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Carlsmed, Inc.
(NASDAQ:CARL)
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Rating:47Neutral
Price Target:
$14.00
▼(-10.26% Downside)
Action:Reiterated
Date:09/30/26
The score is primarily held back by weak financial performance—large ongoing losses and sustained cash burn outweigh strong revenue acceleration and high gross margins. Technical indicators also reflect soft near-term momentum. Offsetting these negatives, recent corporate events were constructive, including leadership strengthening and reaffirmed 2026 revenue guidance, while valuation remains difficult to assess due to negative earnings and no dividend.
Positive Factors
Accelerating revenue with strong gross margins
Faster revenue growth combined with consistently high gross margins indicates solid product economics and increasing commercial traction. If sustained, this combination can provide more gross profit to fund expansion, support operating leverage, and strengthen the company’s competitive position in personalized spine surgery.
Negative Factors
Deep and widening net losses
Large and increasing losses show that Carlsmed’s current operating cost structure absorbs most of the value created by revenue and gross profit. Without meaningful operating leverage, continued growth may not translate into earnings, limiting internal funding capacity and extending the path to sustainable profitability.
Read all positive and negative factors
Positive Factors
Negative Factors
Accelerating revenue with strong gross margins
Faster revenue growth combined with consistently high gross margins indicates solid product economics and increasing commercial traction. If sustained, this combination can provide more gross profit to fund expansion, support operating leverage, and strengthen the company’s competitive position in personalized spine surgery.
Read all positive factors
Carlsmed, Inc. (CARL) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$384.15M
Dividend YieldN/A
Average Volume (3M)101.71K
Price to Earnings (P/E)―
Beta (1Y)2.08
Revenue Growth65.39%
EPS Growth-39.10%
CountryUS
Employees127
SectorGeneral
Sector StrengthN/A
IndustryMedical - Healthcare Information Services
Share Statistics
EPS (TTM)-1.36
Shares Outstanding27,302,744
10 Day Avg. Volume76,855
30 Day Avg. Volume101,709
Financial Highlights & Ratios
PEG Ratio-0.14
Price to Book (P/B)1.78
Price to Sales (P/S)3.48
P/FCF Ratio-5.93
Enterprise Value/Market Cap<0.01
Enterprise Value/Revenue<0.01
Enterprise Value/Gross Profit<0.01
Enterprise Value/Ebitda>-0.01
Forecast
1Y Price Target
$19.33Price Target Upside23.93% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering5
EPS Forecast (FY)-1.45
Revenue Forecast (FY)$76.71M
Carlsmed, Inc. Business Overview & Revenue Model
Company Description
Carlsmed, Inc., a commercial-stage medical technology company, designs, manufactures, and markets AI-enabled personalized spine surgery solutions. The company develops aprevo, a comprehensive technology platform for spine fusion surgery procedures...
Carlsmed, Inc. Earnings Call Summary
Earnings Call Date:May 05, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Nov 05, 2026
Earnings Call Sentiment Positive
The call conveyed strong commercial and clinical momentum: robust top-line growth (Q1 revenue +58%), significant surgeon adoption (+60% surgeon users YoY), production efficiencies (lead time cut >30%, gross margin +220 bps), compelling peer‑reviewed clinical outcomes (74% reduction in two-year revisions), and constructive reimbursement developments (NTAP renewal and proposed favorable CMS coding). Offsetting these positives are rising operating expenses (+61% YoY), deeper GAAP losses and negative adjusted EBITDA, and higher cash burn from operations. The company raised full-year revenue guidance and expects operating leverage as revenue scales, while some policy items remain preliminary. On balance, the business appears to be in a growth-investment phase with improving unit economics and strong market validation but elevated near-term losses as it invests to scale.Positive Updates
Strong Revenue Growth
Q1 2026 revenue of $16.1M, up 58% year-over-year from $10.2M, driven by expansion of surgeon user base and increased unit volume sales.
Negative Updates
Increasing Operating Expenses
Total operating expenses rose to $21.7M in Q1 2026 from $13.4M in Q1 2025 (+61.2%), driven by higher R&D ($5.2M vs $3.2M, +62.5%), sales & marketing ($10.3M vs $6.7M, +53.7%), and G&A ($6.2M vs $3.5M, +77.1%).
Read all updates
Q1-2026 Updates
Positive
Negative
Strong Revenue Growth
Q1 2026 revenue of $16.1M, up 58% year-over-year from $10.2M, driven by expansion of surgeon user base and increased unit volume sales.
