Alrighty, morning. Thank you everybody for day two at the MS Healthcare Conference. I appreciate it. The most exciting bit, disclaimers, focusfamily.com forward slash research disclosures. I'm sure you'll all be going there. What is exciting is having Laura and Anshul here, CEO and CFO at SI-BONE respectively. Doing a beautiful morning for us. Thanks so much for joining, guys. You got in late last night. Yesterday afternoon, coming in from LSI in London and served in dinner last night and meeting with a banker. I think we got done around 11:00, 11:00 last night. Inevitably, it's typical. It's always a lot. Why don't we start big picture? You know, the business, you know, originally on the circle of COVID, joined the space, but it's really, over the last few years, become more of a platform. It might be helpful for the audience if you could sort of walk through that evolution of that journey and discuss the end markets and products that you're currently exposed to. Yeah, thanks for the question. I've been with the company for over 10 years at this point. I started out with the company in 2015. I was the CFO at the time of the company. We were a private company and really focused very specifically on the SI joint, the largest joint in the human body. It was what we called the last joint in the human body because there was no surgical solution for that largest joint. What I think today is quite obvious at the time wasn't. We established ourselves as a company that can actually identify an unmet clinical need and figure out how to address that need. That's how we really built the capabilities that we have. This innovation, clinical data has been absolutely critical. We have over 180 peer-reviewed published papers right now, four randomized controlled trials, a dozen prospective studies, and so on that talk about the safety, efficacy, biomechanics, economics of our solutions. The reason why that's so important is when you are actually building markets, you have to have that sort of data, especially from a reimbursement perspective. What's also important is the education side of things too, right? In our case, when I started with the company, many surgeons had not been trained on the SI joint in medical school. We took on the responsibility of really educating on the joint, the anatomy, the prevalence of pain in the joint, the diagnosis, and ultimately the treatment. That's really how we started the business. We are the undisputed leader in the SI joint space, whether it's market share, thought leadership, clinical data, what have you. What we've done is we've taken that base and we have built a diversified high-growth platform. That's what I'm really excited to talk about. What we've done with all of those core competencies that I just mentioned is we have started to launch a series of breakthrough devices that address different sacropelvic needs. Our first breakthrough device was in 2022, our iFuse Bedrock Granite product, and that focused on pelvic fixation. Multi-level construct procedures and providing a better solution to address fixation failure. That was our first breakthrough device. Our second breakthrough device we just launched for pelvic ring fractures, and we're going to have an NPAP going in place next month already for that particular product. For our iFuse Bedrock Granite product, we recently got a Transitional Pass-Through for outpatient procedures. You can see that we're continuing to build on the foundation, developing this more diversified platform. What does all of that translate to? I mean, this year we'll do a little less than $200 million in revenues, which is exciting. We are a high-growth platform. If you look at us since our IPO, we've grown over 20% on average per year, and that includes the last quarter that we just came out of. If you look at the number of surgeons that we're working with last quarter, I think we're at around 25% year over year, and we still have a long way to go. We also have been adjusted EBITDA profitable for the last three quarters, and we were also operating cash flow positive for the first time this last quarter. That's what all of this has translated into. We're definitely going to hit it on the lower side, but you know, over that time period, it's a long journey. Did you end up today where, how does it compare to the vision when you were first there? Like, how's that 10 years been in terms of expectations versus where you landed? Boy, it's a constant adventure, is the way I would describe it. I started out as the Chief Financial Officer of the business. I became the CEO. I'm going on five years now as the CEO of the company. The CEO, Jeff Dunn, who was our Chairman of the Board, he was the founder of the company. When I took over, we were really a one-product company. We had our iFuse 3D triangular titanium implant. Since I took over, we've really diversified in a pretty significant way. I would say that it's just that transition from founder to the next stage of management. Right now we're putting together a business plan of how do we get to a half a billion dollars in sales, right? We have kind of an overarching theme, given the way that we started in the sacrum. The quality of bone in the sacrum is the poorest quality bone in the body, and we have been working with solutions and developing this core competency of addressing patients with poor bone quality. As we're thinking about an overarching principle, kind of taking us to that next level, that's really where we're focusing our energies. I would say the short answer to your question is we're evolving over time as we continue to grow and expand and generate profitability. You mentioned in your comments before you've got two 510(k) products coming out and a couple next year. Could you expand to the audience on what you've got going on there and then maybe the SI joint dysfunction products? The FQ1, I think, coming out. That's correct. Yeah. SI Joint Fusion continues to provide the core base of the business. I had mentioned SI Joint Fusion. I had mentioned pelvic fixation. I had mentioned pelvic ring fractures as