Raises full-year 2026 revenue guidance to a range of $101-$105 million

Significantly strengthens balance sheet

Enters into exclusive U.S. distribution agreement for Dilon Technologies' HEMOBLAST^® Bellows product for high-performance hemostasis; hires Dilon's U.S. sales team

BELGRADE, Mont., May 13, 2026 /PRNewswire/ -- Xtant Medical Holdings, Inc. (NYSE American: XTNT), a medical technology company focused on surgical solutions for spinal and other orthopedic conditions, today reported financial and operating results for the first quarter ended March 31, 2026.

First Quarter 2026 Financial Highlights

• Generated total revenue of $20.9 million for the first quarter of 2026, as compared to $32.9 million for the first quarter of 2025. The decline in revenue relates primarily to the sale of assets and businesses to Companion Spine in December 2025 as well as 2025 license revenue that will not repeat in 2026. 
• Reduced total indebtedness by $13.3 million in the first quarter of 2026, including a $10.4 million reduction in net amounts outstanding under the Company's revolving line of credit, and a $2.8 million reduction in its term loan balance. 
• Increased full-year 2026 revenue guidance to a range of $101 million to $105 million, from $95 million to $99 million previously, to reflect anticipated incremental revenue contribution from Dilon's HEMOBLAST^® Bellows hemostatic product that was licensed in April 2026.

First Quarter 2026 and Recent Business Highlights

• Announced an exclusive U.S. distribution agreement with privately held Dilon Technologies whereby Xtant has acquired the exclusive U.S. commercial rights to Dilon's HEMOBLAST^® Bellows product for high-performance hemostasis following certain surgical procedures. As part of the transaction, Xtant has hired Dilon's approximately 20-person U.S. sales team.    
• Launched Trivium^™ Shaped, an extension of its Trivium line of premium, next-generation demineralized bone matrix allograft for bone grafting procedures. Trivium^™ Shaped is available in pre‑shaped configurations designed to support handling, preparation, and placement across a range of surgical applications.
• Received the final $10.7 million due from Companion Spine in March, finalizing the previously announced sale of Xtant's non-core Coflex^®/CoFix assets and its international hardware business to Companion, and resulting in a total cash purchase price of $21.4 million.

Sean Browne, President and CEO of Xtant Medical, stated, "The first quarter of 2026 and subsequent period were pivotal for Xtant. Proceeds from the Companion Spine transaction allowed us to strengthen our balance sheet while the HEMOBLAST^® Bellows distribution agreement announced in April expanded our addressable market into the multi-billion-dollar hemostatics category. We are particularly encouraged by the potential commercial synergies to be realized following the integration of Dilon's 21-person field sales force into our own organization, positioning us to drive topline growth and margin expansion this year and beyond. These developments, together with recent product launches, position us to best serve the needs of surgeons and patients alike with our comprehensive biologics product portfolio."

First Quarter 2026 Financial Results

Revenue for the first quarter of 2026 was $20.9 million, compared to $32.9 million for the same period in 2025. The year-over-year decline is primarily due to the sale of the company's Coflex/CoFix assets and international hardware business to Companion Spine in December of 2025, as well as license revenue from Xtant's Q-code and amniotic membrane agreements in the first quarter of 2025 that did not repeat in the first quarter of 2026 due to changes in the reimbursement environment.  

Gross margin for the first quarter of 2026 was 57.3%, compared to 61.5% for the same period in 2025. The decrease was primarily due to the cessation of Q-code high-margin license revenue from the amniotic membrane agreements that ceased at the end of 2025.

Operating expenses for the first quarter of 2026 totaled $14.9 million, compared to $19.2  million for the first quarter of 2025. The decrease was primarily due to the company's sale of its Coflex/CoFix assets and international hardware business to Companion Spine in December 2025.

First quarter 2026 net loss was $3.1 million, compared to net income of $58,000 for the first quarter of 2025.

Non-GAAP adjusted EBITDA loss for the first quarter of 2026 totaled $1.6 million, compared to positive adjusted EBITDA of $3.0 million for the same period in 2025.

The Company defines adjusted EBITDA as net income/loss from operations before depreciation, amortization and interest income/expense and provision for income tax/benefit, and as further adjusted to add back in or exclude, as applicable, separation-related expenses, non-cash compensation, disposition/acquisition-related income and expenses, acquisition-related fair value adjustments, and unrealized foreign currency translation gain or loss. A calculation and reconciliation of adjusted EBITDA to net income (loss) can be found in the attached financial tables.

As of March 31, 2026, the Company had $12.2 million of cash and cash equivalents, total indebtedness of $12.2 million, and availability under its revolving credit facility of $11.8 million compared to $17.3 million of cash and cash equivalents, total indebtedness of $25.4 million, and availability under its revolving credit facility of $3.8 million as of December 31, 2025. The reduction in total indebtedness was due primarily to the term loan payment of $2.8 million from some of the February 2026 proceeds from Companion Spine and net repayments of $10.4 million on the revolving credit facility from cash and cash equivalents, and the resulting increase in availability under the revolving credit agreement is due to an effort to reduce interest expense by minimizing the outstanding balance on the Company's revolving credit facility.

