Xtant Medical Announces Second Quarter Revenue Growth of 32% Raises 2023 Annual Revenue Guidance to $75 Million - $77 Million BELGRADE, MT

Medical Announces Second Quarter Revenue Growth of 32%

2023 Annual Revenue Guidance to $75 Million - $77 Million

MT, August 1, 2023 - Xtant Medical Holdings, Inc. (NYSE American: XTNT), a global medical technology company focused on surgical

solutions for the treatment of spinal disorders, today reported financial and operating results for the second quarter ended June 30,

the second quarter, we achieved strong revenue growth on both a sequential and annual basis driven by our core biologics and fixation

businesses," said Sean Browne, President & CEO of Xtant Medical. "I am particularly pleased that we closed the quarter

with positive adjusted EBITDA, which is ahead of our expectations. We are driving growth across all channels of our business, and with

solid contributions from our newly acquired Coflex interlaminar stabilization device and the addition of new Coflex distributors, we

are encouraged regarding our longer-term expansion opportunities. By leveraging and advancing our platform, we now expect to generate

full year annual revenue growth of approximately 29% to 33%."

Quarter 2023 Financial Results

quarter 2023 revenue grew 32%, representing organic growth of 14% plus an 18% increase from products added in the acquisition of the

Coflex and CoFix lines, to $20.2 million, compared to $15.3 million for the same period in 2022. These revenue increases are attributed

primarily to greater independent agent and private label sales, and sales from the acquired Coflex and CoFix product lines.

margin for the second quarter of 2023 was 61.6%, compared to 54.8% for the same period in 2022. The increase was primarily attributable

to the contribution of Coflex and CoFix products, partially offset by higher production costs.

expenses for the second quarter of 2023 totaled $13.9 million, compared to $9.7 million for the second quarter of 2022. The increase

was primarily due to additional independent agent sales commissions, higher employee compensation expenses and amortization of intangible

assets associated with the Coflex and CoFix product lines.

quarter 2023 net loss totaled $2.2 million, or $0.02 per share, compared to the second quarter 2022 net loss of $1.7 million, or $0.02

Adjusted EBITDA for the second quarter of 2023 was $0.1 million, compared to a Non-GAAP Adjusted EBITDA loss of $0.4 million for the

prior-year period. The Company defines Adjusted EBITDA as net income/loss from operations before depreciation, amortization and interest

expense and provision for income taxes, and as further adjusted to add back in or exclude, as applicable, non-cash compensation and acquisition-related

expenses. A calculation and reconciliation of Adjusted EBITDA to net loss can be found in the attached financial tables.

Medical raises its expectation for full year 2023 revenue to $75 million to $77 million, up from the Company's prior guidance of

$73 million to $75 million. The revised guidance range represents annual revenue growth of approximately 29% to 33% compared to full

year 2022 revenue, and excludes any potential contributions from the Surgalign transaction, if and when that transaction closes.

Medical will host a webcast and conference call to discuss the second quarter 2023 financial results on Tuesday, August 1, 2023 at 9:00

AM ET. To access the webcast, Click Here. To access the conference call, dial 877-407-6184 within the U.S. or 201-389-0877 outside

the U.S. A replay of the call will be available at www.xtantmedical.com under "Investor Info."

Xtant Medical Holdings, Inc.

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 and spinal implant systems to facilitate spinal fusion in complex spine, deformity and

degenerative procedures. Xtant people are dedicated and talented, operating with the highest integrity to serve our customers.

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.

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 and organic revenue growth. 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 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.

Statement Regarding Forward-Looking Statements

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," similar expressions or the negative thereof, and the use of future dates. Forward-looking

statements in this release include the Company's financial guidance for 2023. 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 and financial performance; its ability to increase or maintain

revenue; risks associated with its recent acquisition of the Coflex product line and its pending acquisition of certain assets and liabilities

related to the domestic and international biologics and spinal fixation offerings of Surgalign Holdings, Inc.; possible future impairment

charges to long-lived assets and goodwill and write-downs of excess inventory if revenues decrease; the ability to remain competitive;

the ability to innovate, develop and introduce new products; the ability to engage and retain new and existing independent distributors

and agents and qualified personnel and the Company's dependence on key independent agents for a significant portion of its revenue;

the effect of COVID-19, labor and hospital staffing shortages on the Company's business, operating results and financial condition,

especially when they affect key markets; the Company's ability to implement successfully its future growth initiatives and risks

associated therewith; the effect of inflation, increased interest rates and other recessionary factors and supply chain disruptions;

the effect of product sales mix changes on the Company's financial results; government and third-party coverage and reimbursement

for Company products; the 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; the ability to

obtain and protect Company intellectual property and proprietary rights and operate without infringing the rights of others; the ability

to service Company debt, comply with its debt covenants and access additional indebtedness; the ability to obtain additional financing

on favorable terms or at all; and other factors. Additional risk factors are contained in the Company's Annual Report on Form 10-K

for the year ended December 31, 2022 filed with the Securities and Exchange Commission (SEC) on March 8, 2023 and subsequent SEC filings

by the Company, including without limitation its most recent Quarterly Report on Form 10-Q for the quarterly period ended June 30, 2023

anticipated to be filed with the SEC. 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.

MEDICAL HOLDINGS, INC.

CONSOLIDATED BALANCE SHEETS

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MEDICAL HOLDINGS, INC.

CONSOLIDATED STATEMENTS OF OPERATIONS

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MEDICAL HOLDINGS, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

MEDICAL HOLDINGS, INC.

OF NON-GAAP CONSOLIDATED EBITDA AND ADJUSTED EBITDA