Xtant Medical Holdings, Inc.
For the period ended Jun 30, 2026. Filed Aug 11, 2026.
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Jun 30, 2026 · Filed Aug 11, 2026
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Item 1. FINANCIAL STATEMENTS
| ITEM 1. | FINANCIAL STATEMENTS |
|---|
Condensed Consolidated Balance Sheets
(In thousands, except number of shares and par value)
| As of June 30, 2026 | As of December 31, 2025 | |
|---|---|---|
| (Unaudited) | ||
| ASSETS | ||
| Current Assets: | ||
| Cash and cash equivalents | $9,870 | $17,053 |
| Restricted cash | 347 | 275 |
| Trade accounts receivable, net of allowance for credit losses and doubtful accounts of $2,234 and $2,165, respectively | 19,416 | 17,803 |
| Inventories | 33,287 | 30,263 |
| Note receivable | — | 10,462 |
| Prepaid and other current assets | 1,857 | 2,389 |
| Total current assets | 64,777 | 78,245 |
| Property and equipment, net | 5,542 | 6,202 |
| Right-of-use asset, net | 2,894 | 3,192 |
| Goodwill | 6,074 | 6,074 |
| Intangible assets, net | 252 | 299 |
| Other assets | 128 | 133 |
| Total Assets | $79,667 | $94,145 |
| LIABILITIES & STOCKHOLDERS’ EQUITY | ||
| Current Liabilities: | ||
| Accounts payable | $6,154 | $3,844 |
| Accrued liabilities | 7,481 | 10,626 |
| Current portion of long-term debt | 3,720 | 3,500 |
| Current portion of lease liability | 594 | 622 |
| Current portion of finance lease obligations | 29 | 35 |
| Line of credit | 11,985 | 10,857 |
| Total current liabilities | 29,963 | 29,484 |
| Long-term Liabilities: | ||
| Lease liability, less current portion | 2,397 | 2,665 |
| Finance lease obligation, less current portion | — | 12 |
| Long-term debt, plus premium and less issuance costs | 7,287 | 11,026 |
| Other liabilities | 5 | 5 |
| Total Liabilities | 39,652 | 43,192 |
| Commitments and Contingencies (note 13) | - | - |
| Stockholders’ Equity: | ||
| Preferred stock, $0.000001 par value; 10,000,000 shares authorized; no shares issued and outstanding | — | — |
| Common stock, $0.000001 par value; 300,000,000 shares authorized; 140,262,960 shares issued and outstanding as of June 30, 2026 and 140,039,557 shares issued and outstanding as of December 31, 2025 | — | — |
| Additional paid-in capital | 307,004 | 305,439 |
| Accumulated other comprehensive loss | (1) | — |
| Accumulated deficit | (266,988) | (254,486) |
| Total Stockholders’ Equity | 40,015 | 50,953 |
| Total Liabilities & Stockholders’ Equity | $79,667 | $94,145 |
Condensed Consolidated Statements of Operations
(Unaudited, in thousands, except number of shares and per share amounts)
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| 2026 | 2025 | 2026 | 2025 | |
| Revenue | ||||
| Product revenue | $23,031 | $30,436 | $43,915 | $59,720 |
| License revenue | — | 4,975 | — | 8,595 |
| Total Revenue | 23,031 | 35,411 | 43,915 | 68,315 |
| Cost of Sales | 9,701 | 11,127 | 18,614 | 23,788 |
| Gross Profit | 13,330 | 24,284 | 25,301 | 44,527 |
| Operating Expenses | ||||
| General and administrative | 6,436 | 7,478 | 12,709 | 15,011 |
| Sales and marketing | 10,368 | 11,616 | 18,554 | 22,820 |
| Research and development | 695 | 566 | 1,130 | 1,009 |
| Write-off of distribution agreement deposit | 5,000 | — | 5,000 | — |
| Total Operating Expenses | 22,499 | 19,660 | 37,393 | 38,840 |
| (Loss) Income from Operations | (9,169) | 4,624 | (12,092) | 5,687 |
| Other Expense | ||||
| Interest expense | (542) | (1,004) | (1,141) | (2,049) |
| Interest income | 1 | — | 220 | — |
| Unrealized foreign currency translation gain | 23 | 178 | 22 | 202 |
| Other income (expense) | 347 | 7 | 589 | (2) |
| Total Other Expense | (171) | (819) | (310) | (1,849) |
| Net (Loss) Income from Operations Before Provision for Income Taxes | (9,340) | 3,805 | (12,402) | 3,838 |
| Provision for Income Taxes Current and Deferred | (73) | (255) | (100) | (230) |
| Net (Loss) Income | $(9,413) | $3,550 | $(12,502) | $3,608 |
| Net (Loss) Income Per Share: | ||||
| Basic | $(0.07) | $0.03 | $(0.09) | $0.03 |
| Dilutive | $(0.07) | $0.02 | $(0.09) | $0.02 |
| Shares used in the computation: | ||||
| Basic | 140,258,667 | 139,310,589 | 140,159,255 | 139,190,378 |
| Dilutive | 140,258,667 | 148,574,242 | 140,159,255 | 148,339,423 |
Condensed Consolidated Statements of Comprehensive (Loss) Income
(Unaudited, in thousands)
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| 2026 | 2025 | 2026 | 2025 | |
| Net (Loss) Income | $(9,413) | $3,550 | $(12,502) | $3,608 |
| Other Comprehensive (Loss) Income | ||||
| Foreign currency translation adjustments | — | 361 | (1) | 468 |
| Comprehensive (Loss) Income | $(9,413) | $3,911 | $(12,503) | $4,076 |
Condensed Consolidated Statements of Equity
(Unaudited, in thousands, except number of shares)
| Common Stock · Additional Paid-In- · Accumulated Other Comprehensive · Accumulated · Total Stockholders’ | ||||||
|---|---|---|---|---|---|---|
| Shares | Amount | Capital | Income (Loss) | Deficit | Equity | |
| Balance at December 31, 2024 | 139,045,664 | $— | $302,738 | $(316) | $(259,459) | $42,963 |
| Common stock issued upon settlement of restricted stock units | 44,496 | — | — | — | — | — |
| Withholding of common stock upon settlement of restricted stock units | (7,986) | — | (9) | — | — | (9) |
| Stock-based compensation | — | — | 758 | — | — | 758 |
| Foreign currency translation adjustment | — | — | — | 107 | — | 107 |
| Net income | — | — | — | — | 58 | 58 |
| Balance at March 31, 2025 | 139,082,174 | — | 303,487 | (209) | (259,401) | 43,877 |
| Common stock issued upon settlement of restricted stock units | 342,128 | — | — | — | — | — |