well. All of these areas are growing in the double digits, including our SI Joint Fusion business. As I said, the undisputed leader in that space. What we're continuing to do is to innovate. As you mentioned, we do have a product that's going to come out in the first quarter. That product is really just targeted toward the ambulatory surgery center (ASC) environment and a more streamlined approach to SI Joint Fusion for a physician, as well as for that site of service as well. We just continue to innovate in that SI Joint space in order to continue to catapult ourselves. It's a big market opportunity. Overall, we estimate that there are around 280,000 potential cases. That's the TAM every single year. We're still around 10% penetrated into that market at this point. There's a lot of opportunity, and we continue to innovate in order to make things happen. I'm also really excited about our third breakthrough device. I mentioned our first one in pelvic fixation, our second one in pelvic trauma. We have a third product that we have received breakthrough device for. I'm not saying that much about what the product is because we don't expect to file a 510K for that until the second half of 2026. It's once again building on the foundation of the business and all the core tenets that I just mentioned, selling to our existing call points. We believe probably the largest unmet clinical need in the space currently. Just continuing to show this ability to innovate, develop breakthrough devices. It's very unique, right? If you think about the space that we're in, the orthopedics space, the pain space, you don't see a lot of breakthrough devices. We really are a unique company from the perspective of innovation, which is continuing to drive growth. We combine that with this asset-light model that we have. High gross margins. Our gross margins are approaching 80% as well. It provides a very compelling opportunity, we believe, for investors. We're definitely going to hit on that as well. I think in the breakthrough device, you both referenced it as potentially changing the standard of care, which is often perplexing because in quite a lot of areas, you guys are the standard of care. It's always kind of interesting to sort of, you know, think about that. I know we'll be looking forward to learning a bit more about that. In the first half, or are we going to have to wait for you to file in the second half? I think we'll continue to talk about it the closer that we get to the filing and the launch. It's surprising to say we're very excited about where we're headed with this particular product launch. I really do see it as a very major catalyst for the business. To hit on some of the other breakthrough devices, iFuse Bedrock Granite and iFuse TORQ TNT, could you talk about how that's forming, and how the genesis of those kind of came to be? Yeah. What we typically do is we talk about our business overall, right? Because we're still, you know, a relatively small business. We're focused on the sacropelvic space. As I said, all parts of the business, if we look at, there are really three distinct procedure types: SI joint fusion, pelvic fixation, and pelvic trauma, each of them growing in those double-digit categories. Our pelvic fixation business has been quite exciting from our perspective. When we initially launched our iFuse Bedrock Granite product, we were focused on the deformity side of the business. Long construct procedures, scoliosis patients, the surgeon is trying to straighten the spine. There's a lot of biomechanical forces that can cause fixation failure. That was where we specifically focused with our original iFuse Bedrock Granite launch. The breakthrough in that particular area was we not only provided fixation, but we provided fusion if the surgeon uses two points of fixation on either side of the joint. That was the breakthrough. What we've seen is that we are becoming the standard of care in pelvic fixation. It has grown tremendously. Any KOL spine surgeons that you would speak to, it's orthopedic and neuro spine surgeons that typically are using that product. We have a tremendous reputation. We really take pride in that reputation. Quite frankly, they're using the product as well, right? We have seen a lot of success. We launched a more recent version of the product that was a smaller diameter. The goal was to allow more surgeons to use those two points of fixation with the smaller diameter in, you know, a variety of patients, regardless of the size of the patient. Also to start using the product in shorter level constructs as well. There are certain patients that need pelvic fixation for a shorter level construct too. That is where the Transitional Pass-Through (TPT) code comes in. Our estimate is around 40% of these pelvic fixation procedures can be done outpatient. The Transitional Pass-Through (TPT) code that we received covers the entire cost of the iFuse Bedrock Granite technology for the hospital, which is a big deal. There's no device offset that's there. Not only do you have the compelling reason for why to use pelvic fixation, there's also not an economic barrier to the hospital and to the surgeon to use the technology. We're continuing to drive forward in pelvic fixation. The other area that you mentioned was pelvic trauma. The issue that we're addressing specifically there is what we call sacral insufficiency fractures. These are low-impact pelvic ring fractures. Usually, an older female is going to have this condition. Typically, they're not treated. In a lot of ways, it reminded us of our days of starting out the SI joint fusion business. You have all of these patients. They're not treated. They go through rehab. In this particular case, if these patients don't get mobile, there's a high mortality rate with these patients. After 12 months, it's around 25%. It is very similar to getting a hip reconstruction years ago. The patient is older, we're not going to treat them, and they had a high mortality rate. This is the same situation. It's calling upon these core competencies that we have once again, where