Bioventus (NASDAQ:BVS) executives told investors the company closed 2025 with what leadership described as a “solid quarter” and a “pivotal year,” highlighting stronger organic growth, higher profitability, and record quarterly operating cash flow while laying out a 2026 plan to step up investment in several growth initiatives.
Fourth-quarter performance and mix
For the fourth quarter, CFO Mark Singleton reported revenue of $158 million, up 3% versus the prior year. Organic revenue growth was 10% after adjusting for the impact of the Advanced Rehabilitation divestiture completed at the end of 2024. Singleton said the quarter also benefited from an additional selling day compared to the prior year.
Singleton also noted foreign exchange headwinds and said the company incurred an “unplanned loss of almost $1 million” in the quarter, adding that the business absorbed more than $3 million of unplanned FX impacts for the full year.
Business segment commentary
Management pointed to strong results across several areas of the portfolio, while also addressing comparisons and timing effects.
- Pain Treatments: Revenue advanced 15% in Q4. CEO Rob Claypoole emphasized the company’s hyaluronic acid (HA) franchise, noting favorable demographics for knee osteoarthritis and describing HA as a trusted therapy. Claypoole said performance was “highly driven by volume,” with DUROLANE leading results amid an ongoing market shift from multi-injection to single-injection therapy. During Q&A, management attributed a portion of the quarter’s outperformance to selling days and distributor dynamics.
- Surgical Solutions: Revenue grew 3%. Singleton said Ultrasonics results faced a difficult comparison against an “all-time high” for capital sales in the prior year’s fourth quarter, though generator revenue in the current quarter still represented the company’s “third-highest total ever.” He added that the company exceeded its plan for capital sales in 2025, which management said provides a foundation to accelerate disposable growth in 2026.
- Restorative Therapies: Reported revenue declined 26% due to the Advanced Rehabilitation divestiture. Excluding that impact, organic growth was 10%, which Singleton attributed to another strong quarter for EXOGEN.
- International: Revenue was unchanged year over year in Q4, while organic growth was 10%. Singleton said international organic growth was 11% for the full year, citing improved commercial execution and “talent additions” made throughout 2025, though he also noted that growth in Q4 was impacted by the timing of distributor orders.
Margins, cash flow, and balance sheet
On profitability, Singleton reported adjusted gross margin of 76%, up 180 basis points from the prior year period due to improved product mix and a favorable comparison, which he said more than offset tariffs and foreign exchange impacts. Adjusted operating income was $33 million, up $7 million year over year, while adjusted net income was $20 million, up $1 million. Singleton attributed the net income change to higher gross margin, lower operating expenses, and lower interest expense, partially offset by higher tax expense.
Bioventus posted a quarterly record for cash from operations, with Singleton reporting $38 million in Q4, nearly double the prior-year quarter. He said the improvement was driven by higher profitability, lower interest expense, and a reduction in inventories. Claypoole also cited improved inventory management as a contributor to the operating cash flow result.
For the full year, management said cash from operations was nearly $75 million, meeting the company’s stated goal to nearly double operating cash flow versus the prior year; Singleton quantified that as a 92% increase for 2025.
On the balance sheet, Bioventus ended the quarter with $51 million in cash and $294 million in outstanding debt. Debt declined $29 million in the quarter as the company repaid borrowings on its revolving credit facility. Singleton said the net leverage ratio declined to below 2.5x at quarter-end, and management expects “net leverage well below 2x” by the end of 2026, driven by projected cash flow and adjusted EBITDA growth.
2026 strategy: targeted investment and growth drivers
Claypoole said the company is entering “an exciting new phase,” with an increased focus on accelerating revenue growth while strengthening earnings power and expanding capital allocation flexibility through consistent free cash flow growth. For 2026, management outlined three objectives: accelerate growth drivers through “targeted and disciplined investment,” grow profitability faster than revenue, and further strengthen cash flow.
Claypoole said Bioventus plans to allocate approximately $13 million of incremental investment in 2026 across growth drivers including peripheral nerve stimulation (PNS), platelet-rich plasma (PRP), Ultrasonics, and the international business. He said those investments include expanding commercial resources, generating evidence on clinical and economic benefits, strengthening marketing, and continuing R&D innovation.
In Pain Treatments, Claypoole said PNS will receive the largest share of incremental investment, citing a “rapidly expanding market” and “highly differentiated technology.” Management described positive market feedback from pilot launches, including traction with both trial and permanent solutions. In response to analyst questions, Claypoole said pilot learnings helped refine how to scale the business, including resource allocation and pacing through 2026. The company also highlighted PRP as a growth driver supported by its existing HA commercial team, requiring less incremental investment.
Claypoole said the company expects the combination of PNS and PRP to contribute a minimum of 200 basis points of growth in 2026, with further acceleration in 2027.
In Surgical Solutions, Claypoole said Ultrasonics will receive “a disproportionate amount” of incremental investment, including marketing to raise awareness, medical education to train surgeons earlier, and sales expansion in targeted areas. He added that the company’s primary Ultrasonics focus remains the spine market, which he described as significantly larger than neuro and general surgery, though the same sales organization calls on those segments.
2026 guidance and expected phasing
Singleton provided 2026 guidance calling for net sales of $600 million to $610 million, adjusted EPS of $0.73 to $0.77, and cash from operations of $82 million to $87 million, which he said would represent roughly 10% to 17% growth. He noted the company expects earnings growth to outpace revenue growth, even with incremental investments in growth drivers.
On seasonality and cadence, Singleton said the company expects Q1 to be below the implied guidance range and for growth to accelerate in Q2 and in the second half of 2026 as PRP and PNS investments contribute more meaningfully. He attributed Q1 headwinds to one fewer selling day and a rebalancing of HA distributor inventory levels following strong Q4 results. Management also said revenue and adjusted EBITDA are expected to be lowest in Q1 and highest in Q4, consistent with prior years.
During Q&A, Singleton estimated distributor dynamics in Q4 provided a benefit of “$2-ish million, maybe a little bit higher,” and said selling days were also favorable. Claypoole added that for 2026 the company still expects HA to grow above the market, but at a lower rate than in 2025, driven mainly by an “intentional approach” to pursue business that is accretive to profitable growth, alongside the selling-day and inventory normalization factors.
Management said 2026 guidance does not assume any additional impact from U.S. dollar fluctuation for the year. Closing the call, Claypoole said Bioventus is “confident” it can build on its momentum to deliver above-market revenue growth, improve earnings, and accelerate cash flow.
About Bioventus (NASDAQ:BVS)
Bioventus, headquartered in Durham, North Carolina, is a global medical device company specializing in orthobiologic solutions aimed at accelerating healing and improving patient outcomes in musculoskeletal conditions. The company develops and commercializes a portfolio of non‐surgical therapies designed to address bone healing, osteoarthritis pain management and soft tissue repair. Its flagship EXOGEN® Ultrasound Bone Healing System utilizes low‐intensity pulsed ultrasound technology to stimulate bone growth and has been widely used in the management of delayed fractures and nonunions.