| Withholding of common stock upon settlement of restricted stock units | (108,580) | — | (52) | — | — | (52) |
| Stock-based compensation | — | — | 766 | — | — | 766 |
| Foreign currency translation adjustment | — | — | — | 361 | — | 361 |
| Net income | — | — | — | — | 3,550 | 3,550 |
| Balance at June 30, 2025 | 139,315,722 | — | 304,201 | 152 | (255,851) | 48,502 |
| Balance at December 31, 2025 | 140,039,557 | $— | $305,439 | $— | $(254,486) | $50,953 |
| Common stock issued upon settlement of restricted stock units | 44,496 | — | — | — | — | — |
| Withholding of common stock upon settlement of restricted stock units | (15,793) | — | (10) | — | — | (10) |
| Stock-based compensation | — | — | 746 | — | — | 746 |
| Foreign currency translation adjustment | — | — | — | (1) | — | (1) |
| Net loss | — | — | — | — | (3,089) | (3,089) |
| Balance at March 31, 2026 | 140,068,260 | — | 306,175 | (1) | (257,575) | 48,599 |
| Common stock issued upon settlement of restricted stock units | 288,673 | — | — | — | — | — |
| Withholding of common stock upon settlement of restricted stock units | (93,973) | — | (46) | — | — | (46) |
| Stock-based compensation | — | — | 875 | — | — | 875 |
| Net loss | — | — | — | — | (9,413) | (9,413) |
| Balance at June 30, 2026 | 140,262,960 | — | 307,004 | (1) | (266,988) | 40,015 |
Condensed Consolidated Statements of Cash Flows
(Unaudited, in thousands)
| Six Months Ended June 30, | ||
|---|---|---|
| 2026 | 2025 | |
| Operating activities: | ||
| Net (loss) income | $(12,502) | $3,608 |
| Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||
| Depreciation and amortization | 1,042 | 2,243 |
| Loss (gain) on sale of fixed assets | 5 | (49) |
| Non-cash interest | 251 | 289 |
| Stock-based compensation | 1,621 | 1,524 |
| Provision for reserve on accounts receivable | 463 | 395 |
| Provision for excess and obsolete inventory | 1,496 | 490 |
| Write-off of distribution agreement deposit | 5,000 | — |
| Other | 3 | 46 |
| Changes in operating assets and liabilities: | ||
| Accounts receivable | (2,076) | (6,873) |
| Inventories | (3,591) | (1,349) |
| Prepaid and other assets | (298) | 347 |
| Accounts payable | 2,309 | (880) |
| Accrued liabilities | (3,145) | 2,763 |
| Net cash (used in) provided by operating activities | (9,422) | 2,554 |
| Investing activities: | ||
| Purchases of property and equipment | (441) | (1,557) |
| Proceeds from sale of fixed assets | 102 | 97 |
| Distribution agreement deposit | (5,000) | — |
| Proceeds from divestitures | 10,368 | — |
| Net cash provided by (used in) investing activities | 5,029 | (1,460) |
| Financing activities: | ||
| Borrowings on line of credit | 27,895 | 51,812 |
| Repayments on line of credit | (26,767) | (51,925) |
| Payments on long-term debt | (3,771) | — |
| Debt issuance costs | — | (49) |
| Payments on financing leases | (18) | (34) |
| Payment of taxes from withholding of common stock on settlement of restricted stock units | (56) | (61) |
| Net cash used in financing activities | (2,717) | (257) |
| Effect of exchange rate changes on cash and cash equivalents and restricted cash | (1) | (21) |
| Net change in cash and cash equivalents and restricted cash | (7,111) | 816 |
| Cash and cash equivalents and restricted cash at beginning of period | 17,328 | 6,221 |
| Cash and cash equivalents and restricted cash at end of period | $10,217 | $7,037 |
| Reconciliation of cash and cash equivalents and restricted cash reported in the condensed consolidated balance sheets | ||
| Cash and cash equivalents | $9,870 | $6,923 |
| Restricted cash | 347 | 114 |
| Total cash and restricted cash reported in condensed consolidated balance sheets | $10,217 | $7,037 |
Notes to Unaudited Condensed Consolidated Financial Statements
(1)Business Description, Basis of Presentation and Summary of Significant Accounting Policies
Business Description and Basis of Presentation
The accompanying condensed consolidated financial statements include the accounts of Xtant Medical Holdings, Inc. (“Xtant”), a Delaware corporation, and its wholly owned subsidiaries, which are jointly referred to herein as “Xtant” or the “Company”. The terms “we,” “us” and “our” also refer to Xtant. All intercompany balances and transactions have been eliminated in consolidation.
Xtant is a global medical technology company focused on the design, development, and commercialization of a comprehensive portfolio of orthobiologics and spinal implant fixation systems to facilitate spinal fusion in complex spine, deformity, and degenerative procedures.
The accompanying condensed consolidated balance sheet as of December 31, 2025, which has been derived from audited financial statements, and the unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). They do not include all disclosures required by generally accepted accounting principles for annual consolidated financial statements, but in the opinion of management include all adjustments, consisting only of normal recurring items, necessary for a fair presentation.
Interim results are not necessarily indicative of results that may be achieved in the future for the full year ending December 31, 2026.
These condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto, which are included in Xtant’s Annual Report on Form 10-K for the year ended December 31, 2025. The accounting policies set forth in those annual consolidated financial statements are the same as the accounting policies utilized in the preparation of these condensed consolidated financial statements, except as modified for appropriate interim consolidated financial statement presentation.
