NeuroPace, Inc.

Total revenue in Q2 2026 was $22.8 million, up 17% from $19.5 million in Q2 2025. RNS System revenue was $22.5 million, up 21.3% from $18.6 million, and first-half 2026 RNS revenue was $44.2 million, up 20.4% year over year. Adjusted gross margin was 83.4% versus 84.0% a year ago; GAAP gross margin was 82.8%. Adjusted operating expense was $21.9 million, up about 3% from $21.3 million. Adjusted loss from operations was $2.8 million versus $5.0 million; adjusted EBITDA loss was $2.8 million versus $4.9 million; adjusted net loss was $3.9 million versus $6.8 million. GAAP net loss from continuing operations was $6.2 million versus $10.0 million. Cash equivalents, short-term investments, and restricted cash were $51.9 million, and long-term borrowings were $59.0 million. For 2026, management raised total revenue guidance to $99.5 million-$101.5 million from $99.0 million-$101.0 million, with RNS revenue expected at $98.5 million-$100.5 million, or 21%-23% growth; third-quarter RNS growth is expected to be similar to the first half at about 20% year over year. Adjusted gross margin guidance moved up to 82%-83%, adjusted operating expenses remain $90 million-$92 million, and adjusted EBITDA loss is now expected at $7.5 million-$8.5 million.

Joel Becker said the core business is continuing to gain momentum, with new all-time highs in active prescribers, active accounts, and the patient pipeline. He framed the company’s strategy around three pillars: expanding adoption and utilization in the current adult focal epilepsy market, advancing the IGE opportunity, and building differentiated product capabilities through AI, remote care, and the next-generation platform. On the FDA setback in IGE, he stressed that the agency had not disapproved the filing and that management still sees a path to approval through the SIR process and a planned amendment.

Patrick Williams highlighted operating leverage: revenue grew 17% while adjusted operating expense rose only about 3%, and adjusted gross margin held at 83.4% despite modestly higher material costs. He pointed to improved service revenue visibility as the main reason full-year revenue guidance moved up, and he also raised adjusted gross margin guidance to 82%-83% and adjusted EBITDA loss guidance to $7.5 million-$8.5 million. He ended with a capital discipline message, noting the company is balancing investment in growth with progress toward profitability while maintaining its long-term spending plan.

Analysts focused heavily on the FDA’s IGE response, asking about the SIR meeting timing, possible back-and-forth, and whether a resubmission could still happen this year. Management said the meeting is expected over the next few weeks, the process remains interactive, and they do not expect the FDA to restart the full 180-day clock, though the agency can do so. Questions also centered on commercialization beyond Level 4 epilepsy centers, utilization at existing accounts, and how AI will be monetized; management said community expansion is already underway, AI tools like ECoG Assistant are bundled into the RNS platform rather than sold separately, and the near-term value is mainly through better workflow and higher RNS adoption.