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Q4 2025 FINANCIAL RESULTS PAT MILES, CHAIRMAN & CEO | TODD KONING , EVP & CFO | FEBRUARY 24, 2026
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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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ATEC IS UNIQUELY POSITIONED 100% SPINE FOCUS COMPELLING SURGEON ADOPTION THROUGH CLINICAL DISTINCTION LEADING & ADVANCING LATERAL EARNING SHARE, DRIVING ADOPTION WITH VALENCE ® DEFORMITY LEADERSHIP & EOS INSIGHT ® PROCEDURAL GROWTH ENGINE, POISED FOR A PTP - LIKE RUN INFRASTRUCTURE BUILT FOR LONG RUN FOUNDATIONAL INVESTMENTS ENABLE SCALE AND LONGEVITY DURABLE & PROFITABLE SALES GROWTH INFLECTED TO PROFITABILITY AND CASH FLOW 3
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PROFITABLE GROWTH Q4 2025 HIGHLIGHTS 4 20% 21% $33M Total revenue growth Surgical revenue growth Adjusted EBITDA +$8M 23% Net new surgeon users Free Cash Flow 20% Revenue growth in established territories | Reference non-GAAP reconciliation in appendix $213M Total Revenue
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$764M $153M of YoY growth TOTAL REVENUE Total revenue growth 25% GROWTH LEADERSHIP 12% of revenue $93M ADJUSTED EBITDA PROFITABLE, REVENUE - GROWTH LEADERSHIP 2025 FULL YEAR HIGHLIGHTS +$3M Improving $131M YoY FREE CASH FLOW 5 KEY PROCEDURAL ADVANCEMENTS BONE MINERAL DENSITY | Reference non-GAAP reconciliation in appendix
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Q4 REVENUE PERFORMANCE Q4 2025 YOY $ YOY% Surgical Revenue $190M $33M 21% EOS Revenue $23M $3M 14% TOTAL REVENUE $213M $36M 20% $33M Surgical Revenue YoY $ Growth GROWTH DRIVEN BY SURGICAL VOLUME | May not foot due to rounding6 • 21% surgical volume growth • Revenue per case flat year over year • U.S. surgical revenue per case up 1.4% • 120 bps headwind from OUS surgical revenue per case
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SUSTAINABLE TOPLINE GROWTH 3Q AND 4Q 2025 SURGEON USER GROWTH THE HIGHEST IN THE LAST TWO Y EARS 7 21% 20% 19% 20% 19% 21% 26% 23% Q1 24 Q2 24 Q3 24 Q4 24 Q1 25 Q2 25 Q3 25 Q4 25 SURGEON USERS SURGEON GROWTH %
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SUSTAINABLE TOPLINE GROWTH STRONG MOMENTUM AND EVOLVING SEASONALITY 8 $0 $5 $10 $15 $20 $25 $30 $35 $40 $45 1Q23 2Q23 3Q23 4Q23 1Q24 2Q24 3Q24 4Q24 1Q25 2Q25 3Q25 4Q25 Surgical $ Growth YoY Revenue Growth 12-mo rolling average $0 $20 $40 $60 $80 $100 $120 $140 $160 $180 $200 1Q24 2Q24 3Q24 4Q24 1Q25 2Q25 3Q25 4Q25 Surgical Revenue Surgical Revenue In $ millions
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Q4 2025 NON -GAAP P&L HIGHLIGHTS Q4 2025 YOY TOTAL REVENUE $213M 20% DISCIPLINED EXECUTION DRIVING PROFITABILITY • Gross margin improvements driven by asset efficiency and product mix • Overall operating expenses grew 11% YoY • Adj. EBITDA grew $13M or 61% YoY; drop through of 35% YoY Gross Margin % 70.5% +80 bps R&D % 6.5% (110 bps) SG&A % 55.5% (410 bps) Total Operating Expense % 62.0% (520) bps OP PROFIT MARGIN % 8.4% 580 bps | May not foot due to rounding | Reference non-GAAP reconciliation in appendix9 (10%) (5%) 0% 5% 10% 15% 20% 25% 30% 35% ($10) ($5) $0 $5 $10 $15 $20 $25 $30 $35 Q1 23 Q2 23 Q3 23 Q4 23 Q1 24 Q2 24 Q3 24 Q4 24 Q1 25 Q2 25 Q3 25 Q4 25 AEBITDA $M AEBITDA % ADJUSTED EBITDA $ $33M 61% % of Sales 15.6% +390 bps
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FY 2025 FINANCIAL OVERVIEW PROFITABLE, FULL YEAR GROWTH FY 2025 YOY Surgical Revenue $687M 26% EOS Revenue $77M 15% TOTAL REVENUE $764M 25% 3% Avg revenue / case growth Surgical volume growth 22% ADJUSTED EBITDA $ $93M 205% % of Sales 12.2% +720 bps 10 3x YoY increase in AEBITDA $s Gross Margin % 70.2% 0 bps R&D % 7.4% (140 bps) SG&A % 58.7% (790 bps) Total Operating Expense % 66.2% (920) bps OP PROFIT MARGIN % 4.1% +920 bps | May not foot due to rounding | Reference non-GAAP reconciliation in appendix
