Axogen, Inc. Reports First Quarter 2026 Financial Results

Raises Full Year Revenue Guidance to at Least 20% Growth or $270 million

ALACHUA, Fla. and TAMPA, Fla., April 28, 2026 (GLOBE NEWSWIRE) -- Axogen, Inc. (NASDAQ: AXGN), a global leader in developing and marketing innovative surgical solutions for the restoration of peripheral nerve function, today reported financial results and business highlights for the first quarter ended March 31, 2026.

First Quarter Financial Results 

  • First quarter 2026 revenue was $61.5 million, a 26.6% increase compared to first quarter 2025 revenue of $48.6 million.
  • Gross margin was 75.2% for the first quarter of 2026, compared to 71.9% in the first quarter of 2025.
  • Net loss for the first quarter of 2026 was $19.6 million, or $0.38 per share, compared to $3.8 million, or $0.08 per share for the first quarter of 2025.
  • Adjusted net income was $4.1 million for the first quarter of 2026, or $0.07 per share, compared to an adjusted net loss of $0.9 million, or $0.02 per share for the first quarter 2025.
  • Adjusted EBITDA was $5.7 million for the first quarter of 2026, compared to $2.9 million for the first quarter of 2025.
  • As of March 31, 2026, cash and cash equivalents, restricted cash, and investments was $103.6 million, as compared to $45.5 million as of December 31, 2025, an increase of $58.1 million.

“We are pleased with our first-quarter revenue performance and the progress we’re making across each of Axogen’s strategic plan priorities,” said Michael Dale, President and CEO of Axogen, Inc. “We delivered strong growth across all of our target markets, reinforcing the relevance of our market development strategies and the strength of our commercial execution. We remain well positioned to achieve our financial guidance and continue advancing our strategic objectives for 2026.”

Summary of Business Highlights

  • First quarter 2026 revenue growth was broad-based, including double-digit growth in all markets, which includes Extremities, Oral Maxillofacial & Head and Neck, and Breast.
  • Received positive coverage decisions from Cigna and Elevance Health, two of the nation’s largest commercial insurers.
  • Effective January 1, 2026, CMS created a new Level 3 Nerve Procedure Code, increasing Avance facility reimbursement 40% year-over-year to $8,965 for hospital outpatient and 35% to $6,157 for ASC-based procedures.
  • On January 23, 2026, Axogen closed an upsized public offering with the sale of 4.6 million shares of common stock, yielding net proceeds of $133.3 million. From these net proceeds, $69.7 million were used to fully repay and terminate our Oberland loan facility on January 28, 2026. Remaining funds are available for working capital, capital expenditures, and other general corporate purposes.

2026 Financial Guidance

We expect 2026 revenue growth to be at least 20%, or $270 million, for the full-year and gross margin to be in the range of 74% to 76%. Additionally, we expect to be free cash flow positive for the full-year.

Conference Call

The Company will host a conference call and webcast for the investment community today at 8:00 a.m. ET. Investors interested in participating in the conference call by phone may do so by dialing toll free at (877) 407-0993 or use the direct dial-in number at (201) 689-8795. Those interested in listening to the conference call live via the internet may do so by visiting the Investors page of the Company’s website at www.axogeninc.com and clicking on the webcast link.

Following the conference call, a replay will be available in the Investors section of the Company’s website at www.axogeninc.com under Investors.

About Axogen

Axogen (AXGN) is the leading company focused specifically on the science, development and commercialization of technologies for peripheral nerve regeneration and repair. Axogen employees are passionate about providing the opportunity to restore nerve function and quality of life for patients with peripheral nerve injuries by providing innovative, clinically proven and economically effective repair solutions for surgeons and healthcare providers. Peripheral nerves provide the pathways for both motor and sensory signals throughout the body. Every day people suffer traumatic injuries or undergo surgical procedures that impact the function of their peripheral nerves. Physical damage to a peripheral nerve or the inability to properly reconnect peripheral nerves can result in the loss of muscle or organ function, the loss of sensory feeling, or the initiation of pain.

Axogen’s product portfolio includes Avance® (acellular nerve allograft-arwx), Avance® Nerve Graft, Axoguard Nerve Connector®, Axoguard Nerve Protector®, Axoguard HA+ Nerve Protector™, Axoguard Nerve Cap®, and Avive+ Soft Tissue Matrix™.​

For more information, visit www.axogeninc.com.

