SI-BONE, Inc.

Previous wording

We market our products primarily with a direct sales force as well as a number of third-party sales agents in the United States, and with a combination of a direct sales force and sales agents in other countries. As of March 31, 2026, nearly 150,000 procedures have been performed using our technologies since initial commercialization.

Current wording

We market our products primarily with a direct sales force as well as a number of third-party sales agents in the United States, and with a combination of a direct sales force and sales agents in other countries. As of June 30, 2026, over 150,000 procedures have been performed using our technologies since initial commercialization.

Previous wording

We monitor certain key performance indicators that we believe provide us and our investors indications of conditions that may affect results of our operations. Our revenue growth rate and commercial progress is impacted by, among other things, our key performance indicators, including our ability to expand access to solutions, increase physician penetration, launch new products, address human capital needs and gain operational efficiencies.

Current wording

We monitor certain key performance indicators that we believe provide us and our investors indications of conditions that may affect results of our operations. Our revenue growth rate, commercial progress and profitability are impacted by, among other things, our key performance indicators, including our ability to expand access to solutions, increase physician penetration, launch new products, address human capital needs and gain operational efficiencies.

Previous wording

We believe we are the industry leader in pioneering anatomy-specific solutions that are grounded in our biomechanical design expertise and backed by strong clinical evidence. Our product development strategy focuses on addressing unmet clinical needs while leveraging our existing platform technologies, enabling us to expand surgeon adoption and increase procedure volumes over time. As pioneers of minimally invasive treatment for sacroiliac joint dysfunction and degeneration, we developed a deep competency in addressing the challenges of low-density bone in the sacrum. Over the years, we have expanded our platform of solutions to address spinopelvic fixation and pelvic trauma. Our focus on innovation has resulted in three of our platform technologies being designated as breakthrough devices by the FDA.

Current wording

We believe we are the industry leader in pioneering anatomy-specific solutions that are grounded in our biomechanical design expertise and backed by strong clinical evidence. Our product development strategy focuses on addressing unmet clinical needs while leveraging our existing platform technologies, enabling us to expand physician adoption and increase procedure volumes over time. As pioneers of minimally invasive treatment for sacroiliac joint dysfunction and degeneration, we developed a deep competency in addressing the challenges of low-density bone in the sacrum. Over the years, we have expanded our platform of solutions to address spinopelvic fixation and pelvic trauma. Our focus on innovation has resulted in three of our platform technologies being designated as breakthrough devices by the FDA.

Previous wording

We continue to invest in research and development initiatives to bring new and differentiated solutions to the market. Robust clinical evidence is central to drive adoption and favorable reimbursement, and we remain focused on continuing to set the industry standard in delivering evidence-based care through best-in-class clinical trials that demonstrate the efficacy, safety, and economic benefit of our solutions. During the three months ended March 31, 2026, we spent $4.2 million on research and development, equating to 8.0% of our revenue. During the three months ended March 31, 2025, we spent $4.5 million on research and development, equating to 9.6% of our revenue.

Current wording

We continue to invest in research and development initiatives to bring new and differentiated solutions to the market. Robust clinical evidence is central to drive adoption and favorable reimbursement, and we remain focused on continuing to set the industry standard in delivering evidence-based care through best-in-class clinical trials that demonstrate the efficacy, safety, and economic benefit of our solutions. During the six months ended June 30, 2026, we spent $9.4 million on research and development, equating to 8.7% of our revenue. During the six months ended June 30, 2025, we spent $8.8 million on research and development, equating to 9.2% of our revenue.

Previous wording

Our commercial growth is driven by expansion of our sales organization, increased surgical capacity, and broader site-of-service adoption. As of March 31, 2026, our U.S. commercial organization included 89 territory sales managers, 80 clinical support specialists, and 336 third-party sales agents, compared to 85 territory sales managers, 78 clinical support specialists, and 278 third-party sales agents as of March 31, 2025.

Current wording

Our commercial growth is driven by expansion of our sales organization, increased surgical capacity, and broader site-of-service adoption. As of June 30, 2026, our U.S. commercial organization comprised of more than 175 sales team members, including territory sales managers and clinical support specialists, and more than 350 third-party sales agents. As of June 30, 2025, our U.S. commercial organization comprised of more than 160 sales team members, including territory sales managers and clinical support specialists, and 295 third-party sales agents.

