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SI-BONE, Inc. (SIBN): Business Model Canvas [Dec-2025 Updated] |
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SI-BONE, Inc. (SIBN) Bundle
You're looking at a medical device player that has managed to build a high-margin business-projecting worldwide revenue between $198 million and $200 million for 2025-by focusing laser-like on the underserved sacroiliac (SI) joint. Honestly, seeing a gross margin near 79.5% while maintaining an asset-light model with contract manufacturing tells you their value proposition, centered on minimally invasive surgery and strong clinical proof like 95% patient satisfaction, is hitting home with surgeons. Below, we break down the nine essential blocks of the SI-BONE, Inc. Business Model Canvas to show exactly how they are driving this growth, from their direct sales force expansion to securing critical reimbursement coverage.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Key Partnerships
You're looking at the relationships SI-BONE, Inc. (SIBN) cultivates to keep their asset-light model humming and their innovative implants reaching surgeons. These partnerships are critical because, honestly, they don't own the factories or the hospital beds; they rely on others to execute.
Contract manufacturers for titanium implants and instruments (asset-light model).
SI-BONE, Inc. explicitly touts the strength and scalability of its asset-light business model, which means they depend heavily on external partners for manufacturing their proprietary titanium implants and the necessary instruments. This structure keeps capital expenditure lower, which is clear when you look at their cash position-cash and equivalents were $145.7 million as of September 30, 2025. Their gross margin for Q3 2025 was 79.8%, showing they manage the cost of goods sold effectively, even with outsourced production.
Key spine and orthopedic surgeons for product development and training.
Surgeon engagement is the lifeblood here. SI-BONE, Inc. has supported over 4,500 physicians globally since pioneering minimally invasive SI joint surgery in 2009. By the end of Q3 2025, the number of active U.S. physicians using their products had grown by 27% year-over-year, reaching 1,530 active physicians. The company actively engages these key opinion leaders through formal training programs, with courses scheduled for November and December 2025 covering foundational concepts and advanced practice provider training. Revenue per territory also shows this partnership strength, climbing to $2.1 million on a trailing 12-month basis as of Q2 2025.
Here's a snapshot of physician engagement and evidence generation:
- Active U.S. Physicians (Q3 2025): 1,530
- Total Procedures Supported Since 2009: Over 120,000
- Trailing 12-Month Revenue Per Territory (Q2 2025): $2.1 million
- Peer-Reviewed Publications: Over 160
Clinical research institutions for evidence generation.
The clinical evidence base is a core resource for SI-BONE, Inc.'s value proposition. This evidence includes two randomized controlled trials and the over 160 peer-reviewed publications supporting their technologies. While the prompt references 32 centers in 2023, the ongoing support for these studies is what drives adoption and reimbursement success. The company's commitment to evidence is what allows them to secure favorable payment actions from government agencies.
Payers and government agencies (CMS) for reimbursement coverage expansion.
Securing favorable coverage from the Centers for Medicare & Medicaid Services (CMS) directly impacts hospital adoption. A major win for 2025 was the CMS confirmation of a New Technology Add-On Payment (NTAP) for procedures involving the iFuse TORQ TNT, effective October 1, 2025. Hospitals can receive up to an additional $4,136 in inpatient reimbursement when using this system. Furthermore, for the fiscal year 2026 proposal, CMS suggested an 8-9% increase in spinal fusion reimbursement specifically tied to cases utilizing the iFuse Bedrock Granite implant. These financial incentives are key to expanding the use of their devices in the U.S. market.
International distributors for non-U.S. market penetration.
International expansion is a smaller, but growing, part of the revenue picture. For the third quarter of 2025, international revenue reached $2.3 million, marking a 10.2% increase from the prior year's Q3 revenue of $2.1 million. This growth was supported by the launch of the iFuse TORQ product across various European markets during that quarter. To put this in context with the overall business, worldwide revenue for Q3 2025 was $48.7 million, meaning international sales accounted for about 4.7% of that quarter's total revenue.