Use of Estimates
The preparation of the condensed consolidated financial statements requires the Company’s management to make a number of estimates and assumptions relating to the reported amount of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenue and expenses during the period. Significant estimates include the carrying amount of property and equipment; goodwill, intangible assets and liabilities; valuation allowances for trade receivables, inventory, our deposit paid to Dilon Technologies, Inc. under our distribution agreement with them, deferred income tax assets and liabilities; current and long-term lease obligations and corresponding right-of-use asset; and estimates for the fair value of long-term debt, stock options and other equity awards upon which the Company determines stock-based compensation expense. Actual results could differ from those estimates.
Cash, Cash Equivalents, and Restricted Cash
The Company considers all highly liquid investments purchased with an original maturity date of three months or less to be cash equivalents. Cash equivalents are recorded at cost, which approximates market value. The Company maintains its cash balances primarily with two financial institutions. These balances generally exceed federally insured limits. The Company has not experienced any losses in such accounts and believes it is not exposed to any significant credit risk in cash and cash equivalents.
Cash and cash equivalents classified as restricted cash on the Company’s condensed consolidated balance sheets are restricted as to withdrawal or use under the terms of certain contractual agreements. The June 30, 2026 and December 31, 2025 balances included lockbox deposits that are temporarily restricted due to timing at the period end. The lockbox deposits are applied against the Company’s line of credit the next business day.
Long-Lived Assets
The Company reviews its long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of the asset may not be recovered. No impairments of long-lived assets were recorded for the three and six months ended June 30, 2026 and 2025.
Goodwill
Goodwill represents the excess of costs over fair value of assets of businesses acquired. Goodwill and intangible assets acquired in a purchase business combination and determined to have indefinite useful lives are not amortized. Instead, they are tested for impairment at least annually, and whenever events or circumstances indicate, the carrying amount of the asset may not be recoverable. No impairments of goodwill were recorded for the three and six months ended June 30, 2026 and 2025.
Stock-Based Compensation
The Company accounts for stock-based compensation in accordance with Financial Accounting Standards Board, or FASB, Accounting Standards Codification (“ASC”) 718,Compensation-Stock Compensation. ASC 718 requires the recognition of compensation expense, using a fair-value based method, for costs related to all stock-based payments including stock options, restricted stock units, performance stock units, and shares issued under its employee stock purchase plan. ASC 718 requires companies to estimate the fair value of all share-based payment option awards on the date of grant using an option pricing model. The fair value of stock options is recognized over the period during which an optionee is required to provide services in exchange for the option award, known as the requisite service period (usually the vesting period), on a straight-line basis. The Company accounts for option forfeitures as they occur.
The Company accounts for stock-based compensation for restricted stock units and deferred stock units at their fair value, based on the closing market price of the Company’s common stock on the date of grant. These costs are recognized on a straight-line basis over the requisite service period, which is usually the vesting period.
The Company accounts for stock-based compensation for performance stock units with market-based conditions at their fair value on the date of the award using the Monte Carlo simulation model. These costs are recognized over the requisite service period, which is usually the vesting period, regardless of the likelihood of achievement of the market-based performance criteria.
Recently Issued Accounting Pronouncements
In November 2024, the Financial Accounting Standards Board issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40). This ASU requires that public business entities disclose additional information about specific expense categories in the notes to financial statements at interim and annual reporting periods. The prescribed categories include purchases of inventory, employee compensation, depreciation, intangible asset amortization, and depletion. This authoritative guidance is effective for annual periods beginning after December 15, 2026 and interim periods beginning after December 15, 2027, with early adoption permitted. The Company is currently evaluating the effect of this new guidance on its consolidated financial statements.
Foreign Currency
The Company generates revenues outside the United States in multiple foreign currencies including euros, Swiss francs, British pounds and in U.S. dollar-denominated transactions conducted with customers who generate revenue in currencies other than the U.S. dollar. The Company also incurs operating expenses in euros, Swiss francs and British pounds. All assets and liabilities of foreign subsidiaries which have a functional currency other than the U.S. dollar are translated at the rate of exchange at period-end, while elements of the income statement are translated at the average exchange rates in effect during the period. The net effect of these translation adjustments is shown as a component of accumulated other comprehensive loss. Foreign currency transaction gains and losses are reported in unrealized foreign currency translation gain.
Fair Value of Financial Instruments
The carrying values of financial instruments, including trade accounts receivable, note receivable, accounts payable, accrued liabilities and long-term debt, approximate their fair values based on terms and related interest rates as of June 30, 2026 and December 31, 2025.
(2)Dilon Distribution Agreement
On April 13, 2026, we announced that we entered into a Distribution Agreement (the “Distribution Agreement”) with Dilon Technologies, Inc. pursuant to which we obtained the exclusive rights to import, market, distribute and sell the HEMOBLAST® Bellows product in the United States. The HEMOBLAST® Bellows product is an FDA-approved powder-based, topical, surgical hemostatic agent used to control bleeding during surgical procedures. In connection with the agreement, we hired approximately 20 Dilon sales personnel to assist in selling the product in the United States. Under the Distribution Agreement, Dilon will continue to manufacture the HEMOBLAST® Bellows product at its facility in France and supply it to us at a specified transfer price, subject to adjustment in certain circumstances. The Distribution Agreement does not contain any minimum purchase requirements. Under the Distribution Agreement, we paid Dilon a $5.0 million exclusivity fee upon execution of the agreement. The fee is fully refundable to us in certain circumstances. Given the refundable nature of the payment, we initially recognized the $5.0 million as a deposit asset on our consolidated balance sheet. However, based on an assessment of facts and circumstances, including the uncertainty surrounding recovery of the payment and management’s expectation that repayment was not probable despite contractual repayment provisions, we recognized a $5.0 million charge to operating expenses during the three and six months ended June 30, 2026. Activity within the allowance for credit losses related to the Dilon deposit consists of the following (in thousands):
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| 2026 | 2025 | 2026 | 2025 | |
| Balance at beginning of period | $— | $— | $— | $— |
| Provision for current expected credit losses | 5,000 | — | 5,000 | — |
| Write-offs against allowance | $(5,000) | $— | $(5,000) | $— |
| Balance at June 30 | — | — | — | — |
(3)Sale of Coflex/CoFix Assets and International Hardware Business
On December 1, 2025, we completed the sale of certain assets relating to our Coflex and CoFix products (the “Coflex/CoFix Divestiture”) to Companion Spine, LLC and one of its affiliates, Companion Spine SAS (collectively, “Companion Spine”), pursuant to an Asset Purchase Agreement dated July 7, 2025 (the “Coflex/CoFix Agreement”). The total purchase price of the Coflex/CoFix Divestiture was $17.5 million (subject to a closing inventory valuation adjustment set forth in the Coflex/CoFix Agreement). Of the total purchase price, an aggregate of $7.5 million was previously paid to us in cash as non-refundable deposits during third and fourth quarters of 2025, $1.8 million was paid to us in cash at the closing, and $8.2 million was paid to us as an unsecured promissory note issued by Companion Spine to us at the closing (the “Companion Spine Note”). Pursuant to subsequent amendments to the Coflex/CoFix Agreement, the maturity date of the Companion Spine Note was extended to January 31, 2026. The outstanding principal balance of the Companion Spine Note, together with the related accrued interest, totaling $8.5 million, was paid to us on February 27, 2026.