Previous wording

As of March 31, 2026, our international commercial organization included 10 direct sales representatives and 28 third-party sales agents and resellers, compared to 10 direct sales representatives and 29 third-party sales agents and resellers as of March 31, 2025.

Current wording

As of June 30, 2026, our international commercial organization included 10 direct sales representatives and 31 third-party sales agents and resellers, compared to 10 direct sales representatives and 29 third- party sales agents and resellers as of June 30, 2025.

Previous wording

Our expanded platform allows us to serve our physicians across all sites of care. Over 33% of U.S. sacroiliac joint procedures were performed in ambulatory surgical center (“ASC”) and office-based lab (“OBL”) settings during the quarter.

Current wording

Our expanded platform allows us to serve our physicians across all sites of care. Over 35 percent of U.S. sacroiliac joint procedures were performed in ambulatory surgical center (“ASC”) and office-based lab (“OBL”) settings during the quarter.

Previous wording

Each year, we conduct instructor-led trainings designed to build people leadership capabilities and train managers on delivering actionable feedback. We have also adopted a goal for each of our managers to have regular check-ins with employees to discuss their personal goals and career plans in furtherance of our commitment to career and professional development.

Current wording

We conduct instructor-led trainings designed to build people leadership capabilities and train managers on delivering actionable feedback. We have also adopted a goal for each of our managers to have regular check-ins with employees to discuss their personal goals and career plans in furtherance of our commitment to career and professional development.

Previous wording

We are focused on increasing our territory sales managers’ and sales representatives’ capacity, efficiency and productivity. We may do this by adding more clinical support specialists and third-party sales agents as part of hybrid arrangements for case coverage, and by consigning instrument trays and implants at selective sites of service. As of March 31, 2026, our trailing twelve month average revenue per territory sales manager has increased to approximately $2.2 million from $2.0 million as of March 31, 2025.

Current wording

We are focused on increasing our territory sales managers’ capacity, efficiency and productivity. We may do this by adding more clinical support specialists and third-party sales agents as part of hybrid arrangements for case coverage, and by consigning instrument trays and implants at selective sites of service. As of June 30, 2026, our trailing twelve month average revenue per territory sales manager has increased to approximately $2.2 million from $2.1 million as of June 30, 2025.

Previous wording

Our revenue from sales of implants fluctuates based on volume of cases (procedures performed), discounts, mix of international and U.S. sales, different implant pricing and the number of implants used for a particular patient. Similar to other orthopedic companies, our case volume can vary from quarter to quarter due to a variety of factors including reimbursement, sales force changes, physician activities, product launches, and seasonality. In addition, our revenue is impacted by changes in average selling price as we respond to the competitive landscape and price differences at different medical facilities, such as hospitals, ASCs and OBLs. Further, revenue results can differ based upon the mix of business between U.S. and international sales mix of our products used, and the sales channel through which each procedure is supported. Our revenue from international sales is impacted by fluctuations in foreign currency exchange rates between the U.S. dollar (our reporting currency) and the local currency.

Current wording

Our revenue from sales of implants fluctuates based on volume of cases (procedures performed), discounts, mix of international and U.S. sales, different implant pricing and the number of implants used for a particular patient. Similar to other orthopedic companies, our case volume can vary from quarter to quarter due to a variety of factors including reimbursement, sales force changes, physician activities, product launches, and seasonality. In addition, our revenue is impacted by changes in average selling price as we respond to the competitive landscape and price differences at different medical facilities, such as hospitals, ASCs and OBLs. Revenue results can also vary based upon the mix of business between U.S. and international sales mix of our products used, and the sales channel through which each procedure is supported. Our revenue from international sales is impacted by fluctuations in foreign currency exchange rates between the U.S. dollar (our reporting currency) and the local currency.

Previous wording

Gross Profit and Gross Margin. Gross profit increased $4.2 million for the three months ended March 31, 2026 as compared to the three months ended March 31, 2025, mainly driven by higher revenue. The gross margin remained stable year-over-year, reflecting lower product costs partially offset by higher royalty expenses.

Current wording

Gross Profit and Gross Margin. Gross profit increased $5.7 million for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025, mainly driven by higher revenue. The gross margin was 79.5% for the three months ended June 30, 2026 compared to a gross margin of 79.8% for the three months ended June 30, 2025 due to changes in product mix.