Cautionary Statements Concerning Forward-Looking Statements

This press release and accompanying earnings call contain “forward-looking” statements as defined in the Private Securities Litigation Reform Act of 1995. Forward-looking statements include all statements under the heading “2026 Financial Guidance” and statements regarding our business model optimization plans; market development strategies and objectives; our expectations around the potential positive impact on our business of expanded coverage and reimbursement for peripheral nerve injuries using synthetic conduits or allografts; our ability to sustain growth, operate profitably, generate positive cash flows, and fund our market development initiatives; and the anticipated use of proceeds from our recent public offering. These statements are based on management’s current expectations and estimates of trends and economic factors in the markets in which we are active. Words such as “expects,” “anticipates,” “objectives,” “targets,” “intends,” “plans,” “believes,” “seeks,” “estimates,” “projects,” “forecasts,” “continue,” “may,” “should,” “will,” and variations of such words and similar expressions are intended to identify such forward-looking statements. Actual results or events could differ materially from those described in any forward-looking statements as a result of factors, including, without limitation, disruptions from global supply chain issues, inflation, hospital staffing challenges, product development timelines, regulatory processes, financial performance, surgeon adoption rates, market awareness of our products, the estimated total addressable market, as well as those risk factors described under Part I, Item 1A, “Risk Factors,” in our most recent Annual Report on Form 10-K and other risks and uncertainties that may be detailed from time to time in reports filed by the Company with the SEC. Forward-looking statements are not a guarantee of future performance, and actual results may differ materially from those projected. Forward-looking statements speak only as of the date they are made and, except as required by applicable law, we assume no responsibility to publicly update or revise any forward-looking statements.

About Non-GAAP Financial Measures

To supplement our condensed consolidated financial statements, we use the non-GAAP financial measures of EBITDA, which measures earnings before interest, income taxes, depreciation and amortization, EBITDA margin, and Adjusted EBITDA, which further excludes non-cash stock-based compensation expense and the loss on extinguishment of debt, and Adjusted EBITDA margin. We also use the non-GAAP financial measures of Adjusted Net Income (Loss) and Adjusted Net Income (Loss) Per Common Share - diluted which excludes non-cash stock-based compensation expense and the loss on extinguishment of debt from Net Loss and Net Loss Per Common Share - diluted. Additionally, we use the non-GAAP financial measure of Free Cash Flow which consists of net cash provided by operating activities, less expenditures for property and equipment, and intangible assets.

These non-GAAP measures are not based on any comprehensive set of accounting rules or principles and should not be considered a substitute for, or superior to, financial measures calculated in accordance with GAAP and may be different from non-GAAP measures used by other companies. In addition, these non-GAAP measures should be read in conjunction with our financial statements prepared in accordance with GAAP. The reconciliations of the non-GAAP measures to the most directly comparable financial measures calculated and presented in accordance with GAAP should be carefully evaluated.

We use these non-GAAP financial measures for financial and operational decision-making and as a means to evaluate period-to-period comparisons. We believe that these non-GAAP financial measures provide meaningful supplemental information regarding our performance and that both management and investors benefit from referring to these non-GAAP financial measures in assessing our performance and when planning, forecasting, and analyzing future periods. We believe these non-GAAP financial measures are useful to investors because (i) they allow for greater transparency with respect to key metrics used by management in its financial and operational decision-making and (ii) they are used by our institutional investors and the analyst community to help them analyze the performance of our business.

Contact:
Axogen, Inc.
InvestorRelations@axogeninc.com


Axogen, Inc.
Condensed Consolidated Balance Sheets
(unaudited)
(in thousands, except share and per share amounts)

  March 31,
2026
  December 31,
2025
Assets      
Current assets:        
Cash and cash equivalents   $ 82,654     $ 35,548  
Restricted cash     2,000       4,000  
Investments     18,947       5,980  
Accounts receivable, net of allowance for doubtful accounts of $822 and $948, respectively     28,313       26,169  
Inventory     46,074       42,373  
Prepaid expenses and other assets     6,720       6,352  
Total current assets     184,708       120,422  
Property and equipment, net     83,038       81,783  
Operating lease right-of-use assets     14,280       12,732  
Intangible assets, net     7,270       6,750  
Other assets     192        
Total assets   $ 289,488     $ 221,687  
       
Liabilities and shareholders’ equity        
Current liabilities:        
Accounts payable and accrued expenses   $ 23,898     $ 21,184  
Current maturities of long-term lease obligations     2,115       2,372  
Total current liabilities     26,013       23,556  
       
Long-term debt, net of debt discount and financing fees           48,387  
Long-term lease obligations     18,527       16,870  
Debt derivative liabilities           3,886  
Other long-term liabilities     140       141  
Total liabilities     44,680       92,840  
       