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BALANCE SHEET CASH GENERATION REINFORCING FINANCIAL STRENGTH BALANCE SHEET Q4 2025 Cash $161M Available Borrowing1 $60M CASH + AVAILABLE CASH $221M | 1The Company had $60M of undrawn credit available on its Midcap revolving line of credit at period end | 2Free cash flow defined as cash generated by operating activities less PP&E11 Full year 2025 free cash flow improved by $131M Q4 2025 FY 2025 Operating Cash Flow $21M $45M PP&E Investments ($13M) ($42M) FREE CASH FLOW2 $8M $3M
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2026 REVENUE OUTLOOK 12 $890M ADOPTION OF OUR UNIQUE PROCEDURAL APPROACH FUELS DURABLE REVENUE GROWTH FY’26E YOY Surgical Revenue $805M 17% EOS Revenue $85M 10% TOTAL REVENUE $890M 17% Surgical volume growth mid - teens % Avg revenue / case growth lsd % Total Revenue Topline growing $126M YoY, including $118M of surgical revenue growth
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COMPELLING SURGEON ADOPTION SURGEON UTILIZATION AVG CASES/ SURGEON DURABLE FUTURE GROWTH DRIVEN BY SURGEON UTILIZATION ALGORITHM 13 2018 2019 2020 2021 2022 2023 2024 2025 0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2018 2019 2020 2021 2022 2023 2024 2025 SURGEON USERS Steady new surgeon adoption | Mid-teens underlying average utilization
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P&L OUTLOOK FOR 2026 PROFITABLE, FULL YEAR GROWTH FY 2026 YOY Surgical Revenue $805M 17% EOS Revenue $85M 10% TOTAL REVENUE $890M 17% 14 $0 $500 $1,000 2025 2026 Global Revenue $0 $75 $150 2025 2026 Adj EBITDA YoY Growth: 44% YoY Growth: 17% ADJUSTED EBITDA $ $134M 44% % of Sales 15.1% +290 bps Gross Margin % 70.5% 30 bps R&D % 6.5% (90 bps) SG&A % 56.0% (270 bps) Total Operating Expense % 62.5% (360) bps OP PROFIT MARGIN % 8.0% +390 bps | May not foot due to rounding | Reference non-GAAP reconciliation in appendix
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2026 AEBITDA & CASH FLOW 15 | Reference non-GAAP reconciliation in appendix DRIVING POWERFUL LEVERAGE BY DESIGN Adjusted EBITDA margin of 15% $134M AEBITDA $M AEBITDA % 15% adjusted EBITDA margin % | 32% drop through YoY (15%) (5%) 5% 15% 25% 35% 45% ($50) ($30) ($10) $10 $30 $50 $70 $90 $110 $130 $150 2022 2023 2024 2025 2026 FY 2026 ADJUSTED EBITDA $134M Cash Interest Expense ($23) Non-cash E&O +$15 Other Working Capital ($18) CASH FLOW AVAILABLE $110M Inventory & PP&E ($90) FREE CASH FLOW $20M Cash flow improving by $17M YoY while increasing inventory and PP&E investment
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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 16 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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ADVANCING INTO HIGHER COMPLEXITY A procedural investment approach and expanding indications of PTP and LTP enable us to address more complex pathologies 17 UNRIVALED LEADERSHIP IN LATERAL THE INDUSTRY’S MOST COMPREHENSIVE LATERAL PLATFORM CLINICAL DISTINCTION WITH SAFEOP ® Our competitive moat in lateral— Automated proprietary neuromonitoring enables variable mitigation through actionable intraoperative informatics
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ARCHITECTED EXCLUSIVELY FOR SPINE — PTP CATALYST VALENCE EXTENDS OUR LATERAL ADVANTAGE 18 PROCEDURALLY INTEGRATED Committed to ATEC's proceduralized approach to spine surgery, Valence® serves as the intraoperative centerpiece of our expanding InformatiX portfolio, connecting advanced technologies to create clinical distinction in the O.R.
