Good morning, everyone. I'm Ravi Misra. I work on the MedTech team with Rich Newitter here at Truist Securities. Picture-perfect day here in Boston, thrilled to have Anshul Maheshwari, the CFO and COO of SI-BONE here with us to kick off the morning. With that, thanks, Anshul, for joining us. I want to just start off, MedTech's a product and growth-driven space, and I want to start off with the innovation super cycle that the company has been speaking about over the last several quarters and a rich year here for the pipeline and growth. Just lay out for us and investors maybe the key products that you have, the TAM unlocks that you're seeing, and maybe where penetration is for each one of those. Sure. Happy to do that, thanks for hosting us. Before I get into what we're talking about, a product super cycle, let me just take a step back and talk about the business overall. Until about five years ago, we were a one product, one disease state company. We were always known as the Triangle Company during that period of time. Since then, we've actually evolved into a platform with multiple disease states, procedure types that we're targeting, whether it's on the pelvic fixation side, pelvic trauma side, and have evolved from that one product into a multi-product platform. We started with the, I call the iFuse-3D, the iFuse Implant System. We added on the iFuse-TORQ platform, which includes our iFuse TORQ TNT product for trauma. We've also expanded into pelvic fixation with the launch of our iFuse bedrock GRANITE platform. We've actually added on our iFuse-INTRA platform that's specifically targeted towards interventionalists wanting to do SI joint fusion procedures. When you think about the breadth of the platform and what's the common thread there, it's being able to drive fixation and fusion of one of the most challenging anatomies in the human body because the density of the bone is pretty poor. We've done over 150,000 cases or procedures using our solutions to drive fixation and fusion. Along that way, we've developed the engineering biomechanical expertise, 3D design expertise, ability to get high-quality clinical data. That's truly differentiated us. Now as we think about that next phase of evolution for the company, it's about taking these same core skill sets, which is around design, 3D printing, understanding the biomechanics, driving fixation and fusion of different areas in the human anatomy, which have the same poor quality bone. You could talk about osteoporosis, osteopenia patients, which is a growing population, and that's where our focus is going forward, is how do we take this skill set and build it and build a leading platform like we've done in the SI joint anatomy in other parts of the anatomy. Our next product that we're going to be commercializing in the fourth quarter is our third Breakthrough Device that is building on that core competency, that's an example of the evolution of the business. We have additional products in the pipeline that we expect to commercialize, and what the investors and our customers should expect is a very regular cadence of new products coming out each year going forward. Okay. You haven't given much detail on that Breakthrough Device. Sounds like, I don't know if I'm reading the tea leaves right here, but something beyond the SI joint here, or still SI joint focused for now on that one? Yeah, it's actually going to be beyond the SI joint. Okay At this point because, again, when you think about compromised bone, it's not limited to an anatomy. Because we've developed the skill set of driving fixation and fusion in that challenging anatomy, we know that that technical expertise can have applications in other parts of the anatomy as well. Got it. Then just going back to the core, maybe product portfolio. Intra, iFuse, I think you talked about 300,000 annual procedures here. I think it has been a while since we got an update on market size penetration. Can you maybe talk about that, and then maybe the same thing for TORQ, TNT, and GRANITE? Sure. Our existing portfolio today, the total TAM is around $3.5 billion, around 500,000 procedures. Majority of that is SI joint dysfunction. That is around 300,000 procedures a year, around $2+ billion TAM there. That business has done really well for us. We are the market leader there. Our progress within interventional with the expanded portfolio is serving us really well. We are seeing a lot of good traction on the interventional side. The Intra Ti product that we commercialized in Q1 was that continued expansion of providing a comprehensive set of solutions to interventionalists. That platform has done really well for us and continues to drive good growth. We are still early stages of penetration with interventional, we know there is a lot of growth opportunity there as well. When you think about the other two markets that we have, our GRANITE, that has been the fastest-scaling business for us since the launch of GRANITE four years ago. It is basically addressing one of the known needs at the base of these long construct and degen procedures, driving fixation and fusion, at the base of these constructs. We believe this should become the standard of care. We are still in the early stages. Our focus has predominantly been on the deformity side, where we know this is going to become the standard of care. The degen side continues to evolve for us, and I will be happy to talk about DRG and the changes coming down the pipe there and how that could impact GRANITE. Again, we believe GRANITE has a significant runway for us, and in our most recent earnings call, we did talk about the combination of the application of GRANITE, the potential for the new DRG. This third Breakthrough Device that we want to commercialize, plus additional products that might go into the spinopelvic space, that spinopelvic could become one of