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Q2 2025 FINANCIAL RESULTS PAT MILES, CHAIRMAN & CEO | TODD KONING , CFO | JULY 31, 2025
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FORWARD -LOOKING STATEMENTS This presentation contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainty. Such statements are based on management's current expectations and are subject to a number of risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. The Company cautions investors that there can be no assurance that actual results will not differ materially from those projected or suggested in such forward-looking statements as a result of various factors. Forward-looking statements include, but are not limited to: references to the Company’s revenue, balance sheet, growth, adjusted EBITDA, profitability, free cash flow, financial outlook and commitments; planned product launches, timelines, introductions, regulatory submissions or clearances; expansion of international markets; increases in U.S. market share and procedural volume, the ability to drive surgeon adoption, gain hospital access and create clinical distinction; the development and monetization of informatics platforms; the ability to transform the sales channel; and the Company’s ability to finance its operations and sufficiency of its cash runway. Important factors that could cause actual operating results to differ significantly from those expressed or implied by such forward-looking statements include, but are not limited to: the uncertainty of success in developing and commercializing new products or products currently in the pipeline; the uncertainties in the Company’s ability to execute upon its strategic operating and long-range plan; the uncertainties regarding the ability to successfully license or acquire new products, and the commercial success of such products; failure to achieve acceptance of the Company’s products by the surgeon community; failure to obtain FDA or other regulatory clearance or approval or unexpected or prolonged delays in the process; continuation of favorable third-party reimbursement; unanticipated expenses or liabilities or other adverse events affecting cash flow or the Company’s ability to achieve profitability; uncertainty of additional funding; product liability exposure; an unsuccessful outcome in any litigation; patent infringement claims; claims related to the Company’s intellectual property; competitive pressures and market dynamics; and the Company’s ability to meet its financial obligations and achieve expected financial outcomes. A further list and description of these and other factors, risks and uncertainties can be found in the Company's most recent annual report, and any subsequent quarterly and current reports, filed with the U.S. Securities and Exchange Commission. ATEC disclaims any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise, unless required by law. 2
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+$5M Inflecting to positive cash flow for full year FREE CASH FLOW | 1. Management estimate | 2. Reference non-GAAP reconciliation in appendix Surgical revenue growth; ~6X market growth1 29% GROWTH LEADERSHIP Record 13% of revenue; improving 880 bps YoY2 $23M ADJUSTED EBITDA PROFITABLE, REVENUE - GROWTH LEADERSHIP Q2 2025 FINANCIAL HIGHLIGHTS 3
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PROFITABLE GROWTH Q2 2025 HIGHLIGHTS 4 27% 29% $23M Total revenue growth Surgical revenue growth Adjusted EBITDA +$5M21% Surgeon user growth $217M Free Cash Flow 29% Revenue growth in established territories PROFITABLE Cash and Access to Cash 3rd In U.S. Market Share1Non-GAAP Net Income | 1. Management estimate | Reference non-GAAP reconciliation in appendix $186M Total Revenue
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Total revenue YoY $ growth $40M Q2 2025 NON- GAAP P&L HIGHLIGHTS Q2 2025 YOY Surgical Revenue $168M 29% EOS Revenue $17M 11% TOTAL REVENUE $186M 27% $3M Non-GAAP Net Income DISCIPLINED EXECUTION DRIVING PROFITABILITY • 28% Surgical volume growth & 1% average revenue per case growth • SG&A improvements driven by infrastructure leverage & lower variable costs • Overall operating expenses grew 7% YoY • Inflection to non-GAAP Net Income profitability Gross margin % 70% (130) Bps Total Operating Expense 66% (1,260) bps OPERATING MARGIN % 4% 1,130 bps NON-GAAP NET INCOME $3M | May not foot due to rounding | Reference non-GAAP reconciliation in appendix
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Q2 2025 YOY Adjusted EBITDA $23M +$18M % OF SALES 13% +880 bps Adj. EBITDA leverage being driven by the areas we outlined and expected: • Durable top-line growth • Variable rate improvement • Infrastructure leverage Q2 2025 NON- GAAP AEBITDA AEBITDA $M AEBITDA % DROP THROUGH ON REVENUE GROWTH OF 45% YOY 6 | Reference non-GAAP reconciliation in appendix (15%) (10%) (5%) 0% 5% 10% 15% 20% 25% ($15) ($10) ($5) $0 $5 $10 $15 $20 $25 Q2 22 Q3 22 Q4 22 Q1 23 Q2 23 Q3 23 Q4 23 Q1 24 Q2 24 Q3 24 Q4 24 Q1 25 Q2 25