Also, on December 1, 2025, we completed the sale of all of our shares of equity securities of Paradigm Spine GmbH, one of our then wholly owned subsidiaries engaged in the operation of our hardware business outside of the United States (“Paradigm”), which constituted 100% of the issued and outstanding shares of equity securities of Paradigm (the “Paradigm Divestiture” and together with the Coflex/CoFix Divestiture, the “Divestitures”), to Companion Spine pursuant to an Equity Purchase Agreement dated July 7, 2025 between us, Paradigm and Companion Spine (the “Paradigm Agreement” and together with the Coflex/CoFix Agreement, the “Divestiture Agreements”). The total purchase price of the Paradigm Divestiture was $3.9 million, $1.7 million of which was paid to us in cash at the closing of the Paradigm Divestiture and $2.2 million of which was paid to us on February 27, 2026 in settlement of the net working capital and other purchase price adjustments.
The aggregate purchase price associated with the two Divestitures was $21.4 million.
We determined that the Divestitures do not meet the criteria for classification as discontinued operations for accounting purposes. As a result, all historical operating results for the Coflex/CoFix assets and international hardware business are reflected within the consolidated statements of operations in the consolidated financial statements.
(4)Revenue
In the United States, the Company generates a substantial portion of its revenue from independent commissioned sales agents. The Company consigns its orthobiologics products to hospitals and consigns or loans its spinal implant sets to independent sales agents. The spinal implant sets typically contain the instruments, disposables, and spinal implants required to complete a surgery. Consigned sets are managed by the sales agent to service hospitals that are high volume users for multiple procedures.
The Company ships replacement inventory to independent sales agents to replace the consigned inventory used in surgeries. Loaned sets are returned to the Company’s distribution center, replenished, and made available to sales agents for the next surgical procedure.
For each surgical procedure, the sales agent reports use of the product by the hospital and, as soon as practicable thereafter, ensures that the hospital provides a purchase order to the Company. Revenue is recognized upon utilization of product.
Additionally, the Company sells product directly to domestic and international stocking resellers, original equipment manufacturer resellers and private label resellers. Upon receipt and acceptance of a purchase order from a stocking reseller, the Company ships product and invoices the reseller. The Company recognizes revenue when the control is transferred upon shipment or upon delivery, based on the contract terms and legal requirements, and the transfer of title and risk of loss occurs. There is generally no customer acceptance or other condition that prevents the Company from recognizing revenue in accordance with the delivery terms for these sales transactions. In the normal course of business, the Company accepts returns of product that have not been implanted. Product returns are not material to the Company’s consolidated statements of operations. The Company accounts for shipping and handling activities as a fulfillment cost rather than a separate performance obligation. The Company’s policy is to record revenue net of any applicable sales, use, or excise taxes. Payment terms are generally net 30 days from invoice date and some customers are offered discounts for early payment. The consideration for goods or services reflects any fixed amount stated per the contract and estimates for any variable consideration, such as returns, discounts or rebates, to the extent that it is probable that a significant reversal of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved. For certain sales transactions, we incur group purchasing organization fees that are based on a contractual percentage of applicable sales and are treated as consideration payable to a customer and recorded as a reduction of revenue.
The Company recognizes revenue in certain circumstances before product delivery occurs (commonly referred to as bill-and-hold transactions). When the Company enters into bill-and-hold arrangements, the Company determines if the customer obtains control of the product by determining (a) the reason for the bill-and-hold arrangement; (b) whether the product was identified separately as belonging to the customer; (c) whether the product was ready for physical transfer to the customer; and (d) whether the Company was unable to utilize the product or direct it to another customer. For bill-and-hold arrangements, the associated product inventory is identified separately by the Company as belonging to the customer and is ready for physical transfer. At June 30, 2026, $0.2 million was included in revenue for products that had not shipped. Occasionally the Company will receive consideration in advance of transferring products to its customers and records a contract liability. Contract liabilities are recognized as revenue in proportion to when control of the goods is transferred to the customer.
The Company distributes HEMOBLAST® Bellows product in the United States under the Distribution Agreement as discussed above in Note 2. Under the terms of the agreement, Dilon fulfilled certain customer orders during a transitionary period during which customer contracts were transitioned to the Company. We evaluated whether our performance obligation is a promise to transfer product to a customer as the principal, or to arrange for a product to be provided by another party using a control model as the agent. This evaluation determined that we are not in control of establishing the transaction price, managing all aspects of the shipment process and taking the risk of loss for delivery, collection and returns. Based on our evaluation of the control model, we determined that our responsibility under the Distribution Agreement during the transition period was an agent and not the principal. Correspondingly, during both the three and six months ended June 30, 2026, revenues recognized by the Company included $1.3 million recognized from purchase orders fulfilled by Dilon on behalf of the Company, recognized net of Dilon’s fulfillment costs.
