SI-BONE, Inc. Reports Record Financial Results for the Fourth Quarter 2024 and Issues 2025 Guidance Achieves 26% worldwide revenue growth and positive adjusted EBITDA in Fourth Quarter 2024

SI-BONE, Inc. Reports Record Financial Results for the Fourth Quarter 2024 and Issues 2025 Guidance

Achieves 26% worldwide revenue growth and positive adjusted EBITDA in Fourth Quarter 2024

SANTA CLARA, Calif. February 24, 2025 - SI-BONE, Inc. (Nasdaq SIBN), a medical device company dedicated to solving sacropelvic disorders, today reported financial results for the fourth quarter and full year ended December 31, 2024.

Fourth Quarter 2024 Financial Highlights (all comparisons are to the prior year period)

Worldwide revenue of $49.0 million, representing growth of 26%

U.S. revenue of $46.9 million, representing growth of 28%

Net loss of $4.5 million, representing an improvement of 59%

Positive adjusted EBITDA of $1.9 million, representing an improvement of 139%

Ended the quarter with $150.0 million in cash and equivalents, representing $0.8 million in net cash usage

Fiscal Year 2024 Highlights (all comparisons are to the prior year period)

Worldwide revenue of $167.2 million, representing growth of 20%

U.S. revenue of $158.4 million, representing growth of 21%

Net loss of $30.9 million, representing an improvement of 29%

Adjusted EBITDA loss of $5.1 million, representing an improvement of 71%

Recent Operational Highlights (any comparisons are to the prior year period)

1,400 active U.S. physicians in the fourth quarter, representing an increase of 23%

Granted Transitional Pass-Through payment status effective January 1, 2025 for Granite outpatient procedures

Received third Breakthrough Device Designation for a novel implant system

"2024 was a transformative year for SI-BONE. Years of innovation, strategic investments, and disciplined execution are delivering meaningful results, including record revenue and positive adjusted EBITDA in the fourth quarter. More than 2,000 U.S. physicians performed a SI-BONE procedure last year, improving the lives of nearly 18,000 patients," said Laura Francis, Chief Executive Officer. "With a total addressable market of nearly 500,000 procedures, we are still in the early stages of unlocking SI-BONE's full potential for strong, sustainable, and highly profitable growth. In 2025, I am excited about the opportunities to further expand platform adoption, supported by reimbursement tailwinds, while advancing toward achieving positive annual AEBITDA and improving our margins."

Fourth Quarter 2024 Financial Results

Worldwide revenue was $49.0 million in the fourth quarter 2024, a 26% increase from $38.9 million in the corresponding period in 2023. U.S. revenue for the fourth quarter 2024 was $46.9 million, a 28% increase from

$36.7 million in the corresponding period in 2023. International revenue for the fourth quarter 2024 was $2.1 million compared to $2.2 million in the corresponding period in 2023.

Gross profit was $38.8 million in the fourth quarter 2024, an increase of 35% from $28.7 million in the corresponding period in 2023. Gross margin was 79% for the fourth quarter 2024 compared to 74% in the corresponding period in 2023. The fourth quarter 2023 gross margin reflects a four percentage point reduction, resulting from a $1.7 million excess inventory reserve.

Operating expenses increased 8% to $44.3 million in the fourth quarter 2024, as compared to $41.2 million in the corresponding period in 2023. The change in operating expenses was primarily driven by general commercial activity related to higher revenue and new product rollout, as well as research and development investments related to future products.

Operating loss improved by 56% to $5.5 million in the fourth quarter 2024, as compared to an operating loss of $12.5 million in the corresponding period in 2023.

Net loss improved by 59%, to $4.5 million, or $0.11 per diluted share in the fourth quarter 2024, as compared to a net loss of $11.0 million , or $0.27 per diluted share in the corresponding period in 2023.

Adjusted EBITDA improved by 139% to positive $1.9 million in the fourth quarter 2024, as compared to a loss of $4.8 million in the corresponding period in 2023.

Fiscal Year 2024 Financial Results

Worldwide revenue was $167.2 million for 2024, a 20% increase from $138.9 million in 2023. U.S. revenue for 2024 was $158.4 million, a 21% increase from $130.6 million in 2023. International revenue was $8.8 million in 2024 compared to $8.3 million in 2023.

Gross profit was $132.1 million in 2024, a 21% increase from $109.4 million in 2023. Gross margin was 79% in 2024 and in 2023.

Operating expenses increased 7% to $167.4 million in 2024, as compared to $156.4 million in 2023. The change in operating expenses was primarily driven by general commercial activity related to higher revenue and new product rollout, as well as research and development investments related to future products.