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BALANCE SHEET INFLECTED TO POSITIVE CASH FLOW Trailing 12-month free cash use reduced to ($22M) On track to achieve positive FCF in 2025 BALANCE SHEET Q2 2025 Cash $157M Available Borrowing1 $60M CASH + AVAILABLE CASH $217M CASH FLOW FREE CASH FLOW2 $5M | 1. The Company had $60M of undrawn credit available on its Midcap revolving line of credit at period end | 2. Free cash flow defined as cash generated by operating activities less PP&E ($80) ($70) ($60) ($50) ($40) ($30) ($20) ($10) $0 $10 Q2 22 Q3 22 Q4 22 Q1 23 Q2 23 Q3 23 Q4 23 Q1 24 Q2 24 Q3 24 Q4 24 Q1 25 Q2 25 ($22M)
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ROBUST OUTLOOK FOR 2025 Total revenue $742M Adjusted EBITDA $83M Free cash flow Positive CONTINUED CLINICAL DISTINCTION -DRIVEN REVENUE & PROFIT GROWTH
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2025 AEBITDA OUTLOOK | Reference historical non-GAAP reconciliation in appendix DRIVING POWERFUL LEVERAGE BY DESIGN Adjusted EBITDA $83M AEBITDA $M AEBITDA % 40% drop through of YoY $ revenue growth to $ AEBITDA (10%) (5%) 0% 5% 10% 15% 20% ($40) ($20) $0 $20 $40 $60 $80 2022 2023 2024 2025
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OUR STRATEGY IS STEADFAST. OUR EXECUTION IS RELENTLESS. COMPEL SURGEON ADOPTION CREATE CLINICAL DISTINCTION 2 1 EXPAND, ELEVATE & ENABLE SALES FORCE3 10 EXECUTING WITH PRECISION AND MOMENTUM— FULFILLING COMMITMENTS Architect unparalleled procedural solutions that improve patient outcomes Earn loyalty through differentiated training, technology, and clinical value Build a high-performing, aligned sales force designed to scale and win
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THE SPINE MARKET NEEDS ATEC SPINE IS UNSETTLED — REVISION RATES ARE UNACCEPTABLY HIGH ADULT DEFORMITY SURGERY 3% >5% TOTAL KNEE TOTAL HIP REPLACEMENT5 years 10 years 10-15% 1 to 3 years DEGENERATIVE SURGERY 25-30% 2 to 5 years % OF SURGERIES THAT REQUIRE REVISION 1 SPINE’S MOST PERVASIVE CHALLENGE: LACK OF DURABILITY | 1References on file11 HISTORICAL INDUSTRY INVESTMENT THESIS FOCUSED ON FLAWED CURRENCY
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ECOSYSTEM BUILT FOR LONG RUN EARLY INFORMATICS INVESTMENTS FUELING DURABLE LONG - TERM GROWTH A ND PROFITABILITY DATA-DRIVEN ECOSYSTEM, INFORMING EVERY PROCEDURE INSIGHT PORTAL AI/ML MODELS Standardized Global Imaging 3D Surgical Planning & Simulation Automated Diagnostic Assessments AI ALIGNMENT 3D SURGICAL PLANNING BONE QUALITY 510(k) CURRENTLY UNDER FDA REVIEW EOS IMAGING Patient Specific Implants Navigated/Robot Assisted HW Placement Real-time Neurophysiology Monitoring Intra-Op Alignment Reconciliation CUSTOM RODS NAVIGATION & ROBOTICS MOBILE CLOUD CONNECTION PLAN RECONCILIATION AUTOMATED NERVE MONITORING Consistent Post-Op Imaging & Alignment Patient Trends & Outcomes Practice Analytics & Clinical Research EOS IMAGING AI ALIGNMENT PATIENT ANALYTICS 12
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13 THE MOST COVETED ECOSYSTEM. THE BEST INTEGRATED EXPERIENCE.
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OBJECTIVE MEASURE ENABLES VARIABLE MITIGATION 14 AUTOMATION OTHERS CAN’T REPLICATE
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THE SPINE MARKET NEEDS ATEC COMMITTED TO CLINICAL DISTINCTION ADULT DEFORMITY SURGERY 3% >5% TOTAL KNEE TOTAL HIP REPLACEMENT5 years 10 years 10-15% 1 to 3 years DEGENERATIVE SURGERY 25-30% 2 to 5 years % OF SURGERIES THAT REQUIRE REVISION 1 ATEC: SOLVING SPINE’S MOST PERVASIVE CHALLENGE, ONE VARIABLE AT A TIME | 1. References on file | 2. Management estimates15 EARNING SHARE IN A DISRUPTED & DISTRACTED MARKET THROUGH 100% SPINE FOCUS
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100% SPINE FOCUS UNMATCHED CLINICAL KNOW -HOW SALES FORCE INVESTMENT THE PREFERRED DESTINATION. 16
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WE’RE JUST GETTING STARTED. OUR BEST IS YET TO COME. 17
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APPENDIX 18
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Access this file at https://investors.alphatecspine.com/quarterly-results/default.aspx SUPPLEMENTAL FINANCIAL INFORMATION 19
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Access this file at https://investors.alphatecspine.com/quarterly-results/default.aspx SUPPLEMENTAL FINANCIAL INFORMATION 20
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Access this file at https://investors.alphatecspine.com/quarterly-results/default.aspx SUPPLEMENTAL FINANCIAL INFORMATION 21
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Access this file at https://investors.alphatecspine.com/quarterly-results/default.aspx SUPPLEMENTAL FINANCIAL INFORMATION 22
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SUPPLEMENTAL FINANCIAL INFORMATION Access this file at https://investors.alphatecspine.com/quarterly-results/default.aspx 23