the largest revenue contributors for us in the coming years. Really excited about that opportunity. That is around a $1 billion opportunity for us, and I would say two-thirds of that is in degen, a third of that is in deformity. Our trauma business is around $300 million. Think about it is around 60,000 procedures a year. TNT is the product that has applications in trauma. TNT actually has Breakthrough Device designation and a $4,000 NTAP. As we've announced recently, we entered into a partnership with Smith+Nephew to make sure we can successfully commercialize this product at scale in level one and level two trauma sites. Still in the early stages of it. We think trauma could be a nice incremental growth accretive opportunity for us with this partnership. Again, when you think about holistically, still in the early innings of building out the TAM, penetrating the TAM, it's a combination of within SI joint fusion, launching of new products. Within GRANITE, it's just the continued penetration into degen and commercial and benefits from the new DRG. With TNT, it's the NTAP plus the expansion of the partnership with Smith+Nephew. This is just with the existing portfolio and the third Breakthrough Device that we've talked about and the additional products that we have, we have a significant opportunity to expand our TAM in the coming years. Great. Maybe layer that into broadening the surgeon user base and maybe driving deeper adoption into the caseload that these doctors have. You had about 1,650 docs exiting 1Q. I think you've talked about opportunity, about 8,000 spine docs, 4,000 interventionalists, and a couple of thousand trauma docs. Where do things go over the next year or so? Where are you right now, maybe in each one of those buckets, and those 1,650, and then where do we think about things the next year or two? When you put the 1,650 in context, that was 17% growth year-over-year. That was the 20th consecutive quarter double-digit physician growth for us. We saw double-digit growth across all our call points, whether it's spine surgeons, trauma surgeons, interventionalists as well in the first quarter. That's something that we're really proud of. It's a huge asset for us that we want to be able to capitalize on and continue to drive penetration through density across that call point, across all these call points. We're very well positioned there. In terms of where do we go, we have a long runway of physicians to go after. 1,640 sounds like a big number, but when you think about the 8,000+ spine docs, around 4,000 interventionalists, a couple thousand trauma docs, that's a long runway. We believe that we will continue to drive strong growth on the physician side. Part of that is driven by our innovative strategy of coming up with unique solutions that address unmet needs, improved outcomes, supported by clinical data and better reimbursement and simplified workflow. That algorithm is what's going to drive the continued growth across our physician base, and we feel really good about that with the existing portfolio and the new products coming out. We're increasingly also focused on density of physicians, because when you have that big a physician base, it's all about can you come up with unique solutions that can either work complementary in the same portfolio, in the same procedure that you're in, or be added to a different product portfolio or procedure that that physician is performing. We're really well positioned with the innovation to be able to drive density as well as growth. The best example of that is GRANITE. GRANITE launched four years ago, today about 25% of docs that do SI joint dysfunction also do a second procedure, mostly pelvic fixation. We saw good growth in that number. I think that number grew 10% year-over-year as well. We're seeing continued improvement in density, and density takes time. As we continue to add these new products to the portfolio, I think you're going to see a natural evolution of the density moving up. Just on that front, back to the surgeon install base that you have, so to speak. Would it be fair to say the majority currently of that 1,640, 1,650 is spine or similar proportions to the overall surgeon opportunity? How should we think about where the growth is coming from a doctor perspective before we get into the density? I think like I said, it's double-digit growth across the board. You've got a lot of large numbers too, but the surgeon base continues to grow because of SI joint and also because of the deformity business, degen business with GRANITE. Interventional and trauma are growing from a smaller base, but we've seen really good growth there as well. That double-digit growth is what we focus on, and it's actually a really good leading indicator for us. If you look at it historically, the growth rate in physicians is a really good indicator of the top-line growth in the future, but that's before new products come on as well. When you add new products, that should tack on more growth, both in terms of physician growth but also density. If I could tie that to the sales force metrics that you've mentioned over the last couple earnings calls, getting to 100 reps versus, what is it, roughly 88, 89 territory managers today. Is the focus there going to be on driving doc adds versus increasing density versus green space or white space, rather, where territories that you're not in today? Can you maybe help think about lay out the sales force strategy under this kind of surgeon capture umbrella? Yes. Our sales force truly is our biggest asset. We've got 160 feet on the ground in the field today, so it's a very formidable sales force. What we've been able to do over the last several years, I'd say the last four years since GRANITE came out, was we've transformed into this hybrid model. The reason for transforming to the hybrid model was the GRANITE