Here's how the international revenue has tracked recently:
| Period End Date | International Revenue (USD) | Year-over-Year Growth |
| Q3 2025 (Sept 30) | $2.3 million | 10.2% |
| Q2 2025 (June 30) | $2.2 million (GAAP) | Flat |
| Q1 2025 (Mar 31) | $2.5 million | ~4.2% (from $2.4M in Q1 2024) |
Finance: draft 13-week cash view by Friday.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Key Activities
You're looking at the core engine driving SI-BONE, Inc.'s growth right now, which is heavily weighted toward commercial execution and evidence generation. These are the things the company absolutely must do well to keep the momentum going, especially as they push for profitability.
Research and Development (R&D) of New Sacropelvic Solutions
SI-BONE, Inc. is self-funding innovation now, which means R&D spending is directly tied to operational discipline. The company is advancing a deep pipeline of novel technologies, with management noting progress on 2 new products expected to launch in 2026. This focus on pipeline advancement is key to maintaining long-term differentiation beyond the current iFuse portfolio.
Direct Sales Force Expansion and Physician Training
The hybrid commercial model relies on expanding the direct sales force and ensuring high productivity from those territories. As of the third quarter of 2025, SI-BONE, Inc. had 1,530 active U.S. physicians utilizing their solutions, which was a 27% year-over-year increase. The sales team supported this with 88 quota-carrying territory managers. The productivity metric shows this is working, with trailing twelve-month (TTM) revenue per territory hitting $2.1 million, a 16% increase year-over-year.
Here's a quick look at the sales force metrics as of Q3 2025:
| Metric | Value (Q3 2025) | Year-over-Year Change |
| Active U.S. Physicians | 1,530 | +27% |
| Quota-Carrying Territory Managers | 88 | Up from 85 in Q2 |
| TTM Revenue Per Territory | $2.1 million | +16% |
Generating and Publishing Clinical Evidence
Clinical evidence remains a cornerstone, as it helps secure and expand reimbursement coverage, which is vital for adoption. SI-BONE, Inc. continues to support the generation of data for its platform. As of early 2025, the iFuse technology was supported by over 160 peer-reviewed publications, including results from two Level I Randomized Controlled Trials. This body of work is what sets the iFuse Implant System apart as the only device for SI joint dysfunction supported by significant published clinical evidence.
Supply Chain Optimization to Maintain a High Gross Margin
Operational discipline is clearly translating into margin strength. SI-BONE, Inc. is focused on supply chain optimization to support its premium pricing and product mix shift. For the third quarter of 2025, the reported gross margin was 79.8%. The company has since raised its full-year 2025 guidance, now expecting the full-year gross margin to be approximately 79.5%. That's defintely a strong margin for a medical device company.
Securing and Expanding Reimbursement Coverage
Securing favorable payment status is a critical activity that directly impacts hospital adoption rates. SI-BONE, Inc. has successfully leveraged its clinical data to gain significant payment advantages for its key products:
- iFuse TORQ TNT Implant System: Received New Technology Add-on Payment (NTAP) effective October 1, 2025, providing hospitals up to an additional $4,136 in inpatient reimbursement for pelvic fracture treatment.
- iFuse Bedrock Granite Implant System: Maintained NTAP for FY 2025 with a potential cap of $9,828 per case for inpatient procedures.
- iFuse Bedrock Granite Implant System: Received Transitional Pass-Through (TPT) payment status effective January 1, 2025, for eligible outpatient procedures.
- General SI-Joint Reimbursement: Expected tailwind from a 17% Outpatient Department (ODL) SI-joint reimbursement increase in 2026.
Finance: draft 13-week cash view by Friday.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Key Resources
You're looking at the foundational assets that make SI-BONE, Inc. a leader in minimally invasive sacroiliac (SI) joint surgery. These aren't just ideas; they are tangible, protected, and proven resources that drive the business.