we're saying, we need to educate on this, right? We not only need to reach the surgeons and have a solution, our TNT solution in this case, and the economics help as well with the new technology add-on payment. For the most part, these procedures are done inpatient given the nature of the patient and the condition itself. This is the area that we're targeting in order to address this unmet clinical need. It is changing from not treating the patient at all, putting them into rehab versus here's a solution for you. I was in a case, it was one of our first cases last year. It was around a year ago that we did our first cases. I went in, and it was a 77-year-old female, 110 pounds, obviously frail, had clearly had a fracture, and looked miserable going into the operating room. The next day, she was ambulating again. That's what you want. Now she's not running marathons or anything like that. She's getting up with a walker, and she's starting to move, and movement is life. Those two areas are a significant part of the growth that we're seeing in addition to our core market and SI joint fusion. In all fairness to her, I'm also not running marathons. Our SI joint fusion patients, in a lot of cases, talk about, "I used to be a runner, and I can run again." That typical patient population is actually a 50-year-old female is the typical patient. They do actually run marathons after getting an SI joint fusion. Usually, the patients that are being treated for a pelvic ring fracture, it's more just basic mobility for the patient. Can they take care of themselves? Can they stay in their own home? Those sorts of things. It's incredibly rewarding for us to help these patients that otherwise they're just not being treated or they're being treated with conservative measures that we know really don't work very well. Yeah, makes sense. Anshul, you know the buy side often paints with just a big broad brush. Sometimes it ends up being, oh, spine is spine is spine. Actually, you guys alluded to it earlier with the capital intensity of the business relative to some other spine companies, cash flow break even, which is kind of awesome to see because, again, as you know, there's a lot of smidge cap companies. There's very few that actually end up then breaking out. Maybe, for people in the room who are less familiar, can you highlight the relative differential and how you guys ended up in with the better financial profile that you're in relative to some of your, well, they're not really peers, but you know what I mean. Sure. So when you think about some of the investors bucketing us into the spine category, our code point is ultraspine, right? That's where the similarity actually ends. Laura alluded to a lot of the facts that differentiate us. It starts with innovation. Spine is fraught with me too products. It's price competition. We focus on unmet needs, coming up with good clinical evidence, getting favorable reimbursement that allows us to have premium ASPs, and that translates into 80% gross margins. That's not typical within spine. That's number one. Number two is because we're so focused on addressing these targeted modalities, it allows us to be very asset efficient and asset light. You know, we could typically walk into, let's use a Granite case as an example. We could walk into a Granite case with instruments that could be, you know, in the mid-teens thousands, so $15,000. Let's round it up. We could walk out if they did four implant cases with $12,000. The ROI tends to be pretty high on those trades as well, which is also highly differentiated. The third piece is because we don't have new products and we can leverage our P&L through hybrid sales infrastructure with the high gross margins, with the better reimbursement, and then leveraging the P&L, you can easily see what happens. Our inflection on profitability has been an outcome of our top line growth. You've seen that leverage fall through the P&L, and the asset light model then translates into the cash flow break even. What we've always said about our business is 12 months post getting to Jeffrey, but now you should be able to see cash flow for that reason. You've seen that happen, actually, a year sooner. We had expected from an investor perspective to get to cash flow break even in 2026. We always think that they're sooner. It just shows the effectiveness of the business model there. Super helpful. The other one is, and this comes up sometimes, is, you know, the current guide sort of implies a lower optical, let's say, growth rate in the second half of the year. Help us understand the relative, like, I mean, there's no point in saying it's conservative if you support a conservatism, but you can understand the puts and takes in the second half of the market. Yeah. From a business standpoint, if you look at the last, since our IPO, we've had a 20% CAGR on top line growth, right? You're talking about six years of having 20% CAGR. If you actually look at the last three years, that CAGR has actually accelerated to close to 22, 23%. You look at the first half of this year, our growth was in the low 20s as well, Q2 being around 23% growth in the U.S., led by 25% volume growth in the U.S. We're really pleased with how the business has actually accelerated, and part of that is reflected in our performance in the first half of the year, and that is all reflected in our updated guide. When you think about the drivers of that top line growth, it's strong demand for existing products. We're still in the early stages, whether it's working on iFuse Bedrock Granite, iFuse TORQ TNT with interventional on the SI joint dysfunction side. Those tailwinds will continue. We're going to put up more surgical capacity in the second half of the year for iFuse Bedrock Granite and iFuse TORQ TNT, especially with the NPAP coming online. Number three is the continued growth in the interventional that we're seeing. Then you've got that combined with just adding to our sales force, right? We've got all the ingredients in place that will continue to drive strong demand in the back half of the year. We want