cases are longer cases. If you think about typical SI joint fusion case, that's about 45 minutes. The GRANITE cases can be anywhere between two hours to seven hours, depending on the complexity of the case, whether it's degenerate deformity. Because we have such a unique solution, our sales force has been able to bring on agents that have provided them more bandwidth on the case coverage side, so they can go out and do what they're best at, which is educational training, build physician relationships, drive deeper adoption, and especially lay the groundwork for the new products that we want to be able to commercialize. You've seen the effective outcome of that strategy in our productivity, which has more than doubled in the last four years from sub $1 million to close to $2.2 million. When I think about the future, you're going to actually want to think about it from a platform perspective. SI joint dysfunction continues to be direct, and that will continue to be the case. On the deformity side, degenerate side, you will continue to see the leveraging of the agent model for us just in terms of providing bandwidth for our reps so they can go build the relationships versus being in cases only. The trauma side, the Smith+Nephew partnership is an example where, because it is not a core call point for us, we don't have the full trauma bag. We do have a unique solution that trauma docs want. A partnership like Smith+Nephew, where our reps can be partners with Smith+Nephew, allows us to really create leverage there, too, and penetrate that market. I'd say we're doing really well on the hybrid side. You will continue to see us add more territories. Part of that add of territories from 88-100 is no different than what we did four years ago in 2021, where we were adding territories. The reason to add those territories was to create bandwidth for our reps, especially as we launch these new products, that we can go deeper, not just with the existing portfolio, but also make sure that they have the bandwidth to go sell these new products in those cases. Got it. Okay. Then just going back real quick to that comment on 25% of the docs that are this density comment. Just remind us, what percent of the user base is doing these multimodal procedures, and how does this trend versus a year or two years ago? Yeah. If you think about density on that 25%, that number has definitely grown. It was sub 10% four years ago. To get to 25% is pretty attractive for us, that just shows you the breadth of the platform. If you can come up with solutions for the same call point that addresses another unmet need, you get more share of mind because you're in more procedures with the doc, that allows you to get more procedures with that doc. Tying this together to your guidance and the growth story here for SI-BONE. I think you've talked about the company as a growth acceleration story throughout 2026, right? It's what the guidance has set up for, that should continue into 2027, 2028. Maybe help us understand the magnitude of this, versus the 14%-16% growth this year that's in guidance in the street. I think next year is at 15% for 2027. Just help us think about what do you consider acceleration in terms of magnitude? Like 10 basis points, 100 basis points? How should we frame that in our heads? Yeah, I'm not going to get very specific on the magnitude of growth acceleration here. What I would tell you is we're really excited about the business. As we came into 2026, our focus was how do we lay all the foundational work to support the acceleration of growth as we progress through 2026 into 2027 and 2028. If I step back and I think about things that we've done in Q1, things that are on the come for the rest of the year, and how they translate into not just the acceleration in 2026 but into multi-year tailwinds. Let me just lay it out for the investor base here. Let's talk about innovation to start with. As I said, interventional continues to be a nice growth opportunity for us on the SI joint dysfunction side, really complementary to our surgeon growth. We just launched a new product, INTRA Ti, in Q1. What does INTRA Ti do for us? Over the last few years, we've really expanded our set of solutions to interventionalists. We started with TORQ, we then launched our allograft solution, INTRA X, and now INTRA Ti. What we learned through the journey of INTRA X is the interventionalists really like the technique that we had come up with INTRA X. It was a posterior approach, a percutaneous approach that can be done in an office-based lab setting. That product's done really well for us. As we know, there are certain markets where allograft is not covered. Our focus was how do we make sure interventionalists who want to do these procedures, who have patients waiting to get this procedure done but are challenged by reimbursement, how do we take the learnings from INTRA X and bring it to a titanium implant? When you think about Ti has the same trajectory as INTRA X. It's a single-use kit. It can be done in an ASC setting, and it is reimbursed under 27279. A really good foundation for interventionists to continue to adopt our solutions and we become the one-stop shop, whether they want allograft, lateral, or a posterior metal implant. That's exciting opportunity for us, and we're starting to see green shoots of that opportunity already play out in Q2, and we expect that to accelerate as we go through the rest of the year. That's number one. Number two is the third Breakthrough Device that we've been talking about. We expect to do the 510(k) filing in the third quarter, and then assuming that everything goes to plan, we expect to commercialize that product in the fourth quarter. You'll truly start seeing the annualized impact of that business in 2027 because you generally do an alpha launch, but it's a really exciting large opportunity for