Read all positive updates
Company Guidance
Carlsmed raised full‑year 2026 revenue guidance to $72–$77 million (about 48% growth at the midpoint vs. FY2025) and expects gross margins to remain in the mid‑to‑high‑70% range, while forecasting average revenue per procedure in the mid‑to‑high $20k range as cervical procedures (expected to contribute high‑single‑digit to low‑double‑digit percent of revenue) scale; management also expects operating‑expense leverage and continued adjusted EBITDA improvement on a path toward cash‑flow breakeven. This guidance is supported by Q1 results of $16.1M revenue (+58% YoY), 77.1% gross margin (+220 bps YoY), $21.7M operating expenses, GAAP net loss of $8.7M, adjusted EBITDA (ex‑SBC) of −$7.5M, $97.1M cash & investments, $15.6M outstanding on a $50M debt facility, $13.0M cash used in operations in Q1, and operational improvements (lead time down >30% to six business days) to support scale.Carlsmed, Inc. Financial Statement Overview
Summary
Income Statement
34
Negative
Balance Sheet
52
Neutral
Cash Flow
28
Negative
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 |
|---|---|---|---|---|
Income Statement | ||||
| Total Revenue | 63.30M | 50.51M | 27.16M | 13.78M |
| Gross Profit | 48.50M | 38.04M | 20.05M | 9.90M |
| EBITDA | -24.22M | -27.92M | -22.79M | -18.12M |
| Net Income | -36.34M | -29.63M | -24.26M | -18.90M |
Balance Sheet | ||||
| Total Assets | 118.20M | 130.12M | 51.82M | 14.02M |
| Cash, Cash Equivalents and Short-Term Investments | 89.22M | 109.79M | 40.13M | 7.22M |
| Total Debt | 21.92M | 17.41M | 17.18M | 11.39M |
| Total Liabilities | 33.96M | 31.25M | 122.45M | 60.15M |
| Stockholders Equity | 84.25M | 98.87M | -70.63M | -46.13M |
Cash Flow | ||||
| Free Cash Flow | -34.20M | -29.62M | -25.65M | -17.61M |
| Operating Cash Flow | -34.15M | -28.98M | -25.47M | -17.48M |
| Investing Cash Flow | -44.44M | -25.48M | -180.00K | -135.00K |
| Financing Cash Flow | 91.35M | 100.13M | 58.50M | 3.18M |
Carlsmed, Inc. Technical Analysis
Neutral
15.60
Price Trends
14.55
Negative
12.88
Positive
12.24
Positive
Market Momentum
-0.19
Positive
35.80
Neutral
18.45
Positive
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For CARL, the sentiment is Neutral. The current price of 15.6 is above the 20-day moving average (MA) of 14.97, above the 50-day MA of 14.55, and above the 200-day MA of 12.24, indicating a neutral trend. The MACD of -0.19 indicates Positive momentum. The RSI at 35.80 is Neutral, neither overbought nor oversold. The STOCH value of 18.45 is Positive, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for CARL.
Carlsmed, Inc. Risk Analysis
Carlsmed, Inc. disclosed 78 risk factors in its most recent earnings report. Carlsmed, Inc. reported the most risks in the "Tech & Innovation" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Carlsmed, Inc. Peers Comparison
UnderperformOutperform
Sector (55)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
79 Outperform | $5.05B | 32.05 | 16.95% | ― | 11.18% | -28.59% | |
55 Neutral | $6.65B | 3.83 | -15.92% | 6.20% | 10.91% | 7.18% | |
55 Neutral | $230.98M | -2.68 | -33.27% | ― | -19.00% | 40.98% | |
52 Neutral | $1.05B | -5.83 | -13.08% | ― | -2.08% | 16.88% | |
47 Neutral | $384.15M | -10.17 | -38.06% | ― | 65.39% | -39.10% | |
47 Neutral | $20.66M | -0.85 | -686.78% | ― | ― | 26.80% |
* General Sector Average
CARL
Carlsmed, Inc.
14.27
1.30
10.02%
TDOC
Teladoc
5.52
-3.49
-38.73%
AMWL
American Well
12.39
6.06
95.73%
DOCS
Doximity
27.93
-45.33
-61.88%
BEAT
HeartBeam
0.43
-1.52
-77.74%
EUDA
EUDA Health Holdings
17.24
-27.36
-61.35%
Carlsmed, Inc. Corporate Events
Business Operations and StrategyExecutive/Board ChangesFinancial Disclosures
Carlsmed Appoints New CFO and Reaffirms 2026 Guidance
Positive
Sep 30, 2026
On September 28, 2026, Carlsmed announced the departure of Chief Financial Officer Leo Greenstein, effective September 25, 2026, under a separation agreement that includes cash severance, incentive compensation, COBRA coverage, and accelerated ves...
Business Operations and StrategyExecutive/Board Changes
Carlsmed appoints Jeff Bertolini as new COO
Positive
Sep 8, 2026
On September 4, 2026, Carlsmed’s board appointed veteran operations executive Jeff Bertolini as Chief Operating Officer, effective September 8, 2026, formalizing his promotion from Senior Vice President, Operational Excellence. BertoliniR...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.