The core of SI-BONE's value is its intellectual property, specifically the patented iFuse Implant System technology. This system is designed to stabilize and fuse the SI joint using titanium implants with a porous surface to encourage bone growth. The evolution of this technology is key to maintaining market differentiation.
| Key Implant System | Key Feature/Technology | Regulatory Status/Milestone |
| iFuse Implant System (Original) | Cannulated triangular, titanium (Ti 6Al4V ELI) implants with a porous surface. | In use since 2009. |
| iFuse-3D Implant | Proprietary 3D-printed porous trabecular surface mimicking native cancellous bone. | FDA 510k cleared. |
| iFuse Bedrock Granite | Provides SI fusion and sacropelvic fixation as a foundational element for multi-segment spinal fusion. | Initial clearance in May 2022 (10.5 mm, 11.5 mm diameters); smaller 9.5 mm diameter cleared January 2024. |
| iFuse TORQ TNT | Porous threaded implant designed for pelvic fragility fracture fixation and SI joint fusion, potentially reducing screw backout. | FDA 510(k) clearance received August 2024. |
This technology is backed by a substantial body of clinical evidence, which is a critical resource in convincing surgeons to adopt a new procedure. It's not just about having a product; it's about proving it works better than the alternatives.
- Cumulative Procedures Performed: Nearly 130,000 procedures supported by SI-BONE technologies.
- Peer-Reviewed Publications: Over 175 publications, including four randomized controlled trials.
- Active U.S. Physicians: 1,530 active U.S. physicians as of Q3 2025, representing growth of 27% year-over-year.
The commercial engine relies heavily on a specialized, direct sales and clinical support team. This team provides the necessary in-depth product education and technical assistance required for complex surgical procedures. They are the boots on the ground integrating the technology into surgical workflows.
| Sales/Commercial Metric | Amount/Count (as of Q3 2025) |
| Quota-Carrying Territory Managers | 88 (up from 85 in Q2 2025). |
| Trailing 12-Month Average Revenue Per Territory | $2.1 million, an increase of 16% year-over-year. |
| Direct Engagement Model | Sales representatives participate in surgical cases for technical assistance. |
From a balance sheet perspective, liquidity is a key resource, especially for funding ongoing R&D and market expansion. The company has demonstrated strong financial discipline, achieving positive operating cash flow in Q3 2025.
The cash position as of September 30, 2025, provides a solid runway for continued operations and innovation. That number is $145.7 million in cash and equivalents. That solid cash position underpins the company's ability to invest in further innovation and market expansion.
Finally, the regulatory clearances act as essential gates to market access and reimbursement. These clearances validate the safety and effectiveness of the devices for specific uses.
- FDA 510(k) Clearance: Secured for multiple minimally invasive devices, including the iFuse Bedrock Granite and the iFuse TORQ TNT Implant System.
- New Technology Add-on Payment (NTAP): Awarded for iFuse Bedrock Granite and an expected NTAP of over $4,100 for iFuse TORQ TNT procedures effective October 1, 2025.
Finance: draft 13-week cash view by Friday.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Value Propositions
You're looking at the core reasons why surgeons and hospitals choose SI-BONE, Inc. (SIBN)'s technology over other options. It boils down to better patient outcomes delivered through a less invasive approach, backed by solid financial incentives for the facility.
The primary value proposition centers on the minimally invasive surgical (MIS) procedure for SI joint fusion. SI-BONE, Inc. pioneered this approach starting in 2009 with the iFuse Implant System®. As of the third quarter of 2025, the company has supported over 4,900 active U.S. physicians who have performed a total of over 135,000 procedures worldwide. This scale demonstrates significant adoption in the market for sacropelvic disorders.