Shareholders’ equity:        
Common stock, $0.01 par value per share; 100,000,000 shares authorized; 53,153,471 and 47,199,797 shares issued and outstanding, respectively     532       472  
Additional paid-in capital     570,823       435,338  
Accumulated deficit     (326,547 )     (306,963 )
Total shareholders’ equity     244,808       128,847  
Total liabilities and shareholders’ equity   $ 289,488     $ 221,687  


Axogen, Inc.
Condensed Consolidated Statements of Operations
(unaudited)
(in thousands, except share and per share amounts)

  Three Months Ended
  March 31, 2026   March 31, 2025
Revenues   $ 61,457     $ 48,560  
Cost of goods sold     15,268       13,627  
Gross profit     46,189       34,933  
Costs and expenses:        
Sales and marketing     28,633       21,045  
Research and development     7,517       6,091  
General and administrative     12,871       9,458  
Total costs and expenses     49,021       36,594  
Loss from operations     (2,832 )     (1,661 )
Other income (expense):        
Investment income     768       272  
Interest expense     (694 )     (2,250 )
Loss on extinguishment of debt     (16,849 )      
Change in fair value of debt derivative liabilities           (158 )
Other income (expense), net     23       (37 )
Total other expense, net     (16,752 )     (2,173 )
Net loss   $ (19,584 )   $ (3,834 )
         
Weighted average common shares outstanding — basic     51,591,504       45,204,076  
Weighted average common shares outstanding — diluted     51,591,504       45,204,076  
         
Net loss per common share — basic   $ (0.38 )   $ (0.08 )
Net loss per common share — diluted   $ (0.38 )   $ (0.08 )


Axogen, Inc.
Condensed Consolidated Statements of Cash Flows
(unaudited)
(in thousands)​

  Three Months Ended
  March 31, 2026   March 31, 2025
Cash flows from operating activities:      
Net loss   $ (19,584 )   $ (3,834 )
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:        
Depreciation     1,604       1,728  
Amortization of right-of-use assets     420       87  
Amortization of intangible assets     101       67  
Amortization of debt discount and deferred financing fees     68       220  
(Recovery of) provision for bad debts     (120 )     187  
Change in fair value of debt derivative liabilities           158  
Investment losses (gains), net     33       (45 )
Loss on extinguishment of debt     16,849        
Stock-based compensation expense     6,843       2,909  
Change in operating assets and liabilities:        
Accounts receivable     (2,024 )     (2,377 )
Inventory     (3,701 )     (2,321 )
Prepaid expenses and other assets     (368 )     (489 )
Other assets     (192 )      
Accounts payable and accrued expenses     2,198       (9,079 )
Operating lease obligations     (559 )     (452 )
Cash paid for interest portion of financing lease obligations     (2 )     (1 )
Other long-term liabilities     (1 )     63  
Net cash provided by (used in) operating activities     1,565       (13,179 )
     
Cash flows from investing activities:      
Purchase of property and equipment     (2,789 )     (256 )
Purchase of investments     (19,000 )      
Proceeds from sale of investments     6,000       2,000  
Cash payments for intangible assets     (175 )     (405 )
Net cash (used in) provided by investing activities     (15,964 )     1,339  
     
Cash flows from financing activities:      
Proceeds from issuance of common stock     134,044        
Payment of stock issuance costs     (792 )      
Repayment of long-term debt     (48,585 )      
Fees paid to lender related to debt extinguishment     (20,498 )      
Fees paid to third parties related to debt extinguishment     (107 )      
Payments of employee tax withholding on vested stock awards     (8,776 )      
Cash paid for debt portion of financing lease obligations     (7 )     (1 )
Proceeds from exercise of stock options     4,226       2,383  
Net cash provided by financing activities     59,505       2,382  
Net increase (decrease) in cash and cash equivalents, and restricted cash     45,106       (9,458 )
Cash and cash equivalents, and restricted cash, beginning of period     39,548       33,554  
Cash and cash equivalents, and restricted cash, end of period   $ 84,654     $ 24,096  


Axogen, Inc.
Condensed Consolidated Statements of Changes in Shareholders’ Equity
(unaudited)
(in thousands, except share amounts)

  Common Stock
  Additional Paid-in
Capital
  Accumulated
Deficit
  Total Shareholders'
Equity
  Shares
  Amount
     
Three Months Ended March 31, 2026              
Balance at December 31, 2025   47,199,797     $ 472     $ 435,338     $ (306,963 )   $ 128,847  
Net loss                     (19,584 )     (19,584 )
Issuance of common shares   4,600,000       46       133,206             133,252  
Stock-based compensation               6,843             6,843  
Issuance of restricted and performance stock units, net of shares withheld for withholding taxes   985,796       10       (8,786 )           (8,776 )
Exercise of stock options   367,878       4       4,222             4,226  
Balance at March 31, 2026   53,153,471     $ 532     $ 570,823     $ (326,547 )   $ 244,808  
                         