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VAST UNTAPPED OPPORTUNITY IN U.S. SIGNIFICANTLY UNDERPENETRATED ACROSS KEY SEGMENTS WITH ENORMOUS UPSIDE | Management estimates19 FASTEST - GROWING SEGMENTS LATERAL & DEFORMITY U . S . T L I F & P L I F conventional techniques that can be treated with PTP $2B U . S . L A T E R A L M A R K E T$1B ~20% S H A R E ~$10B U . S . S P I N E M A R K E T
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LATERAL CONFIDENCE CREATION EARNS SURGEON TRUST… LATERAL DISTINCTION AND UNIQUE APPROACH TO PROCEDURAL SOLUTIONS … AND EXPANDS UTILIZATION OF OUR ENTIRE PROCEDURAL PORTFOLIO ACROSS CERVICAL | ANTERIOR | POSTERIOR 20 SURGEON UTILIZATION AVG CASES/ SURGEON 2018 2019 2020 2021 2022 2023 2024 2025 LATERAL 0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2018 2019 2020 2021 2022 2023 2024 2025 SURGEON USERS FIXATION IMPLANTS INFORMATIX ACCESS BIOLOGICS POSITIONERS CUSTOM RODS NAVIGATION
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ACCELERATING DEFORMITY INFLUENCE THROUGH EOS INTEGRATION END - TO - END ECOSYSTEM POSITIONS ATEC TO BECOME THE PROCEDURAL LEA DER IN DEFORMITY 21
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ADVANCING PEDIATRIC DEFORMITY ELEMENTS OF FULL DEFORMITY SOLUTION ARE CONVERGING TO ENABLE ANO THER PTP - LIKE RUN PEDIATRIC POSITIONING CURVE CORRECTION MEASURED USING INTRAOP ALIGNMENT MOST - COVETED IMAGING AUTOMATED ALIGNMENT 3D SURGICAL PLANNING WITH AXIAL ROTATION BEST - IN - CLASS FIXATION NEUROMONITORING 22
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ADVANCING PATIENT -SPECIFIC SPINE CARE VIA ACTIONABLE INFORMATICS BONE MINERAL DENSITY X CUSTOM ROD 23
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ADVANCING SPINE THROUGH PROPRIETARY DATA-DRIVEN PROCEDURAL ECOSYSTEM INTEGRATED TECHNOLOGY STACK — INFORMED DECISION - MAKING TO ELEVATE SPINE CARE INSIGHT PORTAL AI/ML MODELS PRE-OP Standardized Global Imaging 3D Surgical Planning & Simulation Automated Diagnostic Assessments AI ALIGNMENT 3D SURGICAL PLANNING BONE QUALITY EOS IMAGING POST-OP INTRA-OP 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 24 Synthetic CT from MRI SYNTHETIC CT
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EXCLUSIVE BMP2 DISTRIBUTION PARTNERSHIP WITH THERADAPTIVE 25 TOTAL ADDRESSABLE SPINE MARKET $2.5B ~$700M EST. ANNUAL SALES OF COMPETITIVE BMP2 SOLUTION 1 Exclusive Distribution Agreement for OsteoAdapt ® THE MOST ADVANCED BMP2 BONE GRAFT IN EXISTENCE. • Easy to use, familiar handling—enables precise delivery of therapy • 2-3x faster bone formation than gold standard autograft2 • 325% higher molar osteoinductivity than sole alternative2 • Projected to have the highest safety margin of any BMP product on the market | 1Management estimates | 2Data on file
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($50) $0 $50 $100 $150 $200 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 FOUNDATIONAL INFRASTRUCTURE BUILT— WELL-POSITIONED FOR PROFITABLE GROWTH | 1Trajectory to 2027 based on LRP commitments 26 E S T . A D J U S T E D E B I T D A $ 1 DISCIPLINED EXECUTION IS UNLOCKING SCALE, DRIVING THE NEXT PHASE OF GROWTH • Lever infrastructure investments • Integrate data and informatic platform into surgical experience • Expand and evolve procedural approaches • Proliferate algorithm-based sales growth model • Deepen partnerships with leading hospital systems and academic institutions • Drive focal growth of key international markets
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2026 FINANCIAL OUTLOOK COMMITTED TO CONTINUING INDUSTRY - LEADING PROFITABLE GROWTH & INN OVATION Total revenue; 17% growth $890M GROWTH LEADERSHIP $134M POWERFUL LEVERAGE Adjusted EBITDA; 15% margin 27 $20M FREE CASH FLOW Investing in growth and generating cash | Reference non-GAAP reconciliation in appendix
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ATEC IS UNIQUELY POSITIONED 100% SPINE FOCUS COMPELLING SURGEON ADOPTION THROUGH CLINICAL DISTINCTION LEADING & ADVANCING LATERAL EARNING SHARE, DRIVING ADOPTION WITH VALENCE® DEFORMITY LEADERSHIP & EOS INSIGHT ® PROCEDURAL GROWTH ENGINE, POISED FOR A PTP - LIKE RUN INFRASTRUCTURE BUILT FOR LONG RUN FOUNDATIONAL INVESTMENTS ENABLE SCALE AND LONGEVITY DURABLE & PROFITABLE SALES GROWTH INFLECTED TO PROFITABILITY AND CASH FLOW 28
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29 THE PREFERRED DESTINATION IN SPINE.
