AxoGen, Inc.

Second quarter revenue was $69.7 million, up 23.1% year over year. Gross profit was $50.7 million and gross margin was 72.7%, down 150 basis points year over year. Net loss was $1.5 million, or $0.03 per share, versus net income of $0.6 million, or $0.01 per share, in Q2 2025. Adjusted net income was $7.3 million, or $0.12 per share, and adjusted EBITDA was $8.4 million. Cash, cash equivalents, restricted cash and investments totaled $113.4 million, and free cash flow was $4.1 million through the first half of 2026. For full-year 2026, management now expects revenue growth of at least 24%, or revenue of at least $279 million, gross margin of at least 73%, and continued free cash flow positivity. Management said this guidance does not assume material benefit from payer coverage decisions beyond what is already known.

Michael Dale framed the quarter as validation of Axogen’s six-priority strategy, emphasizing that customer creation and market development are outperforming plan across Extremities, OMF & Head and Neck, and Breast. He said the company is exceeding goals for surgeon adoption, new surgeons, new accounts, and patient awareness, with Breast growing especially fast and becoming a larger part of the mix. His tone was upbeat and confident, while acknowledging execution challenges such as margin pressure from mix and the need to keep expanding the sales footprint without sacrificing profitability.

Lindsey Hartley highlighted that Q2 revenue growth was driven by strong Avance demand and broader adoption of the product algorithm, with unit volume the primary driver. She detailed gross profit of $50.7 million and a 72.7% gross margin, explaining the shortfall versus plan by higher-cost biologic Avance sales and faster growth in long-length Avance tied to Breast demand, which together impacted margin by about 1% versus internal expectations. She also noted operating expenses of $52.8 million, adjusted net income of $7.3 million, adjusted EBITDA of $8.4 million, and year-to-date free cash flow of $4.1 million, while reiterating full-year guidance of at least 24% revenue growth, at least $279 million in revenue, at least 73% gross margin, and free cash flow positivity.

Analysts focused on the slower sequential growth versus Q1, the updated full-year outlook, Breast mix, payer coverage, and the Trace investment. Management said the biggest growth lever is sales-footprint expansion, along with rising patient and surgeon awareness, but also stressed that reimbursement wins are not yet easy to quantify because coverage changes take time to be socialized and implemented. On Aetna and Elevance, the team said timing is slower than expected but they remain hopeful, and on Trace they said the technology could broadly improve nerve visualization across indications rather than being limited to one segment.