License revenue
License revenue is recognized when control of the intellectual property (“IP”) rights is transferred to a customer in an amount that reflects the consideration the Company expects to be entitled to in exchange for the licensing of the Company’s IP. Revenue for IP rights is accounted for based on the nature of the promise to grant the license. In determining whether the Company’s promise is to provide a right to access its IP or a right to use its IP, the Company considers the nature of the IP to which the customer will have rights. IP is either functional IP which has significant standalone functionality or symbolic IP which does not have significant standalone functionality. Revenue from functional IP is recognized at the point in time when control of the distinct license is transferred to the customer. Revenue from symbolic IP is recognized over the access period to the Company’s IP.
Revenues from sales-based royalties promised in exchange for a license of IP is recognized at the later of when the underlying sale occurs, or the performance obligation to which some or all of the sales based royalty has been allocated is satisfied.
The Company has a license agreement which grants an exclusive, nontransferable, non-sublicensable, royalty bearing right to manufacture and commercialize one of our products in the United States. The Company concluded that this agreement represented one performance obligation of transferring the IP rights to manufacture and commercialize the product. This was determined to be functional IP. The transaction price included quarterly royalty payments based on the volume of product sold subject to guaranteed quarterly minimums. Due to policy changes by the Centers for Medicare & Medicaid Services that went into effect on January 1, 2026, no revenue was recognized in connection with the license agreement during the three and six months ended June 30, 2026.
Disaggregation of revenue
The Company operates in one reportable segment with its net revenue derived primarily from the sale of orthobiologics and spinal implant products across North America, Europe, Asia Pacific, and Latin America. Sales are reported net of returns, discounts and rebates.
The following table presents revenues from these product lines for the three and six months ended June 30, 2026 and 2025 (in thousands):
| Three Months Ended June 30, | ||||
|---|---|---|---|---|
| Percentage of · Percentage of | ||||
| 2026 | Total Revenue | 2025 | Total Revenue | |
| Orthobiologics | $17,360 | 75% | $19,370 | 55% |
| Spinal implant | 5,671 | 25% | 11,066 | 31% |
| License revenue | — | — | 4,975 | 14% |
| Total revenue | $23,031 | 100% | $35,411 | 100% |
| Six Months Ended June 30, | ||||
|---|---|---|---|---|
| 2026 | Percentage of Total Revenue | 2025 | Percentage of Total Revenue | |
| Orthobiologics | $32,969 | 75% | $37,444 | 55% |
| Spinal implant | 10,946 | 25% | 22,276 | 33% |
| License revenue | — | — | 8,595 | 12% |
| Total revenue | $43,915 | 100% | $68,315 | 100% |
(5)Trade Accounts Receivable, Net
Trade accounts receivable is reduced by an estimated allowance for credit losses based on historical collection experience adjusted for current economic conditions affecting collectability and reasonable and supportable forecasts concerning the future. Actual customer collections could differ from estimates. Account balances are charged to the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. Provisions to the allowance for credit losses are charged to expense. Activity within the allowance for credit losses consists of the following (in thousands):
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| 2026 | 2025 | 2026 | 2025 | |
| Balance at beginning of period | $2,115 | $1,705 | $2,165 | $1,437 |
| Provision for current expected credit losses | 283 | 147 | 463 | 390 |
| Write-offs against allowance | $(164) | $(57) | $(394) | $(32) |
| Balance at June 30 | 2,234 | 1,795 | 2,234 | 1,795 |
(6)Inventories
Inventories consist of the following (in thousands):
| June 30, 2026 | December 31, 2025 | |
|---|---|---|
| Raw materials | $6,454 | $5,689 |
| Work in process | 5,338 | 4,799 |
| Finished goods | 21,495 | 19,775 |
| Total | $33,287 | $30,263 |
(7)Property and Equipment, Net
Property and equipment, net are as follows (in thousands):
| June 30, 2026 | December 31, 2025 | |
|---|---|---|
| Equipment | $7,597 | $7,346 |
| Computer equipment | 1,315 | 1,252 |
| Computer software | 361 | 361 |
| Leasehold improvements | 4,559 | 4,483 |
| Surgical instruments | 13,799 | 14,070 |
| Assets not yet in service | 744 | 897 |
| Total cost | 28,375 | 28,409 |
| Less: accumulated depreciation | (22,833) | (22,207) |
| Property and equipment, net | $5,542 | $6,202 |
Depreciation expense related to property and equipment, including property under finance leases, for the three months ended June 30, 2026 and 2025 was $0.5 million and $0.8 million, respectively, and $1.0 million and $1.4 million for the six months ended June 30, 2026 and 2025, respectively.
(8)Intangible Assets
The following table sets forth information regarding intangible assets (in thousands):
| June 30, 2026: | Weighted Average Life | Cost | Accumulated Amortization | Net |
|---|---|---|---|---|
| Patents | 13 years | $1,027 | $(775) | $252 |
| December 31, 2025: | Weighted Average Life | Cost | Accumulated Amortization | Net |
|---|---|---|---|---|
| Patents | 13 years | $1,027 | $(728) | $299 |
Amortization expense for the three months ended June 30, 2026 and 2025 was $0.0 million and $0.5 million, respectively, and $0.0 million and $0.9 million for the six months ended June 30, 2026 and 2025, respectively.