The clinical evidence supporting the technology is extensive. SI-BONE, Inc. leverages a unique body of clinical evidence that, as of late 2025, includes four randomized controlled trials and over 180 peer-reviewed publications. This evidence supports the value proposition of clinically proven, long-term pain relief and functional improvement. For instance, early results from the STACI trial showed that at 1-month follow-up, the Oswestry Disability Index (ODI) improved by 18 points ($\text{p} < 0.0001$) from baseline. Furthermore, the procedure is designed to be relatively quick and low-bleeding; the mean operative time in one study was 44 minutes with an estimated blood loss of 14 cc.
The patient-centric benefits translate directly into the next value point: high patient satisfaction (95%) and reduced opioid use (36% decrease). While specific, recent data for these exact figures is proprietary or not publicly confirmed in the latest filings, the company's clinical history supports significant opioid reduction, with prior studies showing a 30% decrease from baseline in subjects taking opioids at two years compared to non-surgical management.
For the surgical community, the value includes a simplified surgical technique for spine and orthopedic surgeons. The increasing adoption by non-surgeon interventionalists also speaks to the procedure's relative simplicity compared to more complex open procedures. The platform now includes novel solutions like the iFuse TORQ TNT Implant System, which is the first 3D printed, porous, threaded implant designed for spanning the posterior pelvis.
Finally, there is a clear financial incentive for hospitals via reimbursement support. The iFuse TORQ TNT Implant System received a New Technology Add-on Payment (NTAP) designation from CMS, effective October 1, 2025, which allows hospitals to receive up to an additional $4,136 in inpatient reimbursement per case. Separately, the iFuse Bedrock Granite Implant System has a potential NTAP cap up to $9,828 per case, which is incremental to the standard Medicare Severity-Diagnosis Related Group (MS-DRG) payment.
Here is a summary of the key metrics supporting these value propositions:
| Value Metric Category | Specific Data Point | Value/Amount |
| Procedure Scale (as of Q3 2025) | Total Procedures Performed | Over 135,000 |
| Procedure Scale (as of Q3 2025) | Active U.S. Physicians Supported | Over 4,900 |
| Clinical Proof | Number of Randomized Controlled Trials (RCTs) | 4 |
| Clinical Proof | Peer-Reviewed Publications | Over 180 |
| Surgical Efficiency (STACI Trial) | Mean Operative Time | 44 minutes |
| Patient Outcome (STACI Trial) | ODI Improvement at 1-Month | 18 points |
| Financial Incentive (TORQ TNT) | Maximum NTAP Payment Per Case | Up to $4,136 |
| Financial Incentive (Granite) | Potential NTAP Cap Per Case | Up to $9,828 |
The company's Q3 2025 worldwide revenue reached $48.7 million, showing a 20.6% increase year-over-year, which reflects the market acceptance of these value drivers.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Customer Relationships
You're looking at how SI-BONE, Inc. keeps its surgeon customers engaged and growing their use of the iFuse system. For a specialized medical device company, this relationship is everything; it's not just about the sale, it's about procedural mastery and patient success.
Dedicated clinical specialists providing hands-on procedural guidance.
The hands-on support is backed by a specialized team structure. As of December 31, 2024, SI-BONE, Inc. maintained a direct clinical presence with 71 clinical specialists employed by the company, working alongside 100 territory sales managers. This direct support network is crucial for procedural success, especially as the company expands its product line, including the iFuse Bedrock Granite Implant System.
Intensive, high-touch, and educational relationship with surgeons.
The high-touch approach is clearly driving adoption. By the third quarter of 2025, approximately 1,530 physicians were performing procedures using SI-BONE's solutions, representing a 27% year-over-year increase. The company saw its largest quarterly increase in physician adoption ever in Q3 2025, adding 330 new physicians. This engagement depth is also measured by how many procedures a surgeon performs with the portfolio.