Three Months Ended March 31, 2025                        
Balance at December 31, 2024   44,148,836     $ 441     $ 394,726     $ (291,260 )   $ 103,907  
Net loss                     (3,834 )     (3,834 )
Stock-based compensation               2,909             2,909  
Issuance of restricted and performance stock units   1,105,214       11       (11 )            
Exercise of stock options   258,573       3       2,380             2,383  
Balance at March 31, 2025   45,512,623     $ 455     $ 400,004     $ (295,094 )   $ 105,365  


Axogen, Inc.
Reconciliation of GAAP Financial Measures to Non-GAAP Financial Measures
(unaudited)
(in thousands, except share and per share amounts)​

EBITDA & Adjusted EBITDA   Three Months Ended
    March 31, 2026   March 31, 2025
Net loss   $ (19,584 )   $ (3,834 )
Depreciation and amortization expense     1,706       1,795  
Investment income     (768 )     (272 )
Income tax (benefit) expense     (33 )     29  
Interest expense     694       2,250  
EBITDA – non-GAAP   $ (17,985 )   $ (32 )
EBITDA margin – non-GAAP     (29.3 )%     (0.1 )%
         
Non-cash stock-based compensation expense     6,843       2,909  
Loss on extinguishment of debt     16,849        
Adjusted EBITDA – non-GAAP   $ 5,707     $ 2,877  
Adjusted EBITDA margin – non-GAAP     9.3 %     5.9 %

Axogen, Inc.
Reconciliation of GAAP Financial Measures to Non-GAAP Financial Measures
(unaudited)
(in thousands, except share and per share amounts)​

Adjusted Net Income   Three Months Ended March 31, 2026
    GAAP Results
  Non-cash Stock-based Compensation Expense
  Loss on Extinguishment of Debt
  Dilutive Shares Impact(1)
  Adjusted Results
Revenues   $ 61,457     $     $         $ 61,457  
Cost of goods sold     15,268       (919 )               14,349  
Gross profit     46,189       919                 47,108  
Costs and expenses:                      
Sales and marketing     28,633       (1,558 )               27,075  
Research and development     7,517       (1,419 )               6,098  
General and administrative     12,871       (2,947 )               9,924  
Total costs and expenses     49,021       (5,924 )               43,097  
(Loss) income from operations     (2,832 )     6,843                 4,011  
Other income (expense):                      
Investment income     768                       768  
Interest expense     (694 )                     (694 )
Loss on extinguishment of debt     (16,849 )           16,849            
Other income, net     23                       23  
Total other (expense) income, net     (16,752 )           16,849           97  
Net (loss) income   $ (19,584 )   $ 6,843     $ 16,849         $ 4,108  
                       
Weighted average common shares outstanding – diluted     51,591,504       51,591,504       51,591,504       5,183,717       56,775,221  
Net (loss) income per common share – diluted   $ (0.38 )   $ 0.13     $ 0.33     $ (0.01 )   $ 0.07  
__________
(1) Due to a GAAP net loss, antidilutive securities are excluded from GAAP diluted weighted average common shares outstanding. However, considering the adjusted net income position, adjusted diluted weighted average common shares outstanding incorporates securities that would have been dilutive for GAAP.


Axogen, Inc.
Reconciliation of GAAP Financial Measures to Non-GAAP Financial Measures
(unaudited)
(in thousands, except share and per share amounts)​

Adjusted Net Income   Three Months Ended March 31, 2025   Three Months Ended June 30, 2025   Three Months Ended September 30, 2025   Three Months Ended December 31, 2025
    GAAP Results
  Non-cash Stock-based Compensation Expense
  Adjusted Results
  GAAP Results
  Non-cash Stock-based Compensation Expense
  Adjusted Results
  GAAP Results
  Non-cash Stock-based Compensation Expense
  Adjusted Results
  GAAP Results
  Non-cash Stock-based Compensation Expense
  Adjusted Results(1)
Revenues   $ 48,560     $     $ 48,560     $ 56,662     $     $ 56,662     $ 60,082     $     $ 60,082     $ 59,904     $     $ 59,904  
Cost of goods sold     13,627       10       13,637       14,644       (709 )     13,935       14,089       (706 )     13,383       15,495       (2,274 )     13,221  
Gross profit     34,933       (10 )     34,923       42,018       709       42,727       45,993       706       46,699       44,409       2,274       46,683  
Costs and expenses:                                                
Sales and marketing     21,045       (584 )     20,461       23,804       (1,314 )     22,490       25,680       (1,524 )     24,156       27,211       (2,939 )     24,272  
Research and development     6,091       (720 )     5,371       6,853       (1,030 )     5,823       7,565       (1,047 )     6,518       12,376       (6,052 )     6,324  
General and administrative     9,458       (1,615 )     7,843       9,689       (2,115 )     7,574       10,836       (2,147 )     8,689       14,594       (5,346 )     9,248  
Total costs and expenses     36,594       (2,919 )     33,675       40,346       (4,459 )     35,887       44,081       (4,718 )     39,363       54,181       (14,337 )     39,844  
(Loss) income from operations     (1,661 )     2,909       1,248       1,672       5,168       6,840       1,912       5,424       7,336       (9,772 )     16,611       6,839  
Other income (expense):                                                
Investment income     272             272       225             225       319             319       352             352  
Interest expense     (2,250 )           (2,250 )     (1,977 )           (1,977 )     (1,757 )           (1,757 )     (1,718 )           (1,718 )
Change in fair value of debt derivative liabilities     (158 )           (158 )     480             480       209             209       (2,018 )           (2,018 )
Other (expense) income, net     (37 )           (37 )     179             179       25             25                    
Total other expense, net     (2,173 )           (2,173 )     (1,093 )           (1,093 )     (1,204 )           (1,204 )     (3,384 )           (3,384 )
Net (loss) income   $ (3,834 )   $ 2,909     $ (925 )   $ 579     $ 5,168     $ 5,747     $ 708     $ 5,424     $ 6,132     $ (13,156 )   $ 16,611     $ 3,455  
                                                 
Weighted average common shares outstanding – diluted     45,204,076       45,204,076       45,204,076       47,980,830       47,980,830       47,980,830       49,088,436       49,088,436       49,088,436       46,929,309       46,929,309       52,230,508  
Net (loss) income per common share – diluted   $ (0.08 )   $ 0.06     $ (0.02 )   $ 0.01     $ 0.11     $ 0.12     $ 0.01     $ 0.11     $ 0.12     $ (0.28 )   $ 0.35     $ 0.07  
__________
(1) Due to a GAAP net loss during the three months ended December 31, 2025, 5,301,199 antidilutive securities are excluded from GAAP diluted weighted average common shares outstanding. However, considering the adjusted net income position, adjusted diluted weighted average common shares outstanding incorporates securities that would have been dilutive for GAAP. The inclusion of these shares decreased adjusted Net income per common share by less than $0.01.


Axogen, Inc.
Reconciliation of GAAP Financial Measures to Non-GAAP Financial Measures
(unaudited)
(in thousands, except share and per share amounts)​

Adjusted Net Income   Twelve Months Ended December 31, 2025
    GAAP Results
  Non-cash Stock-based Compensation Expense
  Dilutive Shares Impact(1)
  Adjusted Results
Revenues   $ 225,208     $         $ 225,208  
Cost of goods sold     57,855       (3,680 )         54,175  
Gross profit     167,353       3,680           171,033  
Costs and expenses:                
Sales and marketing     97,740       (6,361 )         91,379  
Research and development     32,885       (8,848 )         24,037  
General and administrative     44,577       (11,223 )         33,354  
Total costs and expenses     175,202       (26,432 )         148,770  
(Loss) income from operations     (7,849 )     30,112           22,263  
Other income (expense):                
Investment income     1,168                 1,168  
Interest expense     (7,702 )               (7,702 )
Change in fair value of debt derivative liabilities     (1,487 )               (1,487 )
Other income, net     167                 167  
Total other expense, net     (7,854 )               (7,854 )
Net (loss) income   $ (15,703 )   $ 30,112         $ 14,409  
                 
Weighted average common shares outstanding – diluted     46,050,266       46,050,266       3,761,920       49,812,186  
Net (loss) income per common share – diluted   $ (0.34 )   $ 0.65     $ (0.02 )   $ 0.29  
__________
(1) Due to a GAAP net loss, antidilutive securities are excluded from GAAP diluted weighted average common shares outstanding. However, considering the adjusted net income position, adjusted diluted weighted average common shares outstanding incorporates securities that would have been dilutive for GAAP.


Free Cash Flow   Three Months Ended
    March 31, 2026   March 31, 2025
Net cash provided by (used in) operating activities   $ 1,565     $ (13,179 )
Purchase of property and equipment     (2,789 )     (256 )
Cash payments for intangible assets     (175 )     (405 )
Free cash flow   $ (1,399 )   $ (13,840 )

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Source: Axogen, Inc.