(9)Accrued Liabilities
Accrued liabilities consist of the following (in thousands):
| June 30, 2026 | December 31, 2025 | |
|---|---|---|
| Wages/commissions payable | $6,910 | $6,726 |
| Taxes payable | 94 | 2,183 |
| Other accrued liabilities | 477 | 1,717 |
| Accrued liabilities | $7,481 | $10,626 |
(10)Debt
Long-term debt consists of the following (in thousands):
| June 30, 2026 | December 31, 2025 | |
|---|---|---|
| Amounts due under term loan | $10,229 | $14,000 |
| Accrued end-of-term payments | 988 | 817 |
| Less: unamortized debt issuance costs | (210) | (291) |
| Less: current portion of long-term debt | (3,720) | (3,500) |
| Long-term debt, less issuance costs and current portion of long-term debt | $7,287 | $11,026 |
As of June 30, 2026, scheduled principal payments for our term credit agreement are as follows (in thousands):
| Period | Scheduled Quarterly Payments | Annually |
|---|---|---|
| Remainder of 2026 | $930 | $1,860 |
| 2027 | 930 | 3,720 |
| 2028 | 930 | 3,720 |
| 2029 | 930 | 930 |
As of June 30, 2026, the effective rate of the term loan under our term credit agreement, inclusive of amortization of debt issuance costs and accretion of the final payment, was 14.74%, and the effective rate of the revolving loan under our revolving credit agreement was 8.23%. As of June 30, 2026, we had $12.0 million outstanding and $0.7 million of availability under our revolving credit facility.
The credit agreements contain affirmative and negative covenants customarily applicable to senior secured credit facilities, including covenants that, among other things, limit or restrict the ability of certain subsidiaries of the Company, as borrowers (the “Borrowers”), subject to negotiated exceptions, to incur additional indebtedness and additional liens on their assets, engage in mergers or acquisitions or dispose of assets, pay dividends or make other distributions, voluntarily prepay other indebtedness, enter into transactions with affiliated persons, make investments, and change the nature of their businesses. In addition, the credit agreements require the Borrowers and the Company to maintain net product revenue at or above minimum levels and to maintain a certain minimum liquidity level, in each case as specified in the credit agreements.
On March 26, 2026, we entered into Amendment No. 4 to Amended and Restated Credit, Security and Guaranty Agreement (Term Loan) with MidCap Financial Trust and Amendment No. 4 to Amended and Restated Credit, Security and Guaranty Agreement (Revolving Loan) with MidCap Funding IV Trust pursuant to which we eliminated the requirement to comply with the minimum net revenue covenant for fourth quarter of 2025, adjusted the amortization of the term loan to have amortization calculated off the amount of principal outstanding when amortization payments start instead of the original principal amount of the term loan, and revised the minimum net revenue covenant to align solely with revenue generated from the orthobiologics products and correspondingly adjust the minimum net revenue amounts.
On August 10, 2026, we entered into Amendment No. 5 to Amended and Restated Credit, Security and Guaranty Agreement (Term Loan) with MidCap Financial Trust and Amendment No. 5 to Amended and Restated Credit, Security and Guaranty Agreement (Revolving Loan) with MidCap Funding IV Trust (collectively, the “Amendment No. 5s”) pursuant to which we eliminated the requirement to comply with the minimum net revenue covenant for second quarter of 2026, adjusted the amortization of the term loan to increase quarterly principal payments by $0.15 million in the fourth quarter of 2026 and increased quarterly principal payments by $0.3 million thereafter until the outstanding principal balance of the Term Loan has been paid in full, and revised the minimum net revenue covenant to new minimum net revenue amounts.
As of June 30, 2026, the Company was in compliance with all applicable covenants under the credit agreements. As of June 30, 2026, our credit agreements included a minimum net revenue covenant; however, pursuant to the Amendment No. 5s executed in August 2026, we were not required to comply with the minimum net revenue covenant for the quarter ended June 30, 2026. Under the covenant terms in effect prior to the Amendment No. 5s, we would not have been in compliance with the minimum net revenue requirement for that quarter.
Each of the Borrowers, and the Company, as guarantor, are jointly and severally liable for all of the obligations under the facilities on the terms set forth in the credit agreements. The Borrowers’ obligations, and the Company’s obligations as a guarantor, under the credit agreements are secured by first-priority liens on substantially all of their assets, including, without limitation, all inventory, equipment, accounts, intellectual property and other assets of the Company and the Borrowers.
(11)Stock-Based Compensation
On July 26, 2023, our stockholders approved and adopted the Xtant Medical Holdings, Inc. 2023 Equity Incentive Plan (the “2023 Plan”), which replaced the Xtant Medical Holdings, Inc. 2018 Equity Incentive Plan (as amended and restated, the “2018 Plan”) with respect to future grants of equity awards, although the 2018 Plan continues to govern equity awards granted under the 2018 Plan. The 2023 Plan permits the Board of Directors, or a committee thereof, to grant to eligible employees, non-employee directors, and consultants of the Company non-statutory and incentive stock options, stock appreciation rights, restricted stock awards, restricted stock units, deferred stock units, performance awards, non-employee director awards, and other stock-based awards. The 2023 Plan is administered by the Compensation Committee of the Board of Directors. The Compensation Committee or the Board of Directors may select 2023 Plan participants and determine the nature and amount of awards to be granted. The maximum number of shares of our common stock available for issuance under the 2023 Plan, subject to adjustment pursuant to the terms of the 2023 Plan, as increased by an amendment approved by our stockholders on November 7, 2025, is (i)17,800,000 shares of common stock; (ii)7,695,812 shares of common stock remaining available for issuance under the 2018 Plan but not subject to outstanding awards under the 2018 Plan as of July 26, 2023; and (iii) up to 6,686,090 shares of common stock subject to awards outstanding under the 2018 Plan as of July 26, 2023 but only to the extent such awards are subsequently forfeited, cancelled, expire, or otherwise terminate without the issuance of such shares of common stock after such date.
Total stock-based compensation expense recognized for employees and directors was $0.9 million and $0.8 million for the three months ended June 30, 2026 and 2025, respectively, and $1.6 million and $1.5 million for the six months ended June 30, 2026 and 2025, respectively, and was recognized as general and administrative expense.
Stock Options
Stock option activity was as follows for the six months ended June 30, 2026 and 2025:
| 2026 | 2025 | |||||
|---|---|---|---|---|---|---|
| Shares | Weighted Average Exercise Price | Weighted Average Remaining Contract Term (years) | Shares | Weighted Average Exercise Price | Weighted Average Remaining Contract Term (years) | |
| Outstanding at January 1 | 3,760,472 | 1.30 | 3,925,403 | $1.29 | ||
| Cancelled or expired | (125,000) | 1.08 | (164,931) | 1.19 | ||
| Outstanding at June 30 | 3,635,472 | 1.30 | 5.30 | 3,760,472 | 1.30 | 6.43 |
| Exercisable at June 30 | 3,301,650 | 1.32 | 5.12 | 3,006,140 | 1.35 | 6.06 |
As of June 30, 2026, there was approximately $0.3 million of total unrecognized compensation expense related to unvested stock options. These costs are expected to be recognized over a weighted-average period of 1.1 years.