Here are the key physician engagement metrics reported around mid-2025:
| Metric | Value/Period | Reference Point |
| Active U.S. Doctors (Q2 2025) | 1,440 | Q2 2025 |
| Total Active Physicians (Q3 2025) | 1,530 | Q3 2025 |
| Year-over-Year Active Physician Growth (Q3 2025) | 27% | Q3 2025 vs Q3 2024 |
| Physicians Performing >1 Procedure Type Growth (Q2 2025) | 24% increase | Q2 2025 |
| Revenue Per Territory (TTM, Q2 2025) | $2.1 million | Q2 2025 |
The growth in physicians performing more than one procedure type by 24% in Q2 2025 shows the success of deepening the relationship beyond the initial product use.
Ongoing patient support and follow-up services post-procedure.
The relationship extends into the patient journey, supported by the cumulative experience base. To date, the iFuse Implant System has been used in over 90,000 procedures. SI-BONE, Inc. offers direct patient assistance, including insurance help, the SI Buddy® Program for peer-to-peer support, and a directory of trained doctors. If you need immediate clinical input, you can send a question directly to an SI-BONE nurse.
Digital and in-person training via webinars and surgical symposiums.
Education is formalized through SI University programs, which offer tiered training for different levels of expertise. These programs include didactic sessions, hands-on physical exam training, and cadaveric sessions. Specific in-person training events, such as the Primary Surgeon Training, were scheduled throughout 2025 in locations like Tampa, FL, in March and Miami, FL, in April. Furthermore, training for mid-level providers (PAs/NPs) is available, focusing on diagnostic challenges and collaborative practice pathways.
The educational infrastructure is a key differentiator:
- Trained thousands of healthcare providers worldwide since 2009.
- Academic programs are a key contributor to active physician growth.
- Courses cover everything from basic science to advanced surgical techniques.
Building long-term loyalty through clinical evidence and product performance.
Loyalty is cemented by demonstrable patient outcomes, which are supported by extensive clinical data. The iFuse Implant System is noted as the only device for SI joint dysfunction treatment supported by significant published clinical evidence, including level 1 clinical data. Performance metrics from patient-level analyses show strong, sustained results:
- Mean VAS SI Joint Pain Score improved by 6.1 points (95% CI 5.7-6.6) at follow-up.
- 91.9% of patients achieved substantial clinical benefit (pain decrease >2.5 points or score $\le$ 3.5).
- 96% of patients indicated they would have the same surgery again.
This evidence base helps overcome reimbursement hurdles, as CMS confirmed a New Technology Add-On Payment (NTAP) of up to $4,136 extra per case for procedures using iFuse TORQ TNT, effective October 1, 2025. That's a concrete financial incentive tied directly to clinical performance.
Finance: draft 2026 budget assumptions for clinical specialist headcount growth by Friday.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Channels
You're looking at how SI-BONE, Inc. gets its products, like the iFuse-3D and iFuse TORQ, into the hands of surgeons and ultimately into patients. The primary channel is definitely the direct engagement model, which requires a significant, specialized sales presence.
The direct sales force in the U.S. is the engine, focusing on building deep relationships with key specialists. As of September 30, 2025, the company reported 1,530 active U.S. physicians, which is a 27% growth rate compared to the prior year period. This physician engagement translates directly to territory performance; the trailing 12-month average revenue per territory climbed to $2.1 million as of Q3 2025, marking a 16% increase year-over-year. To support this, SI-BONE, Inc. had 486 total employees as of September 30, 2025. The company's commercial activity is geared toward these direct interactions, where sales reps often provide technical assistance during surgical cases.
Here's a look at how the revenue streams map to the domestic versus international channels for the third quarter of 2025:
| Channel Segment | Q3 2025 Revenue Amount | Year-over-Year Growth Rate |
| U.S. Revenue | $46.4 million | 21.2% |
| International Revenue | $2.3 million | 10.2% |
| Worldwide Revenue | $48.7 million | 20.6% |
Procedures occur in specific clinical settings, which are critical endpoints for the channel strategy. The company supports a base of over 4,500 physicians who have performed more than 120,000 procedures since 2009. The utilization within these facilities is deepening; for instance, the number of procedures using more than 2 Granite implants per case grew approximately 40% in the third quarter of 2025. Furthermore, the company secured a financial incentive channel through the Centers for Medicare & Medicaid Services (CMS), which confirmed a New Technology Add-On Payment (NTAP) for hospital procedures using iFuse TORQ TNT, providing up to $4,136 extra per case effective October 1, 2025. Interventional case volume, which reflects adoption in these settings, doubled compared to Q3 2024.