Operating loss improved by 25% to $35.2 million in 2024, as compared to an operating loss of $46.9 million in 2023.

Net loss improved by 29%, to $30.9 million, or $0.75 per diluted share in 2024, as compared to a net loss of $43.3 million , or $1.13 per diluted share in 2023.

Adjusted EBITDA improved by 71% to a loss of $5.1 million in 2024, as compared to a loss of $17.3 million in 2023.

Cash and marketable securities were $150.0 million and borrowings were $35.5 million as of December 31, 2024.

2025 Financial Guidance

SI-BONE expects 2025 worldwide revenue to be in the range of $193.5 million to $195.5 million, implying year-over-year growth of 16% to 17%. SI-BONE estimates fiscal year 2025 gross margin to be in the range of 77% to 78%, and operating expenses growth to be 9% at the mid-point of the revenue guidance. Based on these assumptions, SI-BONE expects to deliver positive adjusted EBITDA for second half and full year 2025.

SI-BONE will host a conference call to discuss the fourth quarter 2024 financial results after market close on Monday, February 24, 2025 at 4 30 P.M. Eastern Time. The conference call can be accessed live over webcast at https edge.media-server.com mmc p xyxunb4k. Live audio of the webcast will be available on the "Investors" section of the company's website at www.si-bone.com. The webcast will be archived and available for replay for at least 90 days after the event.

SI-BONE (NASDAQ SIBN) is a global leader in developing unique technologies for surgical treatment of sacropelvic disorders. Since pioneering minimally invasive SI joint surgery in 2009, SI-BONE has supported over 4,300 physicians in performing a total of over 115,000 procedures. A unique body of clinical evidence supports the use of SI-BONE's technologies, including two randomized controlled trials and over 160 peer reviewed publications. SI-BONE has leveraged its leadership in minimally invasive SI joint fusion to commercialize novel solutions for adjacent markets, including adult deformity, sacropelvic fixation and pelvic trauma.

For additional information on the company or the products including risks and benefits, please visit www.si-bone.com.

Forward Looking Statements

The statements in this press release regarding expectations of future events or results, including SI-BONE's expectations of continued revenue and procedure growth and financial outlook, contained in this press release are forward-looking statements. These forward-looking statements are based on SI-BONE's current expectations and inherently involve significant risks and uncertainties. These risks include SI-BONE's ability to introduce and commercialize new products and indications, SI-BONE's ability to maintain favorable reimbursement for procedures using its products, the impact of any future economic weakness on the ability and desire of patients to undergo elective procedures including those using SI-BONE's devices, SI-BONE's ability to manage risks to its supply chain, future capital requirements driven by new surgical systems requiring instrument tray and implant inventory investment, and the pace of the re-normalization of the healthcare operating environment including the ability and desire of patients and physicians to undergo and perform procedures using SI-BONE's devices. Actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these and other risks and uncertainties, many of which are described in the company's most recent filing on Form 10-K, and the company's other filings with the Securities and Exchange Commission (SEC) available at the SEC's Internet site (www.sec.gov), especially under the caption Risk Factors. SI-BONE does not undertake any obligation to update forward-looking statements and expressly disclaims any obligations or undertaking to release publicly any updates or revisions to any forward-looking statements contained herein, except as required by law.

Use of Non-GAAP Financial Measures

SI-BONE uses adjusted EBITDA, a non-GAAP financial measures that excludes from net loss the effects of interest income, interest expense, depreciation and amortization, and stock-based compensation. SI-BONE believes the presentation of adjusted EBITDA is useful to management because it allows management to more consistently analyze period-to-period financial performance and provides meaningful supplemental information with respect to core operational activities used to evaluate management's performance. SI-BONE also believes the presentation of adjusted EBITDA is useful to investors and other interested persons as it enables these persons to use this additional information to assess the company's performance in using this additional metric that management uses to assess the company's performance.

Adjusted EBITDA should be considered supplemental to, and not a substitute for, financial information prepared in accordance with GAAP. Because adjusted EBITDA excludes the effect of items that increase or decrease SI-BONE's reported results of operations, management strongly encourages investors to review, when they become available, the company's consolidated financial statements and publicly filed reports in their entirety. The company's definition of adjusted EBITDA may differ from similarly titled measures used by others.

Sr. Director, FP A and Investor Relations

investors SI-BONE.com

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

(In thousands, except share and per share amounts)

CONDENSED CONSOLIDATED BALANCE SHEETS

RECONCILIATION OF NET LOSS TO NON-GAAP ADJUSTED EBITDA