Restricted Stock Units and Deferred Stock Units
Restricted stock unit and deferred stock unit activity was as follows for the six months ended June 30, 2026 and 2025:
| 2026 | 2025 | |||
|---|---|---|---|---|
| Shares | Weighted Average Fair Value at Grant Date Per Share | Shares | Weighted Average Fair Value at Grant Date Per Share | |
| Outstanding at January 1 | 7,669,141 | $0.79 | 5,455,472 | $0.90 |
| Vested | (333,169) | 0.93 | (386,624) | 0.91 |
| Cancelled | (114,486) | 0.67 | (34,197) | 0.98 |
| Outstanding at June 30 | 7,221,486 | $0.79 | 5,034,651 | $0.90 |
Total stock-based compensation expense related to unvested restricted stock units and deferred stock units not yet recognized was $2.8 million as of June 30, 2026, which is expected to be allocated to expenses over a weighted-average period of 2.3 years.
Performance Stock Units
During 2024, the Company awarded performance stock units (“PSUs”) under the 2023 Plan to certain executive officers and key employees. The Company has awarded an aggregate of 1,894,985 PSUs, assuming target performance, and each PSU award can be earned and vested at the end of a three-year performance period based on the total stockholder return, or TSR, of the Company’s common stock price relative to a group of peer companies and subject to continued service to the Company. The number of shares of the Company’s common stock to be issued upon vesting and settlement of the PSUs range from 0% to 200% of the target number of shares underlying the award, depending on the Company’s performance against the group of peer companies.
During 2025, the Company awarded PSUs under the 2023 Plan to certain executive officers and key employees. The Company awarded 1,699,402 PSUs, assuming target performance, and each PSU award can be earned at the end of each of the three one-year performance periods based on stock appreciation goals and subject to continued service to the Company. After each one-year performance period, the amount earned in that period will vest equally over the remaining service periods. The number of shares of the Company’s common stock or deferred stock units to be issued upon vesting and settlement of the PSUs ranges from 0% to 200% of the target number of shares underlying the award, depending on the Company’s performance against the stock appreciation goals set forth in the awards.
Activity for PSU awards granted under the 2023 Plan, assuming target performance, was as follows for the six months ended June 30, 2026 and 2025:
| 2026 | 2025 | |||
|---|---|---|---|---|
| Shares | Weighted Average Fair Value | Shares | Weighted Average Fair Value | |
| Outstanding at January 1 | 3,340,111 | 1.16 | 1,640,709 | 1.49 |
| Forfeited | (122,768) | 1.49 | — | — |
| Outstanding at June 30 | 3,217,343 | 1.15 | 1,640,709 | 1.49 |
The total stock-based compensation cost related to unvested PSUs not yet recognized was $1.7 million as of June 30, 2026, which is expected to be allocated to expenses over a weighted-average period of 1.8 years.
(12)Warrants
Warrant activity was as follows for the six months ended June 30, 2026 and 2025:
| 2026 | 2025 | |||||
|---|---|---|---|---|---|---|
| Shares | Weighted Average Exercise Price | Weighted Average Remaining Contract Term (years) | Shares | Weighted Average Exercise Price | Weighted Average Remaining Contract Term (years) | |
| Outstanding at January 1 | 12,237,470 | 1.53 | 12,237,470 | 1.53 | 1.8 | |
| Cancelled or expired | (7,111,112) | 2.29 | — | — | ||
| Outstanding at June 30 | 5,126,358 | 0.48 | 1.17 | 12,237,470 | 1.53 | 1.3 |
| Exercisable at June 30 | 5,126,358 | 0.48 | 1.17 | 12,237,470 | 1.53 | 1.3 |
(13)Commitments and Contingencies
Litigation
We may be subject to potential liabilities under government regulations and various claims and legal actions that are pending but we believe are immaterial at this time or may be asserted in the future from time to time.
These matters arise in the ordinary course and conduct of our business and may include, for example, commercial, product liability, intellectual property, and employment matters. We intend to continue to defend the Company vigorously in such matters and when warranted, take legal action against others. Furthermore, we regularly assess contingencies to determine the degree of probability and range of possible loss for potential accrual in our financial statements. An estimated loss contingency is accrued in our financial statements if it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. Based on our assessment, we have adequately accrued an amount for contingent liabilities currently in existence. We do not accrue amounts for liabilities that we do not believe are probable or that we consider immaterial to our overall financial position. Litigation is inherently unpredictable, and unfavorable resolutions could occur. As a result, assessing contingencies is highly subjective and requires judgment about future events. The amount of ultimate loss may exceed the Company’s current accruals, and it is possible that its cash flows or results of operations could be materially affected in any particular period by the unfavorable resolution of one or more of these contingencies.
Indemnification Arrangements
Our indemnification arrangements generally include limited warranties and certain provisions for indemnifying customers against liabilities if our products or services infringe a third-party’s intellectual property rights. To date, we have not incurred any material costs as a result of such warranties or indemnification provisions and have not accrued any liabilities related to such obligations in the accompanying consolidated financial statements.
We have also agreed to indemnify our directors and executive officers for costs associated with any fees, expenses, judgments, fines, and settlement amounts incurred by any of these persons in any action or proceeding to which any of those persons is, or is threatened to be, made a party by reason of the person’s service as a director or officer, including any action by us, arising out of that person’s services as our director or officer or that person’s services provided to any other company or enterprise at our request.