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APPENDIX 30
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| Access this file at https://investors.alphatecspine.com/financials/financial-results/default.aspx SUPPLEMENTAL FINANCIAL INFORMATION 31 HISTORICAL GAAP P&L TREND - CONSOLIDATED ($000's) Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Revenue from products and services 109,110$ 116,920$ 118,262$ 137,970$ 482,262$ 138,477$ 145,573$ 150,719$ 176,793$ 611,562$ 169,180$ 185,544$ 196,503$ 212,928$ 764,155$ Cost of sales 38,685 52,379 38,215 42,780 172,059 41,126 42,979 47,990 55,205 187,300 53,184 56,443 59,203 63,437 232,267 Gross profit 70,425 64,541 80,047 95,190 310,203 97,351 102,594 102,729 121,588 424,262 115,996 129,101 137,300 149,491 531,888 Operating expenses: Research and development 13,260 14,571 20,000 22,284 70,115 18,012 19,105 20,357 23,244 80,718 17,032 18,276 18,679 22,281 76,268 Sales, general and administrative 91,262 87,287 91,411 104,120 374,080 113,727 112,731 109,200 114,541 450,199 127,017 118,507 124,303 128,699 498,526 Litigation-related expenses 3,192 6,908 2,715 9,472 22,287 4,428 2,090 2,093 1,188 9,799 12,214 1,593 6,520 3,457 23,784 Amortization of acquired intangibles 2,883 3,705 3,873 3,823 14,284 3,854 3,836 3,848 4,720 16,258 3,653 3,803 3,731 3,873 15,060 Transaction-related expenses - 1,900 278 (65) 2,113 (117) - - 327 210 - - - - - Restructuring expenses 175 29 129 386 719 788 139 934 1,386 3,247 371 7 - - 378 Gain on Settlement - - - - - Total operating expenses 110,772 114,400 118,406 140,020 483,598 140,692 137,901 136,432 145,406 560,431 160,287 142,186 153,233 158,310 614,016 Operating Loss (40,347) (49,859) (38,359) (44,830) (173,395) (43,341) (35,307) (33,703) (23,818) (136,169) (44,291) (13,085) (15,933) (8,819) (82,128) Other expense, net: Cash interest expense, net (3,014) (3,038) (3,581) (3,367) (13,000) (4,283) (4,754) (5,417) (5,967) (20,421) (5,356) (5,289) (5,312) (5,184) (21,141) Noncash interest expense, net (860) (854) (878) (1,049) (3,641) (1,058) (1,061) (1,155) (1,184) (4,458) (2,485) (7,020) (7,566) (7,710) (24,781) Loss on debt extinguishment - - - - - - - - - - (17,576) - - - (17,576) Gain on derivative liability - - - - - - - - - - 17,400 (16,780) - - 620 Other (expense) income, net 706 2,324 47 44 3,121 118 156 623 (1,922) (1,025) 337 993 307 (34) 1,603 Total other expense, net (3,168) (1,568) (4,412) (4,372) (13,520) (5,223) (5,659) (5,949) (9,073) (25,904) (7,680) (28,096) (12,571) (12,928) (61,275) Net loss before taxes (43,515) (51,427) (42,771) (49,202) (186,915) (48,564) (40,966) (39,652) (32,891) (162,073) (51,971) (41,181) (28,504) (21,747) (143,403) Income tax provision (benefit) 14 (50) (117) (124) (277) (69) (286) (36) 441 50 (64) (37) 74 (18) (45) Net loss, GAAP (43,529)$ (51,377)$ (42,654)$ (49,078)$ (186,638)$ (48,495)$ (40,680)$ (39,616)$ (33,332)$ (162,123)$ (51,907)$ (41,144)$ (28,578)$ (21,729)$ (143,358)$ Net loss per share, GAAP (0.40)$ (0.43)$ (0.35)$ (0.37)$ (1.54)$ (0.34)$ (0.29)$ (0.28)$ (0.23)$ (1.13)$ (0.35)$ (0.27)$ (0.19)$ (0.14)$ (0.96)$ Weighted average shares outstanding, basic and diluted 109,751 118,719 122,468 133,750 121,242 140,980 142,687 143,492 144,583 142,946 146,732 149,907 151,401 152,106 150,064