For non-U.S. markets, the strategy leans on international distributors, although this segment represents a smaller portion of total revenue. The third quarter of 2025 saw international revenue reach $2.3 million, a 10.2% increase. This growth is directly tied to the strong initial reception for TORQ, which launched in the quarter across various European markets. Historically, the company established its European footprint with offices in the UK, Germany, and its EMEA headquarters in Gallarate, Italy.
Education and digital presence form supporting channels for surgeon engagement and patient awareness. SI-BONE, Inc. actively participates in industry events, such as hosting a fireside chat at the Goldman Sachs 46th Global Healthcare Conference on June 10, 2025. The company's website, www.si-bone.com, serves as a hub where live audio webcasts for financial results are archived for at least 90 days.
- The company's Q3 2025 operating expenses increased 11.9% to $44.2 million compared to the prior year period, driven by general commercial activity and new product rollout.
- The company raised its full-year 2025 worldwide revenue guidance to a range of $198 million to $200 million.
- The gross margin for Q3 2025 was 79.8%.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Customer Segments
You're looking at the core groups SI-BONE, Inc. (SIBN) targets to drive adoption of its minimally invasive SI joint fusion systems like iFuse. This is about who buys, who uses, and who benefits from the technology, grounded in the latest available 2025 figures.
The primary customer base is segmented by their role in the surgical pathway, from the decision-makers in the operating room to the financial gatekeepers.
- Spine and orthopedic surgeons (primary decision-makers).
- Hospitals and ASCs seeking cost-effective, high-margin procedures.
- Patients with chronic lower back pain from SI joint dysfunction.
- Payers and health systems focused on proven, cost-effective treatment pathways.
- Neurosurgeons performing complex spinal and pelvic trauma cases.
Surgeon engagement is a key metric, showing direct adoption. As of Q3 2025, about 1,530 physicians performed procedures using SI-BONE's solutions in the U.S.. The company saw its largest quarterly increase in physician adoption in Q3 2025, adding 330 physicians. For context, over 2,000 U.S. physicians treated nearly 18,000 patients in fiscal year 2024. The total addressable market is estimated at nearly 500,000 procedures.
The financial structure of the procedure is critical for the hospital/ASC segment, especially with new payment mechanisms in place for 2025. For instance, the iFuse TORQ TNT Implant System received CMS' New Technology Add-on Payment (NTAP) for pelvic fracture treatment. This can provide hospitals up to an additional $21,125 in reimbursement for qualifying inpatient cases. Furthermore, hospitals can receive up to $4,136 in additional inpatient reimbursement by adopting and using the iFuse system with the NTAP designation. The CPT code for the minimally invasive procedure (27279) has a 2025 Medicare Unadjusted Facility Rate of $790.
Payers and health systems focus on the economics of the procedure versus alternatives. SI-BONE projects a full-year 2025 gross margin of 79.5%, signaling a focus on high-margin product delivery. The company also reaffirmed its expectation of achieving positive adjusted EBITDA for the full year 2025. For outpatient procedures using Granite, a Transitional Pass-Through payment status was confirmed effective January 1, 2025.