(14)Income Taxes
Information on the Company’s income taxes for the periods reported is as follows:
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| 2026 | 2025 | 2026 | 2025 | |
| Income tax expense from continuing operations | $73 | $255 | $100 | $230 |
| (Loss) income from continuing operations before income taxes | $(9,340) | $3,805 | $(12,402) | $3,838 |
| Effective income tax rate | -0.8% | 6.7% | -0.8% | 6.0% |
Our effective tax rate for the three and six months ended June 30, 2026 differs from the statutory rate due to a valuation allowance against deferred tax assets, offset by the impact of cash state taxes.
Our effective tax rate for the three and six months ended June 30, 2025 differs from the statutory rate due to a valuation allowance against deferred tax assets, offset by the impact of cash state and foreign taxes.
As of June 30, 2026, the Company is not currently under examination by tax authorities.
(15)Net Income (Loss) Per Share
Basic net (loss) income per share is computed by dividing net (loss) income by the weighted average number of shares of common stock outstanding. Shares issued during the period and shares reacquired during the period are weighted for the portion of the period that they were outstanding. Diluted net (loss) income per share is computed in a manner consistent with that of basic earnings per share while giving effect to all potentially dilutive shares of common stock outstanding during the period, which include the assumed exercise of stock options and warrants using the treasury stock method. Diluted net (loss) income per share was the same as basic net (loss) income per share for the three and six months ended June 30, 2026, as shares issuable upon the exercise of stock options and warrants were anti-dilutive as a result of the net losses incurred for the periods.
The table below sets forth the computation of basic and diluted (loss) earnings per share (in thousands, except per share data):
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| 2026 | 2025 | 2026 | 2025 | |
| Numerator: | ||||
| Net (loss) income | $(9,413) | $3,550 | $(12,502) | $3,608 |
| Denominator: | ||||
| Basic – weighted average shares outstanding | 140,258,667 | 139,310,589 | 140,159,255 | 139,190,378 |
| Effect of dilutive securities: | ||||
| Employee restricted stock units and deferred stock units | — | 4,011,541 | — | 3,896,933 |
| Warrants | — | 5,252,112 | — | 5,252,112 |
| Diluted – weighted average shares outstanding | 140,258,667 | 148,574,242 | 140,159,255 | 148,339,423 |
| Basic (loss) earnings per share | (0.07) | 0.03 | (0.09) | 0.03 |
| Diluted (loss) earnings per share | (0.07) | 0.02 | (0.09) | 0.02 |
For the three months ended June 30, 2026 and 2025, an aggregate of 19,200,659 and 13,410,148 shares, respectively, underlying outstanding stock options, restricted stock units, deferred stock units, performance stock units and warrants were excluded for the diluted (loss) earnings per share calculation as they were anti-dilutive. For the six months ended June 30, 2026 and 2025, an aggregate of 19,200,659 and 13,524,756 shares, respectively, underlying outstanding stock options, restricted stock units, deferred stock units, performance stock units and warrants were excluded for the diluted (loss) earnings per share calculation as they were anti-dilutive.
(16)Supplemental Disclosure of Cash Flow Information
Supplemental cash flow information is as follows (in thousands):
| Six Months Ended | ||
|---|---|---|
| June 30, | ||
| 2026 | 2025 | |
| Cash paid during the period for: | ||
| Interest | $890 | $1,760 |
| Income taxes | 2,607 | 52 |
| Non-cash activities: | ||
| Increase in right of use assets and lease liability | $— | $2,107 |
(17)Segment and Geographic Information
The Company operates asone reportable and operating segment based upon the Company’s organization structure and the way in which the operations and investments are managed and evaluated by the chief operating decision maker (“CODM”), who is the Company’s Chief Executive Officer. The CODM uses consolidated net (loss) income as the primary measure of segment profit or loss to monitor performance and allocate resources.
The measure of segment assets is reported on the balance sheet as total assets. The CODM does not review segment assets at a level other than that presented in the Company’s consolidated balance sheets.
The table below provides the calculation of consolidated net (loss) income, which is the performance measure that is most consistent with GAAP, and the significant operating expenses included in this performance measure (in thousands):
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| 2026 | 2025 | 2026 | 2025 | |
| Revenue | $23,031 | $35,411 | $43,915 | $68,315 |
| Less cost of sales | 9,701 | 11,127 | 18,614 | 23,788 |
| Gross Profit | 13,330 | 24,284 | 25,301 | 44,527 |
| Gross Margin | 57.9% | 68.6% | 57.6% | 65.2% |
| Less: | ||||
| General and administrative | 6,436 | 7,478 | 12,709 | 15,011 |
| Sales and marketing | 10,368 | 11,616 | 18,554 | 22,820 |
| Research and development | 695 | 566 | 1,130 | 1,009 |
| Write-off of distribution agreement deposit | 5,000 | — | 5,000 | — |
| Interest expense | 542 | 1,004 | 1,141 | 2,049 |
| Interest income | (1) | — | (220) | — |
| Unrealized foreign currency translation gain | (23) | (178) | (22) | (202) |
| Other (income) expense | (347) | (7) | (589) | 2 |
| Provision for income taxes | 73 | 255 | 100 | 230 |
| Net (Loss) Income | $(9,413) | $3,550 | $(12,502) | $3,608 |
The Company attributes revenues to geographic areas based on the location of the customer. Total revenue by major geographic area is as follows (in thousands):
| Three Months Ended | Percentage of | Three Months Ended | Percentage of | |
|---|---|---|---|---|
| June 30, 2026 | Total Revenue | June 30, 2025 | Total Revenue | |
| United States | $22,462 | 98% | $32,133 | 91% |
| Rest of world | 569 | 2% | 3,278 | 9% |
| Total revenue | $23,031 | 100% | $35,411 | 100% |
| Six Months Ended | Percentage of | Six Months Ended | Percentage of | |
|---|---|---|---|---|
| June 30, 2026 | Total Revenue | June 30, 2025 | Total Revenue | |
| United States | $43,169 | 98% | $62,250 | 91% |
| Rest of world | 746 | 2% | 6,065 | 9% |
| Total revenue | $43,915 | 100% | $68,315 | 100% |
The text of this filing, as the company filed it with the SEC, without its images or exhibits. This is not investment advice.