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SUPPLEMENTAL FINANCIAL INFORMATION 32 | Access this file at https://investors.alphatecspine.com/financials/financial-results/default.aspx NON-GAAP RECONCILIATION - CONSOLIDATED ($000's) NON-GAAP GROSS PROFIT & GROSS MARGIN Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Gross Profit, GAAP 70,425$ 64,541$ 80,047$ 95,190$ 310,203$ 97,351$ 102,594$ 102,729$ 121,588$ 424,262$ 115,996$ 129,101$ 137,300$ 149,491$ 531,888$ + Amortization of acquired intangible assets 220 220 221 278 939 307 307 308 (814) 108 50 64 65 66 245 + Stock-based compensation 6,006 16,226 2,369 481 25,082 483 554 1,439 2,485 4,961 3,043 553 414 519 4,529 + Purchase accounting adjustments on acquisitions 195 - - 198 393 - 197 - - 197 - - - - - Non-GAAP Gross Profit 76,846$ 80,987$ 82,637$ 96,147$ 336,617$ 98,141$ 103,652$ 104,476$ 123,259$ 429,528$ 119,089$ 129,718$ 137,779$ 150,076$ 536,662$ Gross Margin, GAAP 64.5% 55.2% 67.7% 69.0% 64.3% 70.3% 70.5% 68.2% 68.8% 69.4% 68.6% 69.6% 69.9% 70.2% 69.6% + Amortization of acquired intangible assets 0.2% 0.2% 0.2% 0.2% 0.2% 0.2% 0.2% 0.2% -0.5% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% + Stock-based compensation 5.5% 13.9% 2.0% 0.3% 5.2% 0.3% 0.4% 1.0% 1.4% 0.8% 1.8% 0.3% 0.2% 0.2% 0.6% + Purchase accounting adjustments on acquisitions 0.2% 0.0% 0.0% 0.1% 0.1% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% Non-GAAP Gross Margin 70.4% 69.3% 69.9% 69.7% 69.8% 70.9% 71.2% 69.3% 69.7% 70.2% 70.4% 69.9% 70.1% 70.5% 70.2% NON-GAAP OPERATING EXPENSES Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Research & Development, GAAP 13,260$ 14,571$ 20,000$ 22,284$ 70,115$ 18,012$ 19,105$ 20,357$ 23,244$ 80,718$ 17,032$ 18,276$ 18,679$ 22,281$ 76,268$ - Stock-based compensation in R&D 1,317 1,480 6,790 9,154 18,741 4,315 5,614 7,207 9,894 27,030 3,644 4,159 3,307 8,421 19,531 Non-GAAP R&D 11,943 13,091 13,210 13,130 51,374 13,697 13,491 13,150 13,350 53,688 13,388 14,117 15,372 13,860 56,737 Sales General & Administrative, GAAP 91,262 87,287 91,411 104,120 374,080 113,727 112,731 109,200 114,541 450,199 127,017 118,507 124,303 128,699 498,526 - Stock-based compensation in SG&A 9,139 6,488 10,914 10,880 37,421 12,524 10,792 8,816 9,154 41,286 15,631 10,912 12,658 10,458 49,659 - Other non-recurring expenses 1,349 - - - 1,349 - 1,608 - - 1,608 - - - - - Non-GAAP SG&A 80,774 80,799 80,497 93,240 335,310 101,203 100,331 100,384 105,387 407,305 111,386 107,595 111,645 118,241 448,867 Other Operating Expense, GAAP 6,250 12,542 6,995 13,616 39,403 8,953 6,065 6,875 7,621 29,514 16,688 5,403 10,251 7,330 39,222 - Litigation-related expenses 3,192 6,908 2,715 9,472 22,287 4,428 2,090 2,093 1,188 9,799 12,214 1,593 6,520 3,457 23,784 - Amortization of acquired intangibles assets 2,883 3,705 3,873 3,823 14,284 3,854 3,836 3,848 4,720 16,258 3,653 