2026 Financial Guidance

The Company is today increasing its full-year 2026 revenue guidance to a range of $101 million to $105 million, from $95 million to $99 million previously, to reflect the recently announced exclusive license agreement with Dilon Technologies and anticipated incremental revenue contribution from Dilon's HEMOBLAST^® Bellows.

Conference Call

Xtant Medical will host a webcast and conference call to discuss its first quarter 2026 financial and operating results at 8:30 am ET today, May 13, 2026.

To access the webcast: https://www.webcaster5.com/Webcast/Page/3039/53872

To access the conference call, dial 888-506-0062 (US) or 973-528-0011 (International) and reference Participant Access Code 638297.

A replay of the call will be available on the Investor section of the Company's website at www.xtantmedical.com for a period of one year.

About Xtant Medical Holdings, Inc.

Xtant Medical's mission of honoring the gift of donation so that our patients can live as full and complete a life as possible, is the driving force behind our company. Xtant Medical Holdings, Inc. (www.xtantmedical.com) is a global medical technology company focused on the design, development, and commercialization of a comprehensive portfolio of orthobiologics serving the chronic and surgical wound care and sports medicine markets, as well as spinal implant systems. Xtant people are dedicated and talented, operating with the highest integrity to serve our customers.

The symbols ^™ and ^® denote trademarks and registered trademarks of Xtant Medical Holdings, Inc. or its affiliates, registered as indicated in the United States, and in other countries. All other trademarks and trade names referred to in this release are the property of their respective owners.

Non-GAAP Financial Measures

To supplement the Company's consolidated financial statements prepared in accordance with U.S. generally accepted accounting principles (GAAP), the Company uses certain non-GAAP financial measures in this release, including adjusted EBITDA, adjusted EBITDA as a percentage of total revenue. Reconciliations of the non-GAAP financial measures used in this release to the most comparable GAAP measures for the respective periods can be found in this release or tables later in this release. The Company's management believes that the presentation of these measures provides useful information to investors. These measures may assist investors in evaluating the Company's operations, period over period. Management uses the non-GAAP measures in this release internally for evaluation of the performance of the business, including the allocation of resources. Investors should consider non-GAAP financial measures only as a supplement to, not as a substitute for or as superior to, measures of financial performance prepared in accordance with GAAP.

Cautionary Statement Regarding Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include statements that are predictive in nature, that depend upon or refer to future events or conditions, or that include words such as "intends," ''expects,'' ''anticipates,'' ''plans,'' ''believes,'' ''estimates,'' "continue," "future," ''will,'' "potential," "going forward," "guidance," similar expressions or the negative thereof, and the use of future dates. Forward-looking statements in this release include the Company's full year 2026 revenue guidance, including anticipated incremental revenue contribution from Dilon's HEMOBLAST^® Bellows hemostatic product. The Company cautions that its forward-looking statements by their nature involve risks and uncertainties, and actual results may differ materially depending on a variety of important factors, including, among others: the Company's future operating results, financial performance and need for additional capital; the Company's ability to drive topline growth and margin expansion this year and beyond; the success of the distribution arrangement and the HEMOBLAST^® Bellows product, including future U.S. sales and the additional U.S. sales personnel and their impact on the Company's business and operating results; the possibility that the distribution agreement may be terminated by either party; the effect of the distribution agreement on the Company's business, including its relationships with other distributors, independent sales representatives and personnel, and its business and operating results; the success of the Company's expanded field sales force to improve the Company's reach and leverage its contract portfolio and independent agent network; the Company's ability to become operationally self-sustaining and less reliant on third-party manufacturers and suppliers; risks associated with acquisitions and dispositions; its ability to implement successfully its future growth initiatives and risks associated therewith; possible future impairment charges to long-lived assets and goodwill and write-downs of excess and obsolete inventory; its ability to continue to innovate, develop and introduce new products and the success of those products; its ability to remain competitive; its ability to engage and retain new and existing independent distributors and agents and qualified sales and other personnel and its dependence on key independent agents for a significant portion of its revenue; the effect of inflation, elevated interest rates and other recessionary factors and supply chain disruptions; the effect of product sales mix changes on its financial results; the effect of government and third-party coverage and reimbursement for its products; its ability to obtain and maintain regulatory approvals and comply with government regulations; the effect of product liability claims and other litigation to which the Company may be subject; the effect of product recalls and defects; its ability to license intellectual property on commercially reasonable terms and to maintain any such licenses and its ability to obtain and protect its intellectual property and proprietary rights and operate without infringing the rights of others; its ability to service its debt, comply with debt covenants, and access additional indebtedness or financing on favorable terms or at all, if and when needed; and other factors described in its Annual Report on Form 10-K for the year ended December 31, 2025 to be filed with the Securities and Exchange Commission (SEC) on March 30, 2026 and subsequent SEC reports, including its Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2026 to be filed with the SEC on May 13, 2026. Investors are encouraged to read the Company's filings with the SEC, available at www.sec.gov, for a discussion of these and other risks and uncertainties. The Company undertakes no obligation to release publicly any revisions to any forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events, except as required by law. All forward-looking statements attributable to the Company or persons acting on its behalf are expressly qualified in their entirety by this cautionary statement.

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SOURCE Xtant Medical Holdings, Inc.

Investor Relations Contact: Kevin Gardner, LifeSci Advisors, kgardner@lifesciadvisors.com; Rob Windsor, LifeSci Advisors, rwindsor@lifescipartners.com