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MIMEDX GROUP, INC. (MDXG)·Q3 2025 Earnings Summary

Executive Summary

  • Record quarter: net sales $114.0M (+35% YoY), GAAP diluted EPS $0.11, Adjusted EBITDA $35.0M (31% margin), and Free Cash Flow $29.1M .
  • Broad-based strength: Wound sales +40% YoY to $77.1M and Surgical +26% YoY to $36.6M; adjusted gross margin expanded to 87.6% .
  • Guidance raised: 2025 net sales growth to mid-to-high teens (from low double-digits) and full-year Adjusted EBITDA margin at least mid-20% (from above 20%) .
  • Policy catalyst: CMS published CY2026 PFS final rule largely as proposed; management expects share gains as market rationalizes and will “leverage these strengths to gain share” .
  • Estimate beats: Revenue $113.7M vs S&P consensus $94.7M*; Primary EPS $0.15 vs $0.0625*; momentum builds sequentially across Q1–Q3 2025 (see Estimates Context). Values retrieved from S&P Global.

What Went Well and What Went Wrong

What Went Well

  • Commercial execution delivered highest-ever quarterly revenue, Adjusted EBITDA, and cash generation: “we achieved the highest quarterly revenue, adjusted EBITDA and cash flow in the Company's history” .
  • Surgical momentum and portfolio breadth: Surgical sales +26% YoY, driven by AMNIOFIX, AMNIOEFFECT, and HELIOGEN; adjusted gross margin expanded to 88% on mix and production variances .
  • Strategic positioning for reimbursement reform: “This reform represents a major step in the right direction… we will certainly leverage these strengths to gain share” .

What Went Wrong

  • Elevated operating expenses: SG&A rose to $69M (+29% YoY), driven by higher commissions and legal/regulatory spend; G&A was $15M .
  • Ongoing industry uncertainty: Management refrained from quantifying post-2026 scenario ranges on price/application limits pending final rule mechanics; expects some early-2026 “choppiness” .
  • Policy timing risks: LCD implementation timing and mechanics remain fluid; while EPIEFFECT interim analysis is favorable, reimbursement linkage dependencies persist .

Financial Results

Consolidated P&L and Margins (USD)

MetricQ1 2025Q2 2025Q3 2025
Net Sales ($M)$88.205 $98.605 $113.725
GAAP Gross Margin %81% 81% 84%
Adjusted Gross Margin %84.1% 83.6% 87.6%
GAAP Net Income ($M)$7.023 $9.618 $16.748
GAAP Diluted EPS ($)$0.05 $0.06 $0.11
Adjusted Net Income ($M)$9.608 $14.626 $22.604
Adjusted EPS ($)$0.06 $0.10 $0.15
Adjusted EBITDA ($M)$17.221 $24.181 $34.950
Adjusted EBITDA Margin %19.5% 24.5% 30.7%
Free Cash Flow ($M)$4.922 $14.240 $29.137

Year-over-Year and Sequential

MetricQ1 YoYQ2 YoYQ3 YoYQ/Q seq (Q2→Q3)
Net Sales Growth %+4% +13% +35% +15% (from $98.6M to $113.7M)
GAAP Diluted EPS$0.05 vs $0.06 prior year $0.06 vs $0.12 prior year $0.11 vs $0.05 prior year +$0.05

Segment Net Sales (USD)

SegmentQ1 2025Q2 2025Q3 2025
Wound ($000s)$56,073 $64,476 $77,098
Surgical ($000s)$32,132 $34,129 $36,627
Total ($000s)$88,205 $98,605 $113,725

Balance Sheet & Liquidity KPIs

KPIQ1 2025Q2 2025Q3 2025
Cash & Cash Equivalents ($M)$106.4 $118.9 $142.1
Net Cash ($M)$88 $100 $124
Free Cash Flow ($M)$4.9 $14.2 $29.1

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Net Sales Growth (%)FY 2025Low double-digits vs 2024 Mid-to-high teens vs 2024 Raised
Adjusted EBITDA Margin (%)FY 2025Above 20% At least mid-20s Raised
Long-term Net Sales Growth (%)LTLow double-digits Low double-digits Maintained
Long-term Adjusted EBITDA Margin (%)LTAbove 20% Above 20% Maintained

Earnings Call Themes & Trends

TopicPrevious Mentions (Q1 & Q2)Current Period (Q3)Trend
CMS reimbursement reformAdvocating PFS changes; LCD delay; ongoing engagement with CMS; market spend ~$1B/month by mid-2024; contingency via third-party allografts Final rule published largely as proposed; management expects to leverage integrated ops, IP, and commercial org to gain share Visibility improving; execution readiness rising
Surgical growth & use casesMid-teens growth; evidence in Mohs, GI anastomosis; HELIOGEN ramp Surgical +26% YoY; AMNIOFIX/AMNIOEFFECT strong; HELIOGEN accelerating; particulate portfolio meaningful Strengthening
EPIEFFECT RCT & EPIEXPRESSEnrollment progressing; TRG letter for EPIEXPRESS; interim readout targeted Over half target enrolled; interim analysis favorable; full market release of EPIEXPRESS underway Advancing
Customer intimacy & MiMedx ConnectBuilding features; adoption rising ~60% sequential growth in Portal orders; added bill-pay; more features planned Adoption accelerating
Legal/regulatoryLitigation expenses; AXIOFILL case; IP defense AXIOFILL path reset; case remains strong; strategic legal spend ongoing Ongoing
M&A/BD pipelineEvaluating complementary solutions; Vaporox collaboration initiated Scanning surgical assets; balance sheet “firepower” to aggregate share; continued Vaporox pilot Expanding optionality
Regional trends (Japan)EPIFIX in Japan “on track” but small No incremental disclosureStable

Management Commentary

  • “We achieved the highest quarterly revenue, adjusted EBITDA and cash flow in the Company's history.” — Joseph H. Capper, CEO .
  • “Final rules… are essentially what was proposed in July, and we believe it provides a large opportunity for MIMEDX given our many competitive advantages… We will certainly leverage these strengths to gain share.” — Joseph H. Capper, CEO .
  • “Our third quarter adjusted EBITDA grew by nearly $11 million, as we focus on expense management that enables our sales increases to drop to the bottom line.” — Douglas Rice, CFO .
  • “We are extremely confident about the company's position post-Medicare reimbursement reform… When product performance is once again the primary factor… our best-in-class technology will carry the day.” — Joseph H. Capper, CEO .

Q&A Highlights

  • Guidance composition: Momentum expected in Surgical into Q4; Wound comps tougher; some early adjustments possible once rules are announced .
  • CMS mechanics: Management declined to speculate on final price/application limits; expects improved stability/predictability and market share opportunities as marginal players exit .
  • Liquidity and net cash: Ending cash of $142M; net cash expected >$150M by year-end; gross cash likely “high $160M” with $18M drawn; maintaining flexibility for opportunities .
  • HELIOGEN and particulate portfolio: Adoption increasing; becoming meaningful contributor; particulate business (AXIOFILL + HELIOGEN) remains strong .
  • AXIOFILL litigation: Process reset; case viewed as strong; mitigation via HELIOGEN underway .

Estimates Context

MetricQ1 2025Q2 2025Q3 2025
Revenue Consensus Mean ($)$86,320,000*$90,793,750*$94,735,000*
Revenue Actual ($)$88,205,000 $98,605,000 $113,725,000
Primary EPS Consensus Mean ($)$0.0525*$0.05333*$0.0625*
Primary EPS Actual ($)$0.05 (GAAP diluted) / $0.06 (Adj.) $0.06 (GAAP diluted) / $0.10 (Adj.) $0.11 (GAAP diluted) / $0.15 (Adj.)
EBITDA Consensus Mean ($)$16,833,330*$18,450,000*$20,166,670*
EBITDA Actual ($)$17,221,000 (Adj.) $24,181,000 (Adj.) $34,950,000 (Adj.)
  • Q3 beats: Revenue +$19.0M vs consensus; EPS: GAAP diluted $0.11 vs $0.0625*, Adjusted $0.15 vs $0.0625*. Values retrieved from S&P Global.

Key Takeaways for Investors

  • Q3 print materially de-risked near-term trajectory: outsized revenue, margin expansion, and free cash flow reflect portfolio breadth and operating leverage .
  • Structural catalysts ahead: CY2026 reimbursement reset should compress excesses and favor efficacy/real-world evidence, where MiMedx has advantages; expect competitive shakeout and share capture .
  • Surgical franchise is a durable growth vector: double-digit growth, expanding indications, and xenograft adoption provide diversification from private-office reimbursement dynamics .
  • Balance sheet optionality: rising net cash supports organic R&D, BD/licensing, and potential acquisitions to accelerate surgical expansion .
  • Near-term trading: Expect focus on sustainability of Wound growth through Q4, clarity on rule mechanics, and confirmation of FY margin targets; any CMS-related details could drive volatility .
  • Medium-term thesis: Mix shift toward surgical, normalized reimbursement, and evidence-led product selection support low-double-digit LT revenue growth and >20% Adjusted EBITDA margin profile .
  • Monitor execution: EPIEFFECT reimbursement pathway, HELIOGEN adoption curves, legal/regulatory spend, and SG&A productivity as leverage points .

Additional Notes

  • Cross-checks: Reported adjusted gross margin and adjusted EBITDA reconciliations provided in 8-K appendices .
  • Other Q3-relevant release: Company commented on the CMS CY2026 PFS final rule on Nov 3, 2025, confirming alignment with July proposals and opportunity to gain share .
  • Segment dynamics: Wound growth driven by CELERA and EMERGE; surgical growth led by AMNIOFIX/AMNIOEFFECT and HELIOGEN .

Values retrieved from S&P Global.