Previous wording

Sales and Marketing Expenses. The increase in sales and marketing expenses for the three months ended March 31, 2026 as compared to the three months ended March 31, 2025 was primarily due to a $0.8 million increase in commissions and employee related costs driven by higher revenues and increase in headcount, and a $1.6 million increase in travel, training and marketing activities, partially offset by a decrease of $0.3 million related to stock-based compensation.

Current wording

Sales and Marketing Expenses. The increase in sales and marketing expenses for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 was primarily due to a $2.5 million increase in commissions and personnel cost driven by higher revenues and increase in headcount, and a $1.1 million increase related to travel, training and marketing activities, partially offset by a decrease of $0.4 million related to stock-based compensation.

Previous wording

Research and Development Expenses. The decrease in research and development expenses for the three months ended March 31, 2026 as compared to the three months ended March 31, 2025 was due to timing and stage of product development across projects, as we continue to invest in recently launched products, next generation product development, and clinical and regulatory initiatives.

Current wording

Research and Development Expenses. The increase in research and development expenses for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 was primarily due to a $0.9 million increase in next generation product development activities, clinical and regulatory initiatives.

Previous wording

General and Administrative Expenses. The increase in general and administrative expenses for the three months ended March 31, 2026 compared to the three months ended March 31, 2025 was primarily due to a $0.3 million increase in personnel costs and stock-based compensation, partially offset by a $0.3 million decrease in professional service costs.

Current wording

General and Administrative Expenses. The decrease in general and administrative expenses for the three months ended June 30, 2026 compared to the three months ended June 30, 2025 was primarily due to a $0.3 million decrease in personnel costs and stock-based compensation and a $0.3 million decrease in professional service costs.

Previous wording

Interest Income. The decrease in interest income for the three months ended March 31, 2026 as compared to the three months ended March 31, 2025 was primarily due to lower interest earned on our investments in marketable securities, primarily as a result of lower interest rates.

Current wording

Interest Income. The decrease in interest income for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 was primarily due to lower interest rate earned on our investments in marketable securities, primarily as a result of lower interest rates.

Previous wording

Interest Expense. The decrease in interest expense for the three months ended March 31, 2026 as compared to the three months ended March 31, 2025 was primarily due to lower interest rates associated with the First-Citizens Fourth Amended Loan Agreement.

Current wording

Interest Expense. The decrease in interest expense for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 was due to lower interest rates associated with the First-Citizens Fourth Amended Loan Agreement.

Previous wording

Revenue. The increase in revenue for the three months ended March 31, 2026 as compared to the three months ended March 31, 2025 was primarily driven by higher U.S. procedure volumes, supported by expanded adoption of our product portfolio, increased sales channel coverage, and continued growth in ASC and OBL settings.

Current wording

Revenue. The increase in revenue for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025 was primarily driven by an $11.3 million increase in U.S. revenue driven by 12.3% increase in procedure volumes, supported by expanded adoption of our product portfolio, increased sales channel coverage, and continued growth in ASC and OBL settings.

Previous wording

As of March 31, 2026, we had cash and marketable securities of $144.7 million as compared to $147.8 million as of December 31, 2025. We have financed our operations primarily through our public offerings and debt financing arrangements. As of both March 31, 2026 and December 31, 2025, we had $35.6 million in outstanding debt.

Current wording

As of June 30, 2026, we had cash and marketable securities of $145.9 million as compared to $147.8 million as of December 31, 2025. We have financed our operations primarily through the sale of our common stock in our public offerings and debt financing arrangements. As of both June 30, 2026 and December 31, 2025, we had $35.6 million in outstanding debt.

Previous wording

As of March 31, 2026, we had an accumulated deficit of $454.6 million as compared to $450.3 million as of December 31, 2025. During the three months ended March 31, 2026, we incurred a net loss of $4.3 million. During the years ended December 31, 2025 and 2024, we incurred a net loss of $18.9 million and $30.9 million, respectively, and expect to incur additional losses in the future.

Current wording

As of June 30, 2026, we had an accumulated deficit of $458.7 million as compared to $450.3 million as of December 31, 2025. During the six months ended June 30, 2026, we incurred a net loss of $8.4 million. During the years ended December 31, 2025 and 2024, we incurred a net loss of $18.9 million and $30.9 million, respectively, and expect to incur additional losses in the future. We have not achieved positive cash flow from operations for the six months ended June 30, 2026.