3,803 3,731 3,873 15,060 - Transaction-related expenses - 1,900 278 (65) 2,113 (117) - - 327 210 - - - - - - Restructuring expenses 175 29 129 386 719 788 139 934 1,386 3,247 371 7 - - 378 Non-GAAP Other Operating Expense - - - - - - - - - - - - - - - Total Non-GAAP Operating Expenses 92,717$ 93,890$ 93,707$ 106,370$ 386,684$ 114,900$ 113,822$ 113,534$ 118,737$ 460,993$ 124,324$ 121,712$ 127,017$ 132,101$ 505,604$ Non-GAAP Operating Expenses as a % of Revenue Research & development 10.9% 11.2% 11.2% 9.5% 10.7% 9.9% 9.3% 8.7% 7.6% 8.8% 7.9% 7.6% 7.8% 6.5% 7.4% Sales, general & administrative 74.0% 69.1% 68.1% 67.6% 69.5% 73.1% 68.9% 66.6% 59.6% 66.6% 65.8% 58.0% 56.8% 55.5% 58.7% Total Non-GAAP Operating Expenses as a % of Revenue 84.9% 80.3% 79.2% 77.1% 80.2% 83.0% 78.2% 75.3% 67.2% 75.4% 73.8% 65.6% 64.6% 62.0% 66.2%
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SUPPLEMENTAL FINANCIAL INFORMATION 33 | Access this file at https://investors.alphatecspine.com/financials/financial-results/default.aspx NON-GAAP RECONCILIATION - CONSOLIDATED ($000's) ADJUSTED EBITDA Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Net loss, GAAP (43,529)$ (51,377)$ (42,654)$ (49,078)$ (186,638)$ (48,495)$ (40,680)$ (39,616)$ (33,332)$ (162,123)$ (51,907)$ (41,144)$ (28,578)$ (21,729)$ (143,358)$ Cash interest expense, net 3,014 3,038 3,581 3,367 13,000 4,283 4,754 5,417 5,967 20,421 5,356 5,289 5,312 5,184 21,141 Noncash interest expense, net 860 854 878 1,049 3,641 1,058 1,061 1,155 1,184 4,458 2,485 7,020 7,566 7,710 24,781 Loss on debt extinguishment - - - - - - - - - - 17,576 - - - 17,576 Gain on derivative liability - - - - - - - - - - (17,400) 16,780 - - (620) Other (expense) income, net (706) (2,324) (47) (44) (3,121) (118) (156) (623) 1,922 1,025 (337) (993) (307) 34 (1,603) Income tax provision (benefit) 14 (50) (117) (124) (277) (69) (286) (36) 441 50 (64) (37) 74 (18) (45) Depreciation expense 8,589 9,758 10,651 11,918 40,916 13,724 15,735 16,491 16,102 62,052 15,754 15,012 14,889 14,695 60,350 Amortization expense 3,103 3,925 4,094 4,101 15,223 4,161 4,143 4,156 3,906 16,366 4,153 4,316 4,267 4,406 17,142 Total EBITDA (28,655) (36,176) (23,614) (28,811) (117,256) (25,456) (15,429) (13,056) (3,810) (57,751) (24,384) 6,243 3,223 10,282 (4,636) + Stock-based compensation 16,462 24,194 20,073 20,515 81,244 17,322 16,960 17,462 21,533 73,277 22,318 15,624 16,379 19,398 73,719 + Purchase accounting adjustments on acquisitions 195 - - 198 393 - 197 - - 197 - - - - - + Litigation-related expenses 3,192 6,908 2,715 9,472 22,287 4,428 2,090 2,093 1,188 9,799 12,214 1,593 6,520 3,457 23,784 + Transaction-related expenses - 1,900 278 (65) 2,113 (117) - - 327 210 - - - - - + Restructuring expenses 175 29 129 386 719 788 139 934 1,386 3,247 371 7 - - 378 + Other non-recurring expenses 1,349 - - - 1,349 - 1,608 - - 1,608 - - - - - Total Adjusted EBITDA (7,282)$ (3,145)$ (419)$ 1,695$ (9,151)$ (3,035)$ 5,565$ 7,433$ 20,624$ 30,587$ 10,519$ 23,467$ 26,122$ 33,137$ 93,245$ Adjusted EBITDA as a % of Revenue -6.7% -2.7% -0.4% 1.2% -1.9% -2.2% 