2022 and 60.8% for the full year 2023, compared to 55.4% for the full year 2022. These increases were primarily attributable to product mix and greater scale and production efficiencies, partially offset by higher product costs.

Operating expenses for the fourth quarter of 2023 totaled $20.9 million, compared to $10.0 million for the fourth quarter of 2022, and were $65.6 million for the full year 2023 compared to $38.9 million for the full year 2022. These increases were primarily due to additional independent agent sales commissions and higher employee compensation expenses, legal expenses, and amortization of intangible assets associated with the Coflex and CoFix product lines.

Fourth quarter 2023 net loss totaled $4.3 million, or $0.03 per share, compared to a net loss in the fourth quarter 2022 of $2.2 million, or $0.02 per share. Net income for 2023 was $0.7 million, or $0.01 per share, compared to a net loss of $8.5 million, or $0.09 per share, for 2022.

Non-GAAP adjusted EBITDA for the fourth quarter of 2023 totaled $0.7 million, compared to a loss of $0.8 million for the same period in 2022. Non-GAAP adjusted EBITDA for 2023 totaled $1.0 million, compared to a loss of $3.0 million for 2022. The Company defines adjusted EBITDA as net income/loss from operations before depreciation, amortization and interest expense and provision for income taxes, and as further adjusted to add back in or exclude, as applicable, non-cash compensation, acquisition-related expenses, acquisition-related fair value adjustments, gain on bargain purchase, unrealized foreign currency translation gain, and litigation settlement reserve. A calculation and reconciliation of adjusted EBITDA to net loss can be found in the attached financial tables.

2024 Financial Guidance

Xtant Medical expects full year 2024 revenue of $112 million to $116 million. The guidance range represents annual growth of approximately 23% to 27% compared to full year 2023 and includes contributions from the Surgalign acquisition.

Conference Call

Xtant Medical will host a webcast and conference call to discuss the fourth quarter and full year 2023 financial results on Monday, April 1, 2024 at 9:00 AM ET. To access the webcast, Click Here. To access the conference call, dial 877-407-6184 within the U.S. or 201-389-0877 outside the U.S. A replay of the call will be available at, under “Investor Info.”

About Xtant Medical Holdings, Inc.

Xtant Medical Holdings, Inc. ( is a global medical technology company focused on the design, development, and commercialization of a comprehensive portfolio of orthobiologics and spinal implant systems to facilitate spinal fusion in complex spine, deformity and degenerative procedures. Xtant people are dedicated and talented, operating with the highest integrity to serve our customers.

The symbols ™ and ® denote trademarks and registered trademarks of Xtant Medical Holdings, Inc. or its affiliates, registered as indicated in the United States, and in other countries. All other trademarks and trade names referred to in this release are the property of their respective owners.

Non-GAAP Financial Measures

To supplement the Company’s consolidated financial statements prepared in accordance with U.S. generally accepted accounting principles (GAAP), the Company uses certain non-GAAP financial measures in this release, including adjusted EBITDA and organic revenue growth. Reconciliations of the non-GAAP financial measures used in this release to the most comparable GAAP measures for the respective periods can be found in tables later in this release. The Company’s management believes that the presentation of these measures provides useful information to investors. These measures may assist investors in evaluating the Company’s operations, period over period. Management uses the non-GAAP measures in this release internally for evaluation of the performance of the business, including the allocation of resources. Investors should consider non-GAAP financial measures only as a supplement to, not as a substitute for or as superior to, measures of financial performance prepared in accordance with GAAP.

Cautionary Statement Regarding Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include statements that are predictive in nature, that depend upon or refer to future events or conditions, or that include words such as “intends,” ‘‘expects,’’ ‘‘anticipates,’’ ‘‘plans,’’ ‘‘believes,’’ ‘‘estimates,’’ “continue,” “future,” ‘‘will,’’ “potential,” “going forward,” “guidance,” similar expressions or the negative thereof, and the use of future dates. Forward-looking statements in this release include the Company’s expectations regarding the continued execution of its strategic initiatives and its financial guidance for 2024. The Company cautions that its forward-looking statements by their nature involve risks and uncertainties, and actual results may differ materially depending on a variety of important factors, including, among others: the Company’s future operating results and financial performance; its ability to increase or maintain revenue; risks associated with its recent acquisitions and the integration of those businesses; anticipated shortages of stem cells which will adversely affect future revenues; possible future impairment charges to long-lived assets and goodwill and write-downs of excess inventory; the ability to remain competitive; the ability to innovate, develop and introduce new products; the ability to engage and retain new and existing independent distributors and agents and qualified personnel and the Company’s dependence on key independent agents for a significant portion of its revenue; the effect of COVID-19, labor and hospital staffing shortages on the Company’s business, operating results and financial condition, especially when they affect key markets; the Company’s ability to implement successfully its future growth initiatives and risks associated therewith; the effect of inflation, increased interest rates and other recessionary factors and supply chain disruptions; the effect of product sales mix changes on the Company’s financial results; government and third-party coverage and reimbursement for Company products; the ability to obtain and maintain regulatory approvals and comply with government regulations; the effect of product liability claims and other litigation to which the Company may be subject; the effect of product recalls and defects; the ability to obtain and protect Company intellectual property and proprietary rights and operate without infringing the rights of others; risks associated with the Company’s clinical trials; international risks; the ability to service Company debt, comply with its debt covenants and access additional indebtedness; the ability to obtain additional financing on favorable terms or at all; and other factors. Additional risk factors are contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 filed with the Securities and Exchange Commission (SEC) on April 1, 2024. Investors are encouraged to read the Company’s filings with the SEC, available at, for a discussion of these and other risks and uncertainties. The Company undertakes no obligation to release publicly any revisions to any forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events, except as required by law. All forward-looking statements attributable to the Company or persons acting on its behalf are expressly qualified in their entirety by this cautionary statement.

Investor Relations Contact

David Carey
Lazar FINN Partners
Ph: 212-867-1762


Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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