PROCEPT BioRobotics Corporation

Second-quarter 2026 total revenue was $94.5 million, up 19% year over year. U.S. revenue was $83.4 million, up 20% year over year, and international revenue was $11.1 million, up 15%. U.S. procedures exceeded 13,100, up about 21% year over year. Gross margin was 66%, compared with 65% in the prior-year period, helped by a $2.9 million tariff recovery. Net loss was $26.9 million versus a net loss of $19.6 million a year ago, and adjusted EBITDA was a loss of $11.3 million versus a loss of $8 million. Cash, cash equivalents and restricted cash were $231 million at June 30, 2026. For 2026, the company guided to revenue of about $390 million to $410 million, international revenue of $50 million to $51 million, U.S. procedures of 54,000 to 56,000, gross margin of about 65%, operating expenses of $355 million to $360 million, and adjusted EBITDA loss of $35 million to $30 million, while still expecting positive adjusted EBITDA in Q4.

Larry Wood’s message was that the company is still executing on a broader commercial reset: reorganizing sales coverage, scaling a dedicated launch team, and pushing a replacement cycle to convert legacy AQUABEAM systems to HYDROS. He framed HYDROS as the stronger platform, citing better utilization, higher ASPs, and faster adoption, and said the company is focusing on durable growth rather than just near-term volume. His tone was confident but candid, acknowledging that legacy-account softness and procedure underperformance were real issues while emphasizing that the foundation for long-term growth is improving.

Kevin Waters walked through the quarter’s financials and guidance, highlighting $94.5 million of revenue, 66% gross margin, $231 million of cash and cash equivalents plus restricted cash, and an adjusted EBITDA loss of $11.3 million. He pointed to higher operating expenses of $89.8 million, driven by patient activation, innovation, and WATER IV spending, and said full-year operating expenses will be $355 million to $360 million. He also reiterated 2026 gross margin around 65%, said replacement sales should reach about 40 at the midpoint of guidance with ASPs of about $300,000 to $325,000, and maintained that positive adjusted EBITDA in Q4 remains expected.

Analysts focused on whether the lower procedure outlook implied weaker system demand and whether legacy AQUABEAM softness reflected competitive pressure, sales-force changes, RVU changes, or PAE. Management said system demand is still strong, with full-year system revenue implied at roughly $210 million to $220 million and no reliance on bulk IDN orders, while the bigger issue is weaker legacy-AQUABEAM utilization rather than HYDROS performance. They also said the launch-team model is still scaling, with about 40% of HYDROS placements launched through that team in Q2 and a goal of 100% by year-end, and that direct-to-patient pilots are showing encouraging leading indicators but will take time to convert into procedures.