3.8% 4.9% 11.7% 5.0% 6.2% 12.6% 13.3% 15.6% 12.2% NON-GAAP EARNINGS (LOSS) PER SHARE Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Net Loss, GAAP (43,529)$ (51,377)$ (42,654)$ (49,078)$ (186,638)$ (48,495)$ (40,680)$ (39,616)$ (33,332)$ (162,123)$ (51,907)$ (41,144)$ (28,578)$ (21,729)$ (143,358)$ + Stock-based compensation 16,462 24,194 20,073 20,515 81,244 17,322 16,960 17,462 21,533 73,277 22,318 15,624 16,379 19,398 73,719 + Amortization of acquired intangible assets 3,103 3,925 4,094 4,101 15,223 4,161 4,143 4,156 3,906 16,366 3,703 3,867 3,796 3,939 15,305 + Restructuring expenses 175 29 129 386 719 788 139 934 1,386 3,247 371 7 - - 378 + Transaction-related expenses - 1,900 278 (65) 2,113 (117) - - 327 210 - - - - - + Litigation-related expenses 3,192 6,908 2,715 9,472 22,287 4,428 2,090 2,093 1,188 9,799 12,214 1,593 6,520 3,457 23,784 + Loss on Debt extinguishment - - - - - - - - - - 17,576 - - - 17,576 + Gain on derivative liability - - - - - - - - - - (17,400) 16,780 - - (620) + Noncash interest expense, net 860 854 878 1,049 3,641 1,058 1,061 1,155 1,184 4,458 2,485 7,020 7,566 7,710 24,781 + Foreign exchange impact (209) 265 7 16 79 (119) (44) (624) 1,592 805 (311) (308) (29) (60) (708) + Long-term income tax rate adjustment 5,168 3,522 3,912 3,693 16,295 5,448 4,606 3,800 21 13,875 2,928 (848) (1,563) (3,283) (2,766) Non-GAAP net income (loss) (14,778)$ (9,780)$ (10,568)$ (9,911)$ (45,037)$ (15,526)$ (11,725)$ (10,640)$ (2,195)$ (40,086)$ (8,023)$ 2,591$ 4,091$ 9,432$ 8,091$ Non-GAAP net income (loss) per share (0.13)$ (0.08)$ (0.09)$ (0.07)$ (0.37)$ (0.11)$ (0.08)$ (0.07)$ (0.02)$ (0.28)$ (0.05)$ 0.02$ 0.03$ 0.06$ 0.05$ Weighted avg shares outstanding, basic and diluted 109,751 118,719 122,468 133,750 121,242 140,980 142,687 143,492 144,583 142,946 146,732 149,907 151,401 152,106 150,064
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SUPPLEMENTAL FINANCIAL INFORMATION 34 NON-GAAP P&L TREND - CONSOLIDATED ($000's) Revenue from products and services $ $ $ $ $ $ Non-GAAP cost of sales 41,921 46,243 53,534 50,091 55,826 58,724 -GAAP gross profit $ Non-GAAP Gross Margin -GAAP 0perating expenses: Non-GAAP research & development 13,491 13,150 13,350 53,688 13,388 14,117 15,372 Non- -GAAP operating expenses $ $ $ Non-GAAP R&D as % of revenue Non-GAAP SG&A as % of revenue Total Non- -GAAP operating loss (9,058) 4,522 (5,685) 8,006 10,762 Op loss as % of revenue - - - - - - - - - - Less: Other amortization expense Less: Depreciation expense 8,589 9,758 15,735 16,491 16,102 62,052 15,754 15,012 14,889 (7,282) (419) 1,695 (9,151) 5,565 7,433 20,624 30,587 10,519 23,467 26,122 Adj EBITDA as % of revenue - - - - - Adj EBITDA drop through % | Access this file at https://investors.alphatecspine.com/financials/financial-results/default.aspx NON-GAAP P&L TREND - CONSOLIDATED ($000's) Q123 Q223 Q323 Q423 2023 Q124 Q224 Q324 Q424 2024 Q125 Q225 Q325 Q425 2025 Revenue from products and services 109,110$ 116,920$ 118,262$ 137,970$ 482,262$ 138,477$ 145,573$ 150,719$ 176,793$ 611,562$ 169,180$ 185,544$ 