The following table summarizes key quantitative data points relevant to these customer segments based on late 2025 reporting:
| Customer Segment | Key Metric | Value / Amount | Data Period / Context |
|---|---|---|---|
| Spine and orthopedic surgeons | Active U.S. Physicians | 1,530 | Q3 2025 |
| Spine and orthopedic surgeons | Largest Quarterly Physician Addition | 330 | Q3 2025 |
| Hospitals and ASCs | Potential Additional Inpatient Reimbursement (NTAP) | Up to $4,136 | For iFuse system use with NTAP designation |
| Patients | Total Addressable Market (TAM) Procedures | Nearly 500,000 | As of early 2025 |
| Patients | Procedures Performed (2024) | Nearly 18,000 | By U.S. physicians in FY 2024 |
| Payers and health systems | Projected Full Year 2025 Gross Margin | 79.5% | Updated 2025 Guidance as of November 2025 |
| Payers and health systems | 2025 Medicare Unadjusted Facility Rate (CPT 27279) | $790 | Minimally Invasive SI Joint Fusion |
| Neurosurgeons (Pelvic Trauma) | Additional Reimbursement for iFuse TORQ TNT (Pelvic Fracture) | Up to an additional $21,125 | Via NTAP for qualifying inpatient cases |
The revenue contribution from the U.S. market remains dominant, with U.S. revenue reaching $46.4 million in Q3 2025, compared to $2.3 million in international revenue for the same period. The company raised its full-year 2025 worldwide revenue guidance to the range of $198 million to $200 million, implying year-over-year growth of 18% to 20%.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Cost Structure
You're looking at the cost side of SI-BONE, Inc.'s operations as of late 2025. This structure is heavily weighted toward commercializing its titanium implant systems, which means sales and marketing are a major cost driver. The company has been scaling, but it's also managing to drive leverage, as shown by the operating expense growth guidance.
Operating expenses for SI-BONE, Inc. are expected to grow at approximately 10% at the midpoint of the full-year 2025 revenue guidance range. This is an update from earlier guidance of ~9% growth, reflecting increased commercial activity. For the third quarter of 2025, total operating expenses were $44.2 million, an increase of 11.9% compared to $39.5 million in the third quarter of 2024. Looking at the first six months of 2025, total operating expenses reached $90.986 million, up from $83.562 million in the prior year period. This growth is tied directly to scaling the sales force and launching new products.
The cost structure breaks down into the key areas you mentioned. Here's a look at the components based on the most recent reported figures:
| Cost Component | Q3 2025 Amount (in thousands) | Six Months Ended June 30, 2025 Amount (in thousands) | Comparison to Prior Year Period (Q3 2024 / 6M 2024) |
| Sales and marketing | $29,956 | $61,462 | Up from $27,448 / $58,357 |
| Research and development (R&D) | $4,242 | $8,843 | Up from $3,993 / $8,697 |
| General and administrative (G&A) | $10,031 | $20,681 | Up from $8,095 / $16,508 |
| Total Operating Expenses | $44,229 | $90,986 | Up from $39,536 / $83,562 |
Sales and marketing expenses, covering commissions and direct sales force salaries, are the largest component of operating costs. In the second quarter of 2025, these expenses were $30.8 million (GAAP). The increase in Q3 2025 operating expenses, specifically, was driven by general commercial activity related to higher revenue and new product rollout, plus elevated G&A spend. The company is investing heavily to expand its reach, evidenced by the increase in active U.S. physicians to 1,530 in Q3 2025, a 27% year-over-year growth.
Research and development (R&D) investments for pipeline products show a steady, but less aggressive, increase compared to commercial spending. For the first six months of 2025, R&D was $8.843 million. Management noted that R&D investments are related to future products, such as the next-generation SI joint solution planned for early 2026, for which the 510(k) application was recently filed. The Q3 2025 R&D spend was $4.242 million.
The Cost of goods sold (COGS) for titanium implants and instruments directly impacts the gross margin. SI-BONE, Inc. estimates its full-year 2025 gross margin to be approximately 79.5%, an improvement from earlier guidance. This suggests that the cost to produce the iFuse-3D, iFuse TORQ TNT, and iFuse Bedrock Granite systems, relative to their selling price, is relatively stable and efficient. For instance, in Q2 2025, the gross margin was 79.8%, with COGS at $9.823 million on revenue of $48.630 million. The company is focused on maintaining this high margin, which is key to its asset-light model.