to be thoughtful. We want to make sure we go into these tailwinds as well, especially when we think about the NPAP going effective October 1. Our assumption is the impact is more 2026 than 2025, but we know from prior experience, you see a pickup in the business. That's number one. Number two is iFuse TORQ in Europe. We've seen really good demand there, even though it's been a seasonally slow quarter in Europe, summer is. We've actually seen really good traction for iFuse TORQ already, but our assumption is, again, that's more of a 2026 tailwind versus 2025. That's number two that could provide upside. Number three is our ASP has actually been fairly stable, but our assumption going into the back half of the year is as the procedure mix shifts to maybe lower implant cases, which should drive higher volume, you could see some ASP pressure, right? We think we can do better than that. The last piece in our guidance was sort of the seasonal expectation of a sequential decline in the third quarter, and that was around 4% sequential decline. If you look at historical trends, we've done better than that. Our focus always has been to set expectations thoughtfully and then outperform them. What we're seeing in the third quarter as well is we are performing better than what our initial expectations were in our updated guide. We still see some seasonality happening in the business. That's general for the industry, but we think we can work well to our original expectations. It's always good to, yeah. I mean, on the end half of the TPT and outside of things, the provider economics get considerably better. I mean, what we've seen a lot of the rest of the med tech is utilization and volume often do very, very well when the coverage in that way picks up. How should we think about the potential impact, even just qualitatively as we move into next year? Because obviously, to your point, you didn't want to assume anything this year, but it's a sizable increase. Yeah, no, it absolutely is. We're one of the rare companies that can sit here today and tell you, if you look at the next three years, what the tails in the business are, right? It starts with the NPAP for iFuse TORQ TNT that goes into effect October 1. The approximate improvement in reimbursement could be anywhere between 20% and 30%, which is quite substantial. The majority of these patients are Medicare, which is where this would play out. The majority of them are going to be inpatient, which is where this would play out. That's a nice real tailwind for us. The second thing Laura talked about was the TPT for iFuse Bedrock Granite. It's mostly for a hospital outpatient and ambulatory surgery centers (ASCs). With the Level 7 APC code going into effect on January 1, 2026, we believe these procedures that will be performed in the outpatient setting or the ASC setting will benefit from Granite device offset, from the TPT, which could be a really nice tailwind for Granite as well. That's number two. Number three is you look at what we've been able to do with interventional, with our iFuse TORQ product, which is reimbursed under 27279, with our allograft product, which is very specific for the office-based lab model. There is approximately a 15% plus increase proposed effective January 1 for the office-based lab procedures as well. Those are three big tailwinds for the business that will be secular. They'll be long-term. When you combine that with the new product launch in Q1 of next year, that's targeting sacroiliac (SI) joint dysfunction, specifically at ASCs, that should be a nice tailwind for a business that's less than 10% penetrated. You've got the next BDD device that we'll file the 510K for in the back half of next year. That should be a nice tailwind for the business as well. When you layer on that, we're spending about 10% of our revenue on R&D, and we've got so many other products in the hopper. We're not just going to stop at these two products. We've got products coming out in 2027 and 2028 that we're not even talking about. It feels really good about the setup, not just for the back half of this year and not just 2026, but even if you look out through 2028. It's always good to hear. The surgeon growth has been double digits, obviously, for a long time now. I'm curious, how are you seeing, if it's relevant, the surgeon utilization curve of the newer surgeons versus the older vintage? Has that changed or is it really identical? How's that evolved? I can talk a little bit about it. We do look at what we call same-store surgeons. Given how rapidly our surgeon base has grown, we had 1,440 surgeons last quarter that did at least one procedure. There are 12,000 physicians that are our target, so we still have a long way to go. We really have this dual-pronged solution that we're going after. One is to continue to just penetrate those physicians, to get them to training and doing their first case and regularly performing one or more of our procedures. The second focus area that we have is on surgeon density. Right now, a typical surgeon does a little less than four procedures. If you look at that same-store number that I mentioned to you and you look at a surgeon that's done a case the year prior as well as in the current year, they're doing almost double the number of procedures. Some of that is just their adoption of one particular modality. They may be primarily doing SI joint fusion procedures, and so it's just getting them to fully adopt that into their practice, regularly diagnosing and treating the patient, right? The other area of focus for us is to have the surgeons perform multiple procedure types with us. The most obvious one is surgeons that are doing SI joint fusion procedures start working with our technology for pelvic fixation, especially for those shorter level constructs that I mentioned to you because they do those procedures pretty much every single day or weekly in their practices. It's once again identifying the appropriate patients for pelvic fixation with the short level construct and perfect procedure, once again, with the transitional pass-through