196,503$ 212,928$ 764,155$ Non-GAAP cost of sales 32,264 35,933 35,625 41,823 145,645 40,336 41,921 46,243 53,534 182,034 50,091 55,826 58,724 62,852 227,493 Non-GAAP gross profit 76,846$ 80,987$ 82,637$ 96,147$ 336,617$ 98,141$ 103,652$ 104,476$ 123,259$ 429,528$ 119,089$ 129,718$ 137,779$ 150,076$ 536,662$ Non-GAAP Gross Margin 70.4% 69.3% 69.9% 69.7% 69.8% 70.9% 71.2% 69.3% 69.7% 70.2% 70.4% 69.9% 70.1% 70.5% 70.2% Non-GAAP 0perating expenses: Non-GAAP research & development 11,943 13,091 13,210 13,130 51,374 13,697 13,491 13,150 13,350 53,688 13,388 14,117 15,372 13,860 56,737 Non-GAAP sales, general & administrative 80,774 80,799 80,497 93,240 335,310 101,203 100,331 100,384 105,387 407,305 111,386 107,595 111,645 118,241 448,867 Total non-GAAP operating expenses 92,717$ 93,890$ 93,707$ 106,370$ 386,684$ 114,900$ 113,822$ 113,534$ 118,737$ 460,993$ 124,774$ 121,712$ 127,017$ 132,101$ 505,604$ Non-GAAP R&D as % of revenue 10.9% 11.2% 11.2% 9.5% 10.7% 9.9% 9.3% 8.7% 7.6% 8.8% 7.9% 7.6% 7.8% 6.5% 7.4% Non-GAAP SG&A as % of revenue 74.0% 69.1% 68.1% 67.6% 69.5% 73.1% 68.9% 66.6% 59.6% 66.6% 65.8% 58.0% 56.8% 55.5% 58.7% Total Non-GAAP OPEX as % of revenue 84.9% 80.3% 79.2% 77.1% 80.2% 83.0% 78.2% 75.3% 67.2% 75.4% 73.8% 65.6% 64.6% 62.0% 66.2% Non-GAAP operating income (loss) (15,871) (12,903) (11,070) (10,223) (50,067) (16,759) (10,170) (9,058) 4,522 (31,465) (5,685) 8,006 10,762 17,975 31,058 Op income (loss) as % of revenue -14.5% -11.0% -9.4% -7.4% -10.4% -12.1% -7.0% -6.0% 2.6% -5.1% -3.4% 4.3% 5.5% 8.4% 4.1% Less: Other amortization expense - - - - - - - - - - 450 449 471 467 1,837 Less: Depreciation expense 8,589 9,758 10,651 11,918 40,916 13,724 15,735 16,491 16,102 62,052 15,754 15,012 14,889 14,695 60,350 Adjusted EBITDA (7,282)$ (3,145)$ (419)$ 1,695$ (9,151)$ (3,035)$ 5,565$ 7,433$ 20,624$ 30,587$ 10,519$ 23,467$ 26,122$ 33,137$ 93,245$ Adj EBITDA as % of revenue -6.7% -2.7% -0.4% 1.2% -1.9% -2.2% 3.8% 4.9% 11.7% 5.0% 6.2% 12.6% 13.3% 15.6% 12.2% Adj EBITDA drop through % 14.2% 22.9% 30.5% 22.8% 22.0% 14.5% 30.4% 24.2% 48.8% 30.7% 44.1% 44.8% 40.8% 34.6% 41.1%
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SUPPLEMENTAL FINANCIAL INFORMATION 35 NON-GAAP P&L TREND - CONSOLIDATED ($000's) Revenue from products and services $ $ $ $ $ $ Non-GAAP cost of sales 41,921 46,243 53,534 50,091 55,826 58,724 -GAAP gross profit $ Non-GAAP Gross Margin -GAAP 0perating expenses: Non-GAAP research & development 13,491 13,150 13,350 53,688 13,388 14,117 15,372 Non- -GAAP operating expenses $ $ $ Non-GAAP R&D as % of revenue Non-GAAP SG&A as % of revenue Total Non- -GAAP operating loss (9,058) 4,522 (5,685) 8,006 10,762 Op loss as % of revenue - - - - - - - - - - Less: Other amortization expense Less: Depreciation expense 8,589 9,758 15,735 16,491 16,102 62,052 15,754 15,012 14,889 (7,282) (419) 1,695 (9,151) 5,565 7,433 20,624 30,587 10,519 23,467 26,122 Adj EBITDA as % of revenue - - - - - Adj EBITDA drop through % | Access this file at https://investors.alphatecspine.com/financials/financial-results/default.aspx