Previous wording

Based upon our current operating plan, we believe that our existing cash and marketable securities will enable us to fund our operating expenses and capital expenditure requirements over the next 12 months from the filing of this Form 10-Q. However, the financial impact of a potential economic downturn or capital market disruptions pose risks and uncertainties in our future available capital resources. We may face challenges and uncertainties and, as a result, may need to raise additional capital as our available capital resources may be consumed more rapidly than currently expected due to, but not limited to (a) decreases in sales of our products and the uncertainty of future revenues from new products; (b) changes we may make to the business that affect ongoing operating expenses; (c) changes we may make in our business strategy; (d) regulatory and reimbursement developments affecting our existing products; (e) changes we may make in our research and development spending plans; and (f) other items affecting our forecasted level of expenditures and use of cash resources. In addition, as we seek to deploy new product offerings, the need for additional capital to fund the purchase of inventories of implants and instrument trays may become more acute and may limit the number of revenue opportunities that we pursue. Each new product family introduced typically requires the purchase of consumable implant inventory as well as investment in a fleet of instrument trays required to support procedures nationwide.

Current wording

Based upon our current operating plan and improved cash flow from operations, we believe that our existing cash and marketable securities will enable us to fund our operating expenses and capital expenditure requirements over the next 12 months from the filing of this Form 10-Q. However, the financial impact of a potential economic downturn or capital market disruptions pose risks to uncertainties in our future available capital resources. We may face challenges and uncertainties and, as a result, may need to raise additional capital as our available capital resources may be consumed more rapidly than currently expected due to, but not limited to (a) decreases in sales of our products and the uncertainty of future revenues from new products; (b) changes we may make to the business that affect ongoing operating expenses; (c) changes we may make in our business strategy; (d) regulatory and reimbursement developments affecting our existing products; (e) changes we may make in our research and development spending plans; and (f) other items affecting our forecasted level of expenditures and use of cash resources. In addition, as we seek to deploy new product offerings, the need for additional capital to fund the purchase of inventories of implants and instrument trays may become more acute and may limit the number of revenue opportunities that we pursue. Each new product family introduced typically requires the purchase of consumable implant inventory as well as investment in a fleet of instrument trays required to support procedures nationwide.

Previous wording

On November 8, 2024, we entered into a Third Amendment to Loan and Security Agreement with First-Citizens to further amend our Second Amended Loan Agreement (the “Third Amendment” and together with the Second Amended Loan Agreement, collectively, the “Third Amended Loan Agreement”). Upon entry into the Third Amended Loan Agreement, we borrowed a new term loan in the aggregate principal amount of $36.0 million (the “Third Amendment Term Loan”), which was substantially used to refinance and repay in full the then-outstanding $36.0 million First Amendment Term Loan. We also paid a certain final payment fee due related to such prior First Amendment Term Loan. The Third Amendment set the maturity date for the Third Amendment Term Loan to September 1, 2029 (the "Third Amendment Term Loan Maturity Date"), and set the first principal repayment due date for to the Third Amendment Term Loan to October 1, 2027, which date will, upon the achievement of the Performance Milestone (as defined in the Third Amendment), be October 1, 2028. Interest on the outstanding principal balance of the Third Amendment Term Loan is payable monthly at a floating rate per annum equal to the greater of 4.25% and the WSJ prime rate minus 0.5%. The Company may elect to prepay the Third Amendment Term Loan in whole prior to the Third Amendment Term Loan Maturity Date, subject to a prepayment fee equal to 1.5% of the original principal amount of the Third Amendment Term Loan if the loan is prepaid within 18 months following the closing of the Third Amendment. The Third Amendment revised certain provisions related to financial covenants and the periods in which such covenants apply, and First-Citizens and the Company also agreed to terminate the Revolving Line and an uncommitted accordion term loan provision.