code, outpatient procedure. It's this focus, first of all, on continuing to penetrate that 10,000, 12,000 physicians, number one. Number two, how do we get those surgeons to do more of our procedures, whether it's just fully adopting a particular procedure into their practice or whether it is working with us on multiple procedure types as well. Yeah, it's really interesting. The other thing that was changing is on the CCO side. You know, Nicholas coming in, what should we think about that change, the genesis of it, and then should we expect a change to the commercial approach at all? Yeah. If you look at our executive team, I think the average tenure is over 10 years for our executive team. I'm incredibly proud of that, by the way. Coming in as the CEO a little less than five years ago, and many of these people were my peers that I worked with, the fact that we've all continued to march forward and be very excited about the business. I would say that we're more excited today than we ever have been in terms of the opportunity that we have. I take a lot of pride in that. On the other hand, some of us are getting to that point. Not me, but some of the people in our executive team, Tony, for example, is turning 67 this month. You wouldn't know it, by the way, by looking at him. He looks absolutely fantastic. He looks younger than the rest of us, but we are starting to see a little bit of that. When he was talking about retiring, and I've been talking to him for a long time about this, when I became the CEO of the company, he said, "Two years from now, I probably am going to want to retire." Every time I would talk to him, he would say, "Two years from now, I'm going to want to retire." Finally, around six months ago, he said, "A year from now, I think I want to retire." That's where you go, "Okay, we actually need to do something about this." He's been incredible, by the way. Our sales force is second to none, quite frankly. I mean, just incredibly high quality because of the educational focus that we take with our physicians and the innovative products that we have. It really is a more complex sale. We call it education, and he has built this tremendous team. What we wanted to do is really just continue that. We did look outside. I would have been remiss to at least not look outside and think about, you know, should we think about bringing somebody else into the business? Ultimately, we decided to promote Nicholas Kerr to our Chief Commercial Officer because I'm really happy with the way that things are going. I think we have a great model. I think we're on the right track. I love the execution that I'm seeing from our team. It's really just taking that next generation team and continuing to drive forward what we've started. Nicholas is not new to the business. Nicholas has been with us for nine years at this point. He's a little shorter in tenure, right? He's only nine years, instead of, you know, 10, 11, 12, what have you. He's been with the business for a very long time. He has really been the leader around the expansion of our product capabilities. I would call him best in the industry around the product side. He's going to work hand in hand with our sales leadership. There's a gentleman, Luke Smith. He's our VP of U.S. Sales. Then Neville Lorimer, who is our VP of European, or OUS, basically, Sales. They work very closely with them to just drive this next level of change. To me, it makes a ton of sense to have the person that has been driving the product roadmap as driving that commercial team. As I said, as we're thinking about the next stage of the business, it really is around continuing to expand the indications that we're going after with these innovative products and who better to help drive that along with the sales leadership team that's been in place for a long time. The person I just mentioned, Luke Smith, has been with us for over 10 years. This is how we're thinking about things, just continuing the great work that has been happening under Tony Roucoupe-Arelle in this next phase of the business. It's amazing duration. I'm so incredibly toxic. My team is the duration of milk. It's impressive. I think maybe the one to end with would be, you're kind of hinting at it in some ways, is, you know, how do we think about growth over the next two to three years? You have a lot of different levers that are happening simultaneously, but nobody ever wants to get over their skis. How do we think about that? Yeah, that's exactly the way we do. We don't want to get over our skis. We want to continue to over-deliver. We're incredibly proud of what we've done here, since we've been a public company, growing the greater than 20% and seeing that acceleration of the top line as well. At the same time, there were a lot of people that said, "I don't think you're ever going to get to profitability just because we were being put in a certain bucket. You're not going to be able to, you know, get to cash flow putting us into that certain bucket." We've already shown those things. I would really encourage people to take a close look at what we've been able to accomplish. We've already talked about some of the things that are near-term catalysts for the business, continuing to build on our SI joint fusion business. That's both with surgeons as well as interventionalists as well, but then also with some of these new breakthrough products that we believe can become the standard of care. That's just the near term. When you think about the longer term for the business, as I said, we're really looking at this overarching principle of how do we address patients that have poor bone quality, and how do we develop these innovative solutions around unmet clinical needs. As I said, we're right now developing that plan of, you know, where are we going to get to half a billion dollars in sales? We already have a pretty firm plan on how we want to do it around these very specific strategies. No pressure for both of you. Makes it fun. Yeah, exactly. Laura, Anshul, thank you so much. We really appreciate the time. Thank you. Thank you. Thank you.