Castle Biosciences (NASDAQ:CSTL) Releases Earnings Results, Beats Estimates By $0.22 EPS

Castle Biosciences (NASDAQ:CSTL) released its quarterly earnings results on Thursday. The company reported ($0.13) EPS for the quarter, beating the consensus estimate of ($0.35) by $0.22, FiscalAI reports. The business had revenue of $101.95 million for the quarter, compared to analysts’ expectations of $92.77 million. Castle Biosciences had a negative net margin of 5.43% and a negative return on equity of 4.15%.

Here are the key takeaways from Castle Biosciences’ conference call:

• Revenue guidance increased substantially: Third-quarter revenue rose 24% year over year to $102.9 million, and Castle raised full-year 2026 guidance by $20 million at the midpoint to $385 million–$395 million, citing strong core-business performance, TissueCypher growth and ASP improvement.
• TissueCypher remained the main growth driver: Test reports increased 47% to 15,574, and the company reiterated its 50%–52% full-year volume-growth outlook. Management estimates market penetration at about 15%, while noting that seasonality and sales-team changes can make quarterly growth uneven.
• Cash generation and adjusted profitability strengthened: Adjusted EBITDA was $12.7 million versus $9.2 million a year earlier, and operating cash flow was $19.7 million for the quarter. Castle reported approximately $278 million in cash and investments and expects positive Adjusted EBITDA for 2026 and 2027.
• GAAP loss widened as expenses rose: Net loss increased to $4.1 million from $0.5 million in the year-ago quarter, while operating expenses including cost of sales grew to $105.6 million from $89.8 million, reflecting higher staffing and other costs.
• Medicare coverage remains a headwind for DecisionDx-SCC: Management said its 2027 revenue outlook does not assume a recovery in Medicare coverage, with a draft coverage decision possible in the coming months but no firm timeline provided.

Castle Biosciences Stock Down 4.1%

CSTL stock traded down $1.39 during mid-day trading on Friday, hitting $32.81. 172,709 shares of the company were exchanged, compared to its average volume of 393,816. The firm has a market cap of $1.00 billion, a P/E ratio of -49.71 and a beta of 1.00. Castle Biosciences has a 1-year low of $17.72 and a 1-year high of $44.28. The firm’s 50 day simple moving average is $34.28 and its 200 day simple moving average is $28.57. The company has a debt-to-equity ratio of 0.02, a quick ratio of 5.85 and a current ratio of 6.04.

Castle Biosciences News Roundup

Here are the key news stories impacting Castle Biosciences this week:

• Positive Sentiment: Castle reported third-quarter 2026 revenue of $102.9 million, up 24% year over year, and said TissueCypher test report volume grew 47%. It raised its 2026 revenue guidance to $385 million–$395 million from $365 million–$375 million, signaling stronger growth expectations. Castle Biosciences Q3 2026 results
• Positive Sentiment: KeyCorp raised its price target to $40 from $35 and reaffirmed an “overweight” rating, reflecting a more favorable analyst outlook. KeyCorp stock recommendations
• Negative Sentiment: The company still posted a quarterly loss of $0.13 per share. Although that was better than analysts expected, it was a larger loss than the $0.02 per share reported a year earlier, leaving profitability as a risk for investors. Zacks Q3 earnings report

Analyst Ratings Changes

Several research firms have issued reports on CSTL. Wall Street Zen raised Castle Biosciences from a “hold” rating to a “buy” rating in a report on Sunday, November 1st. Robert W. Baird set a $36.00 price target on Castle Biosciences in a research note on Friday, July 31st. Weiss Ratings reiterated a “sell (d-)” rating on shares of Castle Biosciences in a report on Thursday, October 29th. Mizuho started coverage on Castle Biosciences in a report on Thursday, October 29th. They issued an “outperform” rating and a $60.00 price target on the stock. Finally, BTIG Research lifted their price objective on Castle Biosciences from $40.00 to $44.00 and gave the stock a “buy” rating in a research report on Monday, August 3rd. One analyst has rated the stock with a Strong Buy rating, eight have issued a Buy rating, one has given a Hold rating and one has issued a Sell rating to the company’s stock. According to data from MarketBeat.com, the company has a consensus rating of “Moderate Buy” and a consensus price target of $44.88.

Insiders Place Their Bets

In other Castle Biosciences news, insider Derek J. Maetzold sold 12,428 shares of the business’s stock in a transaction dated Friday, August 28th. The shares were sold at an average price of $33.20, for a total transaction of $412,609.60. Following the sale, the insider directly owned 21,479 shares of the company’s stock, valued at $713,102.80. The trade was a 36.65% decrease in their position. The sale was disclosed in a filing with the SEC, which is available through this link. The transaction was executed under a pre-arranged Rule 10b5-1 trading plan. Also, COO Kristen Oelschlager sold 12,384 shares of the stock in a transaction that occurred on Tuesday, August 25th. The shares were sold at an average price of $34.42, for a total value of $426,257.28. Following the transaction, the chief operating officer directly owned 72,649 shares of the company’s stock, valued at $2,500,578.58. This trade represents a 14.56% decrease in their ownership of the stock. The disclosure for this sale is available in the SEC filing. Insiders sold a total of 126,184 shares of company stock valued at $4,324,506 in the last quarter. 6.10% of the stock is currently owned by insiders.

About Castle Biosciences

Castle Biosciences, Inc is a molecular diagnostics company that develops and commercializes tests designed to help physicians diagnose cancer, assess disease risk and guide treatment decisions. The company focuses on conditions in which additional biological information can complement traditional pathology and clinical assessment.

Its portfolio includes DecisionDx-Melanoma, which helps evaluate the risk of metastatic recurrence in patients with cutaneous melanoma; DecisionDx-SCC, which assesses metastatic risk in cutaneous squamous cell carcinoma; and DecisionDx-UM, a test for determining metastatic risk in uveal melanoma.