us in a whole new TAM. That's on the innovation side that we're really excited about. You think about it on the reimbursement side, this is the first year of NTAP for TNT, and that's an exciting opportunity for us. We're still scratching the surface. TNT's done really well for us in 2025. It's actually exceeded our internal expectations in 2025, and we're really well-positioned coming into 2026 with the additional reimbursement and the partnership with Smith+Nephew. That should be a multi-year tailwind for us as well as the Smith+Nephew partnership evolves in the back half of the year, sets us up really well for 2027. You've got GRANITE, which has done really well for us in the pelvic fixation side, and when you add on the DRG benefit that might come out, the comments just went in. The final ruling should come out in July or August. Assuming the final ruling is consistent with what was proposed, that would mean a pretty significant step-up in reimbursement starting October 1st under these new DRGs where under the device use criteria, if GRANITE is used in any of those cases, it would default match to those DRGs. The incremental reimbursement could be on the low end, low $20,000s, on the high end, mid-$50,000s increase in reimbursement, so it's a pretty substantial increase. It's more durable. It's also going to be able to expand into commercial, which the NTAP was only Medicare. That could be a nice long-term tailwind for the business starting the fourth quarter as well. You've got all of these tailwinds that are in the business, and then you layer on the commercial expansion that we want to do, which is bringing on more agents, building on the Smith+Nephew partnership, but also expanding our own footprint to 100 territories. A lot of good things happening in the business, but we want to be thoughtful about how we incorporate those in our expectations. We want to grow into these tailwinds and then reflect that in our performance going forward. Definitely the DRG uplift and Smith+Nephew are two areas I want to pivot to. Just first, I guess on the Smith+Nephew partnership. Can you talk about maybe they have a presence in level one and level two trauma centers and what about the opportunity here is incremental versus how you were approaching these accounts pre Smith+Nephew? We've always said TNT is a very special product. It is solving a huge unmet need in pelvic fracture fixation. Before TNT, there was no good treatment for patients other than bed rest or traditional screws, which have the tendency to back out. It's because of the ability to drive fixation and fusion, TNT got Breakthrough Device and then eventually got the NTAP payment of over $4,000. It is a unique solution. Our approach to trauma was always about building out an agent network. There were two approaches to it. We could have done the approach of doing what we did when we went into pelvic fixation, which is continue to add to our agent base, or partner with one of these larger trauma players that have presence in level one, level two sites and be able to scale that business at a much more rapid pace than over time. What Smith+Nephew does for us is allows us to do the latter, which is be able to scale rapidly now. What it also means is, instead of being able to train people individually, we're going to be training the entire sales force, which is what we've been doing in Q2. Instead of a modest balanced rollout of surgical capacity, we're doing a much larger rollout of surgical capacity so that their sales force has access to the trays and the implants. We're scaling the business faster. Now, with that, it'll take some time for that relationship to evolve and the procedure volumes to continue to reflect that growth, but we're doing that setup right now. It actually accelerates our growth potential for trauma in the outer quarters than having to build out the ad hoc agent network that we would have had to build. Is that allowing you to basically reallocate or leverage resources on the sales front now that you don't have to build out that agent network, or? That's the intent. Yeah By being able to partner with somebody at Smith+Nephew's scale, we can do training at a consolidated level. We can do the management at a consolidated level. Our reps are still engaged with the Smith+Nephew side because we are the technical experts on the pelvic trauma side as well. Our reps are still going to be engaged, but it allows them to scale faster, and it also allows them to focus back on interventional and on the surgeon side so that they can continue to penetrate that opportunity and also prepare for this product that's coming out in the fourth quarter. Okay. Just moving to the reimbursement uplift through the IPPS proposal with the new DRGs for GRANITE. Any insight on how this changes the profit equation? I think you talked about $20,000-$50,000 just now, versus the prior paradigm. Let's just say that's finalized as written in October. Is any of that included in your guidance right now in October and 4Q? I guess putting it more bluntly, does that give you an opportunity to take price to capture a little bit more of the reimbursement? In terms of was it in our guidance, we provide our guidance at the start of the year. Right. The prelim recommendations came out in April, no, it was not in our guidance because we've been working on this DRG reassignment for over 12 months with CMS, even longer, actually. For us, if you think about what GRANITE has done, is it addressed an unmet need. The reason GRANITE was adopted was it's a high-quality product. It fits the physician workflow. It's a known issue at the base of these long constructs, and that's what drove adoption. Apollo study reaffirms that. It was a 160-patient study that proved that GRANITE had no breakages, no loosening, and actually really significant pain reduction for patients at 12 months. We know that the product works. What this DRG does do is, like you said, it increases the reimbursement from anywhere between low $20,000s to low $50,000s for procedures where GRANITE is used. It's a huge tailwind. It's more durable for us. NTAP was Medicare only. It was limited to up to $9,000. With this, it opens up the opportunity for us to work closely, even on the commercial side as well. In terms of what it does to the business, this is not going to be one where we're focused on let's just increase the ASP. For us, it's about GRANITE is a billion-dollar opportunity for us between degen and deformity, and we're focused on building out that market and penetrating that opportunity. The reimbursement's going to do two things. One, it takes pricing off the table as a point of friction, especially for newer accounts, because the reimbursement's going to be pretty strong. That's number one. Number two is, in sites where deformity docs are doing one implant on either side, sometimes cost can be a reason for doing that. Now they can be able to do stacked GRANITEs, which allows us to get the ASP higher, just naturally. From a mix perspective. From a mix perspective. That's going to be a nice tailwind for us. The commercial side's going to be a huge tailwind for us as well. Being able to now get these DRGs on the commercial side and being able to get reimbursed there too. I think net-net, it's going to be a nice tailwind for the business starting Q4 but also going into next year. Most tailwinds take some time, especially when you have things like NTAP, where you have to get the hospital staff used to the workflows. With this, it's a proven product. With the new DRGs, the mapping is easy. It's the ICD-10 X codes. If you're using GRANITE, you automatically would be mapped to that reimbursement. It should be really exciting for us. Yeah. Just on the commercial front, just help me understand. Usually, the way we think about it generally is commercial is a premium to CMS. Is it more that the new DRG is bringing it back up to what commercial's paying, or is there room for commercial to go even higher on these cases now? Well, generally, commercial's 10%-30% higher of what CMS or Medicare will put out there. Again, cannot speculate on where commercial would land up on the reimbursement. For us, this is a nice tailwind because in the past, the NTAP was not going over to the commercial side. The commercial was already paying 10%-30% higher than what Medicare was doing. NTAP was on top of what Medicare was doing. In this case, with the new DRGs, you automatically get the benefit. Got it. Okay. I guess in the remaining couple minutes, maybe just a quick question on utilization. The environment here. ASC subsidy expirations have been in focus throughout the year. Just how are you looking at volumes here? Seeing anything abnormal or any commentary on that front? Yeah, from our business perspective, the way I think about our business is our SI joint business is elective. The deformity side, the trauma side is less elective, right? Less sensitive to some of the reimbursement changes you're talking about. A lot of those cases are going to be Medicare cases, too. I think you have the benefit of that on our volume side. Even on the SI joint side, with the innovation that we're doing, we're actually seeing growth happen because of the innovation that we're doing and the call point expansion that we're seeing. I think we feel really great about the business coming into the year and going into the back half of the year as well, enter 2027. Now, it's really hard for us to get specific on what ACA changes or teams or WISeR Model are going to be doing to our business. Our focus is if you can continue to add new products, if you can continue to grow your call points, and if you can continue to solve unmet needs, you're going to be seeing that reflected in your top-line growth. We're continuing to see that. Great, I think we have a minute left. Just one last question, I guess, on pricing mix. If I've interpreted the commentary, it seems like pricing is pretty stable. Your ASP decline is mostly a mix shift issue. How should we think about that going forward, given some of these reimbursement dynamics, the kind of NTAPs around new areas, or not new maybe, but just different areas that you're entering to versus the core business. How should investors look at that kind of $9,000 ASP consolidated? Yeah. What we do when we provide guidance is we always make a conservative assumption on ASP, sort of low to mid-single-digit decline in ASP, and it's twofold. One is just the procedure mix changing. GRANITE can be anywhere between two and four implants per case. Our SI joint dysfunction can be two or three implants per case. Trauma can be one to two implants per case, and degen could be two. That's one big driver is how the mix of the business is shifting. That can impact ASPs now. Like I said, the DRG change could be a big benefit for GRANITE, where you could see more four implant cases. That could lift up the ASP there. On the flip side, you could see the Smith+Nephew partnership take off and the interventional side continue to grow, and you could see more two-implant cases happening there. That could be an offset. I think that's the right place to be. Our focus is how do we maintain our ASP or grow it, and that's through utilization. The other side of the ASP is, especially on the SI joint dysfunction side, is the side of service. As we continue to see the growth on the ASC OBL side, it's around 35% of our business, so it's still predominantly inpatient, outpatient. As that continues to grow, you just see some ASP erosion there. Then we're focused on how do we manage our cost and maintain our gross margins. Great. I think, with that, we're out of time. Thank you, Anshul, and thank you too, for being here today. Thank you.