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MIMEDX GROUP, INC. (MDXG)·Q2 2025 Earnings Summary

Executive Summary

  • Q2 2025 delivered record net sales of $98.6M (+13% y/y) and record Adjusted EBITDA of $24.2M (24.5% margin); management raised full‑year revenue growth outlook to low double‑digits and reiterated Adjusted EBITDA margin “above 20%” .
  • Strength was broad-based: Wound net sales +12% y/y (CELERA and EMERGE contributions) and Surgical +15% y/y (AMNIOFIX, AMNIOEFFECT, HELIOGEN) .
  • CMS proposed fixed reimbursement of $125.38/cm² for skin substitutes across outpatient sites beginning Jan 1, 2026; management supports reform and expects MiMedx to gain share in a rational, evidence-driven market .
  • Liquidity improved: cash rose to $119M (net cash ≈$100M), free cash flow of $14.24M in Q2; management expects >$150M cash by year‑end, providing optionality for growth initiatives .
  • Near-term stock catalysts: raised FY25 revenue guidance, stronger Surgical momentum, Vaporox collaboration to diversify wound care portfolio, and visibility on CMS rulemaking trajectory .

What Went Well and What Went Wrong

What Went Well

  • Record quarterly net sales ($98.6M) and record Adjusted EBITDA ($24.2M; 24.5% margin) driven by balanced growth across Wound (+12% y/y) and Surgical (+15% y/y), with early contributions from CELERA, EMERGE, and accelerating HELIOGEN adoption .
  • Management raised FY25 revenue growth outlook to low double‑digits and reiterated Adjusted EBITDA margin above 20%, citing strong commercial momentum and expense discipline .
  • CEO on reimbursement reform: “We welcome and support improvements to Medicare’s reimbursement… fixed price per square centimeter of $125.38… reform… long overdue,” aligning MiMedx with a more evidence‑based competitive dynamic .

What Went Wrong

  • GAAP gross margin compressed to 81% (vs 83% y/y) due to production variances and product mix; GAAP diluted EPS fell to $0.06 (vs $0.12 y/y), reflecting the lapping of a prior‑year one‑time settlement benefit .
  • SG&A rose to $64.2M (vs $55.4M y/y) driven by higher commissions from sales growth and increased legal expenses; CFO guided Sales & Marketing at 50–51% of net sales and G&A ≈13% of sales for FY25 .
  • Continued uncertainty in the private office wound care setting until Jan 2026 CMS changes; management cautioned that near‑term “choppiness” may persist industry‑wide as incentives normalize .

Financial Results

Core P&L and Margins (GAAP and Non-GAAP)

MetricQ2 2024Q1 2025Q2 2025
Revenue (Net Sales, $USD Millions)$87.207 $88.000 $98.605
GAAP Diluted EPS ($)$0.12 $0.05 $0.06
GAAP Gross Margin (%)83% 81% 81%
Adjusted EBITDA ($USD Millions)$19.817 $17.000 $24.181
Adjusted EBITDA Margin (%)22.7% 20.0% 24.5%

Revenue vs Estimates (S&P Global)

MetricQ2 2025 Consensus EstimateQ2 2025 Actual (Company GAAP)Surprise
Revenue ($USD Millions)$90.794*$98.605 Beat
Primary EPS ($)$0.0533*GAAP Diluted EPS: $0.06 Beat

Notes: S&P Global “Primary EPS” may differ from GAAP diluted EPS; S&P reports Primary EPS actual of $0.10 for Q2 2025* alongside company GAAP diluted EPS of $0.06 . Values retrieved from S&P Global.*

Segment Net Sales

Segment ($USD Thousands)Q2 2024Q2 2025
Wound$57,547 $64,476
Surgical$29,660 $34,129
Total Net Sales$87,207 $98,605

KPIs and Operating Metrics

KPIQ1 2025Q2 2025
Cash & Cash Equivalents ($USD Millions)$106 $119
Net Cash ($USD Millions)~$88 ~$100
Free Cash Flow ($USD Thousands)$5,000 $14,240
Sales & Marketing Expense ($USD Millions)$47 $48
G&A Expense ($USD Millions)$13 $16
R&D Expense ($USD Thousands)$3,000 $3,303

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Net Sales Growth (YoY %)FY 2025At least high single‑digits Low double‑digits Raised
Adjusted EBITDA Margin (%)FY 2025Above 20% Above 20% Maintained
Sales & Marketing (% of Net Sales)FY 202551–52% 50–51% Lowered
G&A (% of Net Sales)FY 202512–13% ~13% Maintained
R&D (% of Net Sales)FY 2025~5% ~4% Lowered
Year‑End Cash ($USD Millions)FY 2025N/A>$150 New disclosure
Long‑Term Net Sales Growth (%)Multi‑yearLow double‑digits Low double‑digits Maintained

Earnings Call Themes & Trends

TopicPrevious Mentions (Q4 2024 and Q1 2025)Current Period (Q2 2025)Trend
CMS reimbursement reformAdvocated for reform; highlighted escalating Medicare spend; expected LCDs to help; reiterated high‑single‑digit FY25 growth pending LCDs Supports fixed $125.38/cm² proposal across outpatient sites; expects share gains in rational market; raised FY25 top‑line outlook Improving visibility
Surgical franchise momentumAMNIOEFFECT strength; HELIOGEN early traction; strategy to expand portfolio and evidence base Surgical +15% y/y; AmnioEffect and AmnioFix strong; HELIOGEN adoption accelerated Accelerating
Wound franchise/product mixEPIEFFECT strong clinically; private office ASP disruption; introduced higher‑priced third‑party products (CELERA) Wound +12% y/y; contributions from CELERA and EMERGE; EPIExpress cleared for launch later in 2025 Stabilizing
Vaporox collaborationN/ACo‑promotion/marketing of VHT device; investment with limited acquisition rights; material contribution not expected until next year Portfolio diversification
Tariffs/macroNo direct tariff exposure anticipated No update; focus on CMS and DOJ enforcement backdrop Neutral
R&D execution (EPIEFFECT RCT)Enrollment ongoing; R&D ~5% of sales planned; interim readout targeted Enrollment continues; interim readout hoped by year‑end; R&D guided ~4% of sales De‑risking costs
Regional trends (Japan)EPIFIX in Japan growing but small contribution No change disclosed Stable
Regulatory/legalIncreased legal spend, IP enforcement; DOJ/OIG attention to waste/fraud Management expects ongoing DOJ actions; advocates provider application fee clarity Elevated scrutiny

Management Commentary

  • CEO: “We grew our top line by 13%, generating the highest quarterly revenue and highest adjusted EBITDA in the history of the company… we are raising top‑line guidance today…” .
  • CEO on CMS: “CMS… will move to a fixed payment for skin substitutes of $125.38 per square centimeter… we plan to submit comments in support of the new reimbursement methodology” .
  • CFO: “Adjusted net income for the second quarter was $15 million, or $0.10 per share… second quarter adjusted EBITDA was $24 million, or 25% of net sales… a new record” .
  • CEO on Vaporox: “We were excited to begin pilot programs… collaboration… VHT… provides clinicians… another innovative option… highly complementary to our portfolio” .
  • CEO on share gains post‑reform: “When the market is acting rationally, we win… we have the most robust evidence… fully integrated… high‑performing direct commercial organization” .

Q&A Highlights

  • Market size and share capture post‑PFS: Management expects to pick up share under fixed pricing; believes not a “ton” of share needed to offset pricing changes given historic ASPs and competitive strengths .
  • Inventory and LCD timing: Team will closely monitor year‑end stocking; has experience managing inventory through ASP methodology and prior LCD delays; capacity and donor network support preparedness .
  • Mobile wound care: Management will advocate for higher provider application fees; expects mobile sites to be impacted but sees the segment as important for access .
  • EPIEFFECT RCT: Enrollment continues; aiming for interim data by year‑end despite market‑wide RCT capacity constraints .
  • Vaporox collaboration: Not expected to contribute materially until next year as details and joint processes are finalized .

Estimates Context

  • Q2 2025 revenue beat S&P Global consensus ($98.6M actual vs $90.8M estimate), supported by double‑digit growth in Wound and Surgical and contributions from new products; this raises the likelihood of upward revenue revisions for FY25 *.
  • EPS exceeded S&P Global Primary EPS consensus (Primary EPS estimate $0.053 vs S&P reported Primary EPS actual $0.10; company GAAP diluted EPS $0.06), with mix and non‑GAAP adjustments affecting comparability; we expect modest upward adjustments to EPS assumptions given margin discipline and cost guidance *.
  • Forward estimates: S&P Global consensus for Q3/Q4 2025 points to continued top‑line and EPS strength (Q3 revenue $94.7M*, EPS $0.0625*; Q4 revenue $106.9M*, EPS $0.09*), consistent with raised FY25 outlook [GetEstimates].
    Values retrieved from S&P Global.

Key Takeaways for Investors

  • Quality beat with raised revenue outlook: Broad-based demand and execution drove a clear beat and outlook upgrade to low double‑digit FY25 growth; Adjusted EBITDA margins remain >20% .
  • Surgical is the growth engine: Two consecutive quarters of mid‑teens Surgical growth with HELIOGEN gaining traction; continued evidence generation should sustain momentum .
  • Wound stabilizing ahead of reform: Private office disruption persists, but CELERA/EMERGE bridged near‑term mix while EPIExpress expands the EPI platform; expect rationalization in 2026 to favor efficacy‑led portfolios .
  • Strong cash and FCF: $119M cash, ~$100M net cash, and Q2 FCF of $14.24M support optionality for BD (e.g., Vaporox) and organic investments; management targets >$150M cash by year‑end .
  • Regulatory trajectory is a tailwind: Fixed pricing proposal and DOJ scrutiny of overutilization likely reduce fraud/waste, level the field, and enhance investability; MiMedx’s evidence base positions it to gain share .
  • Near-term trading lens: Momentum into H2 (raised guidance, Surgical growth, cash build) vs. gross margin pressure and elevated SG&A/legal spend; setup favors positive estimate revisions and multiple support as reform visibility improves .
  • Watch catalysts: EPIEFFECT interim data, further CMS/OPPS clarity, Vaporox co‑marketing updates, and continued HELIOGEN adoption to reinforce growth narrative .

Appendix: Additional S&P Global Consensus Snapshot (Upcoming Quarters)

MetricQ3 2025 EstimateQ4 2025 Estimate
Revenue ($USD Millions)$94.735*$106.930*
Primary EPS ($)$0.0625*$0.09*
EBITDA ($USD Millions)$20.167*$25.000*
# of Revenue Estimates5*5*
# of EPS Estimates4*5*
Values retrieved from S&P Global.*