Current wording

On November 8, 2024, we entered into a Third Amendment to Loan and Security Agreement with First-Citizens to further amend our Second Amended Loan Agreement (the "Third Amendment" and together with the Second Amended Loan Agreement, collectively, the "Third Amended Loan Agreement"). Upon entry into the Third Amended Loan Agreement, we borrowed a new term loan in the aggregate principal amount of $36.0 million (the “Third Amendment Term Loan”), which was substantially used to refinance and repay in full the then-outstanding $36.0 million First Amendment Term Loan. We also paid a certain final payment fee related to such prior First Amendment Term Loan. The Third Amendment set the maturity date for the Third Amendment Term Loan to September 1, 2029 (the "Third Amendment Term Loan Maturity Date"), and set the first principal repayment due date for the Third Amendment Term Loan to October 1, 2027, which date will, upon the achievement of the Performance Milestone (as defined in the Third Amendment) become October 1, 2028. Interest on the outstanding principal balance of the Third Amendment Term Loan is payable monthly at a floating rate per annum equal to the greater of 4.25% and the WSJ prime rate minus 0.5%. The Company may elect to prepay the Third Amendment Term Loan in whole prior to the Third Amendment Term Loan Maturity Date, subject to a prepayment fee equal to 1.5% of the original principal amount of the Third Amendment Term Loan if the loan is prepaid within 18 months following the closing of the Third Amendment. The Third Amendment revised certain provisions related to financial covenants and the periods in which such covenants apply, and First-Citizens and the Company also agreed to terminate the Revolving Line and an uncommitted accordion term loan provision.

Previous wording

During the three months ended March 31, 2026, net cash used in operating activities was $2.4 million, consisting of a net loss of $4.3 million and an increase in net operating assets of $5.9 million, partially offset by non-cash charges of $7.9 million. During the three months ended March 31, 2025, net cash used in operating activities was $4.9 million, consisting of a net loss of $6.5 million and an increase in net operating assets of $6.2 million, partially offset by non-cash charges of $7.8 million.

Current wording

During the six months ended June 30, 2026, net cash used in operating activities was $1.6 million, consisting of a net loss of $8.4 million and an increase in net operating assets of $8.5 million, partially offset by non-cash charges of $15.4 million. During the six months ended June 30, 2025, net cash used in operating activities was $4.7 million, consisting of a net loss of $12.7 million and an increase in net operating assets of $8.7 million, partially offset by non-cash charges of $16.6 million.

Previous wording

Significant changes in net operating assets during the three months ended March 31, 2026 included higher inventory levels to support new product introductions, higher accounts receivable due to timing of sales and cash collections, and lower accrued liabilities and higher accounts payable balance due to the timing of payments. Non-cash charges consisted primarily of stock-based compensation and depreciation.

Current wording

Significant changes in net operating assets during the six months ended June 30, 2026 included higher inventory levels to support new product introductions, higher accounts receivable due to timing of sales and cash collections, and lower accrued liabilities and higher accounts payable balance due to the timing of payments. Non-cash charges consisted primarily of stock-based compensation and depreciation.

Previous wording

Net cash used in investing activities in the three months ended March 31, 2026 was $6.2 million as compared to cash provided by investing activities of $10.6 million in the three months ended March 31, 2025. Net cash used in investing activities for the three months ended March 31, 2026 consisted of purchases of our marketable securities net of maturities of $5.2 million, and purchases of property and equipment of $1.1 million primarily related to individual components in instrument trays to support revenue growth. Net cash provided by investing activities for the three months ended March 31, 2025 consisted of maturities of our marketable securities net of purchases of $12.7 million, and purchases of property and equipment of $2.1 million primarily related to individual components in instrument trays to support revenue growth.

Current wording

Net cash used in investing activities in the six months ended June 30, 2026 was $9.0 million as compared to cash provided by investing activities of $1.2 million in the six months ended June 30, 2025. Net cash used in investing activities for the six months ended June 30, 2026 consisted of a $6.3 million cash outflow from purchase of our marketable securities net of maturities, and $2.6 million purchases of property and equipment primarily related to individual components in instrument sets to support revenue growth and leasehold improvement assets for our new corporate office. Net cash provided by investing activities for the six months ended June 30, 2025 consisted of a $5.3 million cash inflow from maturities of our marketable securities net of purchases, and $4.2 million purchases of property and equipment primarily related to individual components in instrument sets to support revenue growth.

Previous wording

Cash provided by financing activities in the three months ended March 31, 2026 and 2025 resulted from the issuance of common stock under our stock-based incentive compensation plans.

Current wording

Cash provided by financing activities in the six months ended June 30, 2026 and 2025 was $1.7 million and $2.3 million, respectively, resulting from the issuance of common stock under our stock-based incentive compensation plans.