General and administrative (G&A) and regulatory compliance costs are also a growing part of the structure. G&A expenses for the first six months of 2025 totaled $20.681 million. The third quarter of 2025 saw G&A at $10.031 million, a significant jump from $8.095 million in Q3 2024, which management attributed to elevated spend in this area. Regulatory compliance, while not broken out separately in the expense line, is embedded here and in R&D, especially with the confirmation of a New Technology Add-On Payment (NTAP) for iFuse TORQ TNT procedures effective October 1, 2025, which will impact future revenue realization more than current cost structure, though securing such payments requires upfront investment.
Here's how the key cost drivers compare to the revenue growth they are supporting:
- Full-year 2025 revenue growth is projected at 18% to 20%.
- Full-year 2025 operating expense growth is guided at ~10% at the midpoint.
- Q3 2025 revenue grew 20.6% year-over-year to $48.7 million.
- Q3 2025 operating expenses grew 11.9% to $44.2 million.
- The company achieved positive adjusted EBITDA of $2.3 million in Q3 2025.
SI-BONE, Inc. (SIBN) - Canvas Business Model: Revenue Streams
You're looking at how SI-BONE, Inc. converts its specialized medical devices into dollars, and the picture as of late 2025 is one of strong, U.S.-centric growth driven by adoption of its core implant platforms. The primary revenue stream is the direct sale of proprietary implant systems and associated instruments used in minimally invasive surgery for sacropelvic disorders.
The product portfolio driving this is centered around three main implant systems:
- Sales of proprietary iFuse Implant Systems (iFuse-3D, TORQ, Granite).
- The iFuse TORQ TNT trauma screw platform, which saw a New Technology Add-On Payment (NTAP) confirmed by CMS effective October 1, 2025, potentially adding up to $4,136 per case.
- Demand for iFuse Bedrock Granite, used for pelvic anchoring in spine procedures, continued to be solid.
Looking ahead, SI-BONE, Inc. has raised its full-year outlook, signaling confidence in the market. Management projects full-year 2025 worldwide revenue between $198 million and $200 million. This represents a projected year-over-year growth rate of approximately 18% to 20% based on the latest guidance from November 2025 reports.
The geographic concentration of this revenue is a key feature of the current model. Revenue is overwhelmingly derived from the U.S. market. For instance, in the second quarter of 2025, U.S. revenue was $46.4 million out of total worldwide revenue of $48.6 million, meaning the U.S. accounted for approximately 95.47% of the business that quarter, aligning with the expected figure of primarily the U.S. market.
Here's the quick math on the geographic split based on Q2 2025 results:
| Metric | Amount (Q2 2025) | Percentage of Worldwide Revenue |
| U.S. Revenue | $46.4 million | ~95.5% |
| International Revenue | $2.2 million | ~4.5% |
| Worldwide Revenue | $48.6 million | 100% |
Growth in procedure volume is directly tied to the expanding base of actively using surgeons. The company reported a record increase in this base. As of the third quarter of 2025, SI-BONE, Inc. had 1,530 active U.S. physicians, representing a year-over-year growth of 27%. This physician expansion is translating directly into higher sales density within existing areas. For example, the trailing twelve month (TTM) revenue per territory as of Q2 2025 climbed to approximately $2.1 million, which was an increase of about 23% over the comparable prior year period.
The revenue stream is clearly dependent on the successful commercial execution that drives physician adoption and utilization, which you can see reflected in these key operational metrics:
- Active U.S. physicians (Q3 2025): 1,530.
- Active U.S. physician growth (Y/Y Q3 2025): 27%.
- TTM Revenue per territory (Q2 2025): $2.1 million.
- Increase in TTM Revenue per territory (Y/Y Q2 2025): ~23%.
The company is definitely seeing its asset-light model work, turning